Over a week has gone by since I arrived back in Cleveland from the Affordable Housing with Services Study Tour and this fabulous experience is still fresh in my mind. The rich microcosm of the Boston area culture buzzing throughout Jewish Community Housing for the Elderly. The wonderfully refurbished apartments and awesome view of Boston from the dining room at Hebrew SeniorLife – Center Communities of Brookline. The homey feel and warm hearts that support elders at Sanborn Place, Home Care & Day Services. The rugged optimism of the Vermont “housers” at Cathedral Square. The welcoming smile of a formerly homeless resident of the Hearth at Olmsted Green.
I hope you will take the time to get to know these outstanding people and places I have written about in this blog. The tour was a great way to internalize the essence of “affordable housing with services” and provided a vision for aging in place models that can sustainably support elders into the future.
Board member and founder of Hearth, Ellen Feingold says there has been a great deal of progress regarding policy makers’ awareness of the homelessness issue over the last 30 years. Yet, there is still much work to be done to highlight and support the unique needs of homeless elders. Hearth has developed a set of recommendations to spread the word that homeless elders require a different set of approaches than non-elderly homeless. Hearth has been dedicated to the elimination of homelessness among the elderly for 21 years. Their mission is accomplished through a unique blend of prevention, placement, and housing programs designed to help elders find and succeed in homes of their own.
Hearth’s president/CEO Mark Hinderlie, social worker Kathy MacDonald, and resident “Poppy” at the entrance to Hearth at Olmsted Green which opened its doors in April 2012. Hearth at Olmsted Green is home to 59 homeless elders in Boston. Like all Hearth housing, it provides permanent affordable housing with on-site supportive services in order to help elderly residents stay healthy and remain safely housed.
There is a thin line between an elder having a place to live and being homeless
- According to recent HUD estimates, over 250,000 homeless older adults were sheltered in emergency or transitional housing programs in the United States in 2008. The number of homeless elders will continue to rise as the baby boomer generation ages.
- For seniors, the ravages of homelessness can accelerate and magnify the effects of aging, including increased physical frailty, chronic disease, impaired mental function, loneliness and isolation.
- For many elders living on fixed incomes, lack of affordable housing can push them into homelessness. An over-reliance on social security as elders’ only source of income puts them at risk.
- The majority of homeless elders reach later life without ever previously being homeless. Most become homeless due to personal problems and incapacities. At least one-third of elderly homeless have some form of mental illness.
- Personal problems that lead to homelessness include a house being sold, converted or needing repair; difficulties with paying rent or mortgage; death of a relative or close friend; breakdown of a marital or cohabiting relationship; and disputes with the landlord, co-tenants or neighbors.
- Many of the elders who live in Hearth housing come from a wide range of backgrounds – from different parts of the country and different parts of the world. Before they became homeless, they were lawyers, teachers, lobstermen, roofers, caretakers and veterans. They are also parents, grandparents, aunts and uncles, sisters and brothers.
Ending elder homelessness requires more than a “brick and mortar” approach
- Given the vulnerabilities of many homeless older adults, creating stable housing requires supportive, service-enriched housing.
- Homeless elders are clinically 15 years older than their chronological age and have a much shorter life expectancy than non-homeless older adults. Hearth accepts people who are 50 and older with an average age of 67.
- A key component of Hearth’s housing with supportive services includes an ongoing partnership with Harvard medical school (through a HRSA grant) which provides geriatric fellows in medicine, psychiatry, dentistry, and pharmacy for comprehensive medical consultations.
- Fellows and Nurse Practitioners make home visits, establish relationships with residents and are part of Hearth’s routine care conferences where preventive care and wellness education is emphasized. Care conference recommendations are forwarded to the resident’s primary care physician.
- Social work intern students provided by area schools of social work team with Hearth social workers to assist them with resident assessments and stabilization work.
- Hearth housing sites utilize licensed social workers, resident service coordinators, personal care assistants, homemaker and concierge staff who support residents with a variety of needs. Hearth offers a range of meal programs tailored to the needs of residents at each site and provides volunteer escort to medical appointments.
- Homeless elders are one of the highest end users of hospitals. The health and supportive services provided by Hearth has cut down on hospitalizations for the elders it serves.
Hearth’s Outreach Program helps homeless elders find housing and connects them with mainstream resources
- In 2010, Hearth’s Outreach Program served 290 older adults: 244 were homeless and 46 were at risk of homelessness. Staffed with a director and six outreach case managers, the program expects to assist approximately 350 older adults each year.
- The program provides comprehensive services to older adults who are homeless and facing housing instability. Housing search and placement activities take place over a number of months, and the entire process can take as long as two years to complete.
- Outreach case managers partner with eleven area homeless shelters to identify those in need. They assess clients’ housing priorities, barriers, and service needs to formulate an individualized housing search, retention and/or relocation plan.
- The program connects clients with community-based health, behavioral health, and social service providers to help stabilize formerly homeless elders within permanent housing and provides a weekly stabilization support group for additional peer mentoring.