For some time, the number of older people experiencing homelessness has been trending upwards. While there currently is not definitive national information on the number of older adults who are unhoused, staff at emergency shelters are seeing more older adults showing up at their doors.

Older Adults Often Need Help that Goes Beyond a Bed

Older adults are disproportionately affected by chronic health conditions, such as diabetes, arthritis, and heart disease, and these conditions can limit their ability to perform activities of daily living like bathing, dressing, toileting as well as instrumental activities of daily living (e.g. using the telephone, taking medications). In addition, older adults may have memory loss or other cognitive impairments. This means they may need help with tasks such as toileting, bathing and taking medications. Both of which staff are generally not trained or certified to provide, and storage of prescriptions can have licensing requirements.

Older adults may have mobility limitations. According to the Centers for Disease Control and Prevention (CDC), more than one out of four older adults fall each year, and sometimes the fear of falling can make an older adult limit his/her activities. This means older adults with mobility limitations may not be able to stand in line to get meals: they may need modifications for restrooms, and some bed setups (like bunk beds) can create barriers and place them at risk for falls and injuries. Providers may need to reconsider program design like the provision of meals, location of restrooms, and room set-up.

Oral health is important for overall health and well-being. According to the CDC, almost 17 percent of older adults no longer have their natural teeth. For older adults with chronic health conditions, good nutrition takes on even more importance. While emergency shelters may offer meals to meet food preferences (e.g., vegetarian), they may be less likely to provide different types of food (soft or regular) or therapeutic diets, taking into consideration oral health and the prevalence of chronic conditions like diabetes.

One in four older adults report experiencing a behavioral health problem such as depression, anxiety, or substance use disorder.  When these problems are untreated, it can lead to diminished functioning and can complicate treatment of chronic health conditions, and when staff are unable to identify these types of issues and/or unaware of resources, it results in additional unmet needs.

Read the full article about the limitations of emergency shelters by Yolanda Stevens at National Alliance to End Homelessness.