Homelessness Among Older Adults

Homeless older adult in a wheelchair receiving a meal from a food line

In recent years, the issue of homelessness among older adults has become increasingly urgent. Studies have shown that individuals experiencing homelessness often develop conditions associated with older age – such as cognitive and functional impairments – much earlier than those with stable housing. A current Canadian Medical Association Journal report shines a brighter light on the problem. As the proportion of people aged 50 and older using shelters rises, it becomes evident that most shelters in Canada are ill-equipped to meet their specific needs.

The Growing Demographic of Older Adults in Shelters

According to Canada’s National Shelter Study, the proportion of adults aged 50 and older in shelters increased from 13.5% in 2005 to 32% in 2021. This surge highlights a pressing public health and social issue that cannot be ignored. The challenges faced by this demographic are multifaceted and often rooted in a history of trauma and injustice. Addressing these needs requires individualized and integrated approaches, combining efforts from health and long-term care sectors, public health, housing, and other community agencies.

Factors Leading to Homelessness in Older Adults

Older adults experiencing homelessness often have complex histories. Some have faced homelessness earlier in life, while others encounter it for the first time due to circumstances like physical health issues, relationship changes, or fixed incomes post-retirement. The rising cost of living and insufficient affordable housing are core drivers behind this trend.

Economic disadvantages from earlier life stages significantly impact older adults, leaving them with lower incomes and fewer financial reserves. This economic instability, coupled with cognitive issues such as dementia, can lead to challenges like missed rent payments and eventual eviction. Additionally, Black older adults are disproportionately represented in shelters, underscoring the long-term effects of systemic racism on income and housing stability.

Health Implications for Older Adults Experiencing Homelessness

Research indicates that older adults experiencing homelessness exhibit geriatric syndromes at a younger age compared to their housed counterparts. These include higher rates of cognitive impairment, difficulties with daily activities, and chronic health conditions. The risk of premature death is significantly higher among homeless older adults, especially those experiencing homelessness for the first time later in life.

Older adults in shelters face adverse conditions such as prolonged hospital stays and environments that are not conducive to their complex needs. Shelters often require residents to vacate during the day, and older adults are more susceptible to falls, hospital admissions, and victimization. In addition, shelters are seldom universally designed meaning that missing and needed accessibility features may increase the occurrence of falls and other injuries.

Solutions and Support Strategies

Addressing homelessness among older adults requires a multi-faceted approach:

  1. Prevention: Identifying older adults at risk of homelessness and providing early interventions can prevent the loss of housing. Financial subsidies, tenancy monitoring programs, and social support can help maintain stability.
  2. Health and Social Services: Age-friendly shelters need to be equipped with adequate physical environments, appropriate staffing, and access to medical services. Trauma-informed care models are crucial for building trust and ensuring personal safety.
  3. Housing Solutions: Permanent supportive housing is a promising model that integrates housing with necessary support services. Programs like The Oaks in Ottawa offer a managed alcohol program, on-site medical services, and assistance with daily living activities.
  4. Long-Term Care (LTC): For those requiring continuous supervised care, redesigning LTC admission processes and creating specialized care models are essential. This includes accommodating substance use, adopting harm-reduction approaches, and ensuring equitable access regardless of financial ability.

The growing population of older adults experiencing homelessness in Canada demands urgent and coordinated action. By encouraging collaborations between health, LTC, public health, housing, and community agencies, we can create a more supportive environment for our aging population. Without such efforts, older adults will continue to face premature aging, marginalization, and increased risk of deterioration and death in unsuitable accommodations. Working toward solutions as our population ages could have a positive impact on healthcare budgets. As The Oldish frequently says, being proactive rather than reactive is the key.