Our system is failing older adults experiencing homelessness. They are showing up in Toronto’s shelters in increasing numbers and that already under-resourced system is unable to meet their unique needs.
Shelters should never be long-term housing solutions for older adults, but immediate action is needed to enhance shelter programs so they can provide housing, health and social supports that improve health and health equity for this vulnerable population.
Driven by several factors, including the affordability crisis and the aging population, the problem of older adults facing homelessness has become particularly acute in recent years.
Recent homelessness counts in major Canadian cities indicate the older population has risen four-fold over the last two decades. Toronto is among the cities reporting increases. September 2024 data shows there were 1,500 adults aged 55 plus in Toronto’s shelter system. This represented 15 per cent of all shelter users. About half of older adults in shelters have previously experienced homelessness but others are experiencing it for the first time.
Among those with a history of homelessness, the contributing factors to their homelessness often include early-life abuse and trauma, mental health and substance use challenges, and difficulty maintaining stable employment and relationships. In contrast, older adults who become homeless for the first time later in life often do so because of the financial strain from a job loss or retirement, the loss of a partner or declines in their physical health.
Older adults experiencing homelessness may have significant health needs, and shelters are not designed or resourced to meet them. Older adults seeking shelter services have high rates and much earlier onset of age-related health conditions, and they typically present with health conditions of someone who is 10 to 20 years older. They may have difficulties with activities of daily living such as bathing and dressing. They also have higher than average rates of falls, dementia, vision impairments and urinary incontinence.
Research has begun identifying housing, health and social supports that enable older people experiencing homelessness to age as healthily as possible. For some older adults, long-term care services are needed to fully meet their needs. For others, community-based housing models that integrate physical, mental and social health supports will help them thrive.
Until the provincial government delivers the funding and policy changes needed to provide these permanent housing options to every older adult who needs them, it is critical that shelters be resourced properly to support the well-being of older adults experiencing homelessness.
Wellesley Institute has launched a new research project exploring shelter use among older adults in Toronto to shine a light on their service needs and make recommendations on how to improve shelter systems to better support them. This research will help advance health equity for these vulnerable older adults in Toronto.
This work is timely as the City is developing a new Seniors Strategy, as well as a new strategic plan for Shelter & Support Services. In line with its Homelessness Services Capital Infrastructure Strategy, the City also plans to open 20 new shelter sites and enhance existing shelters to respond to the pressing need for more comprehensive services. Wellesley’s research can help inform the development of these sites and be part of the solution to this crisis. We look forward to communicating the results next year.
Ultimately, this issue is one of sickness or health and life or death. The clock is ticking. With the population continuing to age and the affordability crisis enduring, this is a health equity issue we must – and can – deal with now, before it’s too late.