On an average night in 2015, nearly 565,000 people were homeless in the U.S. That is down about 11 percent from 2007 as a result of increased federal funding for beds and services available to the homeless population. The number of homeless older adults is expected to rise. Homeless adults are likely to include veterans, people with physical or mental illness, and those in need of services in addition to just housing. They are less likely than younger people to survive exposure to the severe weather conditions people who are homeless must endure. They are also frequently exposed to unsafe and unsanitary conditions. This can exacerbate health problems that accompany aging.
Older adults with unaddressed housing needs have few options for shelter and sometimes must choose between homelessness and placement in a nursing home because funding is limited to nursing home care (see also Chapter 8, Long-Term Services and Supports).
Homelessness, especially chronic homelessness, can contribute to declines in physical and mental health. This is due both to exposure to harsh environmental conditions and the lack of adequate medical monitoring and access to treatment common among people with inadequate shelter.
Many factors contribute to homelessness, including unemployment, poverty, chronic mental or physical health problems, and lack of affordable housing. Although the economy has improved since the Great Recession, households with low incomes and those with high housing-cost burden are still at risk of becoming homeless should their financial conditions worsen. Therefore, maintaining a supply of affordable and adequate housing along with supportive services can help families mitigate the risk of homelessness.
Homelessness can be addressed in part by permanent supportive housing. This combines affordable units with services specifically targeted to the physical, mental, and social needs of the individual. For older adults, services are provided that meet age-specific needs, such as help with activities ofADLs or Activities of Daily Living are the basic tasks of everyday life, such as eating, bathing, dressing, toileting, and transferring. IADLs or Instrumental Activities of Daily Living are activities related to independent living and include preparing meals, managing money, shopping for… daily living or placement in an accessible home that complies with the Americans with Disabilities Act and includes universal design features to aid mobility (see this chapter’s sections on Housing Accessibility and Universal Design).
Funding and assistance
Policymakers should provide additional housing funds and support services for people who are homeless or mentally ill. This includes day-use centers that provide wraparound services.
Greater emphasis should be placed on early intervention, such as emergency assistance to prevent evictions, and on the development of a continuum of transitional and supportive housing arrangements.
Congress should fund assistance to the homeless, as authorized by the McKinney-Vento Homeless Assistance Act, at least at current levels.
The Department of Housing and Urban Development should encourage the use of the act and other funds to support early-intervention and outreach programs and to develop a continuum of transitional and supportive housing arrangements for homeless people.