Where do you plan to live when you grow old? That is a question 70 million Baby Boomers, millions who came before them and untold millions born after them will have to answer at some point. It will become a national problem as Baby Boomers squeeze elderly housing institutions like they did every other institution they encountered at every stage of their lives. Senior housing is already expensive, and it will become even more expensive in the coming years.
Senior housing is especially problematic for those without family to help them navigate housing or shelter them. Kaiser Family Foundation (KFF) Health News wrote about one such woman:
At age 82, Roberta Rabinovitz realized she had no place to go. A widow, she had lost both her daughters to cancer, after living with one and then the other, nursing them until their deaths. Then she moved in with her brother in Florida, until he also died.
And so last fall, while recovering from lung cancer, Rabinovitz ended up at her grandson’s home in Burrillville, Rhode Island, where she slept on the couch and struggled to navigate the steep staircase to the shower. That wasn’t sustainable, and with apartment rents out of reach, Rabinovitz joined the growing population of older Americans unsure of where to lay their heads at night.
This gist of the article was about the rise of nonprofit organizations that help the elderly find housing. Part of the goal is to keep frail elderly people in their own homes. I wrote about that years ago. A concept known as naturally occurring retirement communities (NORCs), where the residents grow old and want to age in place. But what if someone does not have a home? People who are homeless in their 30s, 40s and 50s are likely to be in no better financial shape in their 60s, 70s and 80s. Nonprofit organizations are assisting with helping seniors and disabled navigate housing options.
A 1997 federal law recognized PACE organizations as a provider type for Medicare and Medicaid. Today, some 185 operate in the U.S., each serving a defined geographic area, with a total of more than 83,000 participants.
PACE stands for a Program of All-Inclusive Care for the Elderly, and the organizations aim to keep frail, older people in their homes. But a patient can’t stay at home if they don’t have one.
I’ve written about the Golden Girls solution, where senior women (divorced or widowed) share a home or apartment providing both care and companionship. That is an underutilized solution that lends itself to the type of coordination that a nonprofit organization could do. Find willing homeowners (or renters) and match them with roommates looking for a place to live. This sounds simple but undoubtedly it is not. The roommates could differ in both age and ability. They could differ in ability and willingness to pay their fair share of the expenses and household tasks. A third party would need to mediate disputes and evict bad actors. When I worked in a hospital there was a department called discharge planning. The basic rules was to know where a patient would go after treatment before they could be admitted to the hospital. The last thing an aging senior would want is a frail, nonpaying roommate squatting in their home. There would have to be safeguards or few would participate.
One problem that cannot be ignored is graft on the part of nonprofit organizations claiming to help seniors. A housing assistance program in Minnesota began in 2020 with an estimated budget of $2.5 million. By 2024 its budget had ballooned to $104 million (some accounts put the total at $107 million). The program was almost entirely fraud and had to be terminated. Many individuals whose names were used to bill Medicaid for assistance securing housing had never heard of the companies or had only talked to them but received no help. One woman claimed all she got was a toaster oven.
Senior housing is going to be a huge market in the coming years. Not everyone will have a place to go or be able to afford the high rents at private equity-owned senior apartments. Policymakers should begin planning now and it will require some outside-the-box thinking. Not far from where I live is a tiny house community. Although it is not age restricted to only seniors, the most logical occupants would be an older couple or two Golden Girls.
Read more at KFF Health News: Health Care Groups Aim To Counter Growing ‘National Scandal’ of Elder Homelessness