In the US, nursing homes are becoming housing of last resort for homeless seniors — TIME
In the US, some older people who lost their housing after an illness or hospitalization end up in nursing homes even though they do not need that level of medical care. As TIME reports, one reason is a shortage of affordable permanent supportive housing, while many shelters are not adapted for people with mobility impairments.
According to the United Health Foundation, one in 11 nursing home residents has low care needs. This means that such people do not need physical assistance to move in bed, transfer from place to place, use the toilet, or eat. The share of such residents varies by state, from 2.5% in Hawaii to nearly 23% in Oklahoma.
At the same time, living in a care facility is significantly more expensive than subsidized permanent supportive housing with certain services. A year in a nursing home costs an average of $119,340, while such housing costs about $16,000 per person per year.
Shelters are not adapted for older people
Occupational therapist Caitlin Synovec described a patient over the age of 50 who lost her housing while receiving treatment after a stroke. The woman could independently carry out most everyday activities, use the bus, and visit family, friends, and church, but needed assistance, including when getting dressed. A relative was willing to take her in, but the patient could not reach the second-floor apartment.
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After falling in a shelter, the woman was taken to the emergency department and was later discharged to a nursing home. According to Synovec, the woman did not want to live in an institutional facility and wanted to remain in the community.
Shelters often have bunk beds, and their bathrooms are usually not adapted for people with disabilities. In addition, residents must leave the shelter every morning and remain outside until it reopens in the evening. This creates additional difficulties for older people and people with mobility impairments.
Waiting lists for supportive housing
The average wait for permanent supportive housing exceeds two years, and even such accommodations are not always adapted for people with limited mobility. University of Pennsylvania housing policy and homelessness researcher Dennis Culhane noted that in 2025, one in five people living on the street or in an emergency shelter was aged 55 or older.
AARP surveys indicate that three out of four older people want to age in their current home and community. Gerontologist Jeffrey Farber believes that homeless older people with manageable medical conditions should have access to subsidized housing and special programs adapted to their needs. In his view, some of these people could be cared for in facilities with a lower level of medical care and lower costs.
