Adobe Stock

The United States is not prepared to provide housing and care for its surging elderly population, according to a new report by the Harvard Joint Center for Housing Studies (JCHS).

The number of older adults, defined as those at least 65 years old, soared by 34% from 43 million in 2012 to 58 million in 2022. JCHS further projects that households headed by a person 80 or older will more than double between 2021 and 2040.

Older adults will face the twin challenges of securing affordable housing and the services they need as they age, according to the “Housing America’s Older Adults 2023” report.

“Housing and long-term care services are both expensive,” said Jennifer Molinsky, project director of the Housing an Aging Society Program at JCSH. “On the housing side, we know that a third of older adults are paying more than a third of their income for housing, half of those are paying more than 50%.”

In addition, people are more likely to struggle with affordability in their 80s and beyond because their incomes are fixed or declining, making it harder for renters to keep up with rising rents or for homeowners to keep up with rising taxes, utilities, and other costs.

“It’s a wonderful thing that the older population is growing overall and people are living longer than a generation ago, but the supports that people need to stay in the community, stay in their home, are really expensive and hard to secure,” Molinsky said during a webcast discussion. “Simply put, that combined cost of housing and daily care is beyond the means of most people, not just people with very low incomes but also a growing number of people with more moderate and middle incomes.”

Nearly 11.2 million older adult households were cost burdened in 2021, meaning they were spending 30% or more of their income on housing, utilities, and, if applicable, taxes and insurance. That’s an all-time high and a significant increase from 9.7 million in 2016.

When long-term care services are added to housing costs, only 14% of single people 75 and older can afford a daily visit from a paid caregiver, and just 13% can afford to move to assisted living.

Other findings include:

  • Older homeowners are increasingly carrying mortgage debt. Between 1989 and 2022, the share of older adults who carry a mortgage jumped tenfold, and the amount of debt they carried increased 750% in real dollars;
  • Federal rental assistance is vital to helping older adults with very low incomes, but it’s not an entitlement. In 2021, just over one-third of income-eligible older households received a subsidy;
  • 10,000 more older adults experienced sheltered homelessness in 2021 than in 2019; and
  • Nearly 70% of older adults will need long-term services and support at some point. However, Medicare does not cover these services, and most states have long waiting lists for home supports through Medicaid.

Elizabeth Chen, secretary of the Massachusetts Executive Office of Elder Affairs, shared two support programs in her state.

The first model brings resident services coordinators into senior affordable housing properties to work with residents to provide on-site health and wellness programs, learning and social activities, and connect people with other needed assistance. There’s also an after-hours emergency response system.

Officials have found that this supportive housing model cuts medical service costs by reducing emergency room visits and hospital admissions, Chen said.

She also cited the federal Program for All-Inclusive Care for the Elderly (PACE), which offers comprehensive care to older adults who have high service needs and are eligible for Medicaid and Medicare. Chen noted that housing has been built with units set aside for PACE-eligible individuals.

“Some locations even have a PACE-tenant selection preference in private assisted housing,” Chen said. “We’re seeing that piece more and more throughout Masschusetts.”

The JCHS report adds that there’s a need for creative alternatives to existing models of housing and care to meet the needs of the aging population.