Aging Right in the Community: A Boston Medical Proposal Ending Homelessness in Older Adults

The American homeless population is in the midst of its own ‘silver tsunami’. As chronically homeless baby boomers reach their 50s, 60s, and 70s, many previously housing-secure seniors are aging into unexpected poverty due to high housing costs on a fixed income. In the U.S., 31 percent of the 564,700 homeless individuals nationwide were over 50 in 2014, a 20% increase from 2007. In Boston alone there are 2,400 homeless individuals over 50 years old. But the age of a homeless person does not reflect the toll the stress of homelessness can take on their health. A recent study found that geriatric conditions, such as frailty, cataracts, and dementia, were more common in older homeless adults than in housed adults 20 years older. These medical issues contribute to the already high mortality rate among the homeless and help to explain why only 5% of the homeless population nationwide is over 65.

Boston Medical Center’s Elder’s Living at Home Program (ELAHP) and MLPB (formerly Medical-Legal Partnership | Boston) have partnered to form the Aging Right in the Community initiative, which works to prevent homelessness amongst the most at-risk seniors through case management and pro bono legal services. In 1986, ELAHP was created to confront the lack of services available to older men and women, above 55, who suffer from or are at risk of experiencing homelessness. Similar to how Boston led the country by creating one of the first medical respite programs in 1985 and ELAHP in 1986, the Aging Right in the Community initiative hopes to lead the way in homelessness prevention.

The Aging Right in the Community initiative is in its fourth year of implementation and has been working to address the elder homelessness issue through three distinct approaches. First, the initiative works with those that are currently homeless to help them transition into safe, affordable, permanent housing. The program also provides services to those who have been homeless in the past to ensure stabilization in their current community. Finally, Aging Right in the Community engages in prevention services with those at imminent risk of losing their access to housing. The central goals for the program remain the same across the three populations it helps. By providing clients with a support system, including help resolving legal issues when needed, Aging Right in the Community hopes to bring about systemic change to the problem of housing insecurity by helping at-risk seniors live independently in stable housing.

Since 2013, Aging Right in the Community has prevented homelessness in 94 percent of its clients and 98 percent of those stabilized through their services have remained in stable housing. Though the initial goal for Aging Right in the Community was 100 clients over the first 3 years, the 148 clients served by the program have saved MassHealth an estimated $2.43 in health care costs for each dollar spent on case management.

The Aging Right in the Community initiative is planning an expansion into the Mystic Valley region this year and the impressive numbers reflecting the program’s success are only likely to grow. By targeting seniors who are at-risk of facing or are currently experiencing housing insecurity, Aging Right in the Community offers a lifeline to some of the most vulnerable in our community.