For homeless seniors, finding stable housing takes a village — and a lot of luck

Two years ago, Kim Hilton and his partner walked out of their home in Columbia Falls, Montana, for the last time. The house had sold, and the new landlord had raised the rent.

They couldn’t afford it. Their Social Security payments couldn’t cover the cost of any apartments in northwest Montana’s Flathead Valley.

Hilton’s partner was able to move into her daughter’s studio apartment. There wasn’t enough space for Hilton, so they reluctantly split up.

At 68 years old, he moved into his truck — a forest-green Chevy Avalanche.

Hilton quickly found out how hard it would be to survive. Hilton is diabetic. That first night, his insulin froze, rendering it useless.

Things didn’t get any easier that winter. On the coldest nights, temperatures dropped to about minus 20 degrees Fahrenheit. Hilton kept the truck running, but eventually his fuel pump failed. He was on his own in the cold.

Hilton is usually quite optimistic, but in that moment, he said his spirit broke.

“I just said I want to go to sleep and not wake up and I won’t have to worry about anything. I’ll just sit here and be a little popsicle in the truck,” Hilton recalled.

Hilton was one of tens of thousands of seniors who became homeless for the first time in 2022. A dramatic increase in the number of homeless seniors nationwide is overwhelming services for unhoused people.

Older Montanans are especially struggling because housing costs have skyrocketed since 2020, in part because of the rise of remote work. The state has one of the fastest growing homeless populations in the country, according to federal data.

University of Pennsylvania researcher Dennis Culhane estimated that the number of homeless people age 65 and up in the U.S. would triple between 2019 and 2030. He recently updated that estimate using federal data for a forthcoming paper.

“We are on track to meet that prediction. In fact, the growth has been slightly higher than we predicted,” he said.

Preparing for the ‘gray wave’ in homelessness

According to Culhane’s research, the number of homeless people over 65 jumped by a little over a third between 2019 and 2022 alone. By 2022, there were about 250,000 people over 55 that were unhoused. About half of this population were becoming homeless for the first time.

What researchers and advocates call the “gray wave” of homeless seniors is overwhelming service providers trying to help.

Wendy Wilson is seeing the gray wave coming first hand. She’s a case manager at ASSIST, a non-profit that helps Flathead residents struggling to meet their medical needs. In the past, that meant helping them get free meals or finding a ride to the doctor’s office.

Increasingly, Wilson is helping older people like Hilton find housing.

“They have medical issues. It’s not easy for them to be living in a truck or at the homeless shelter when you have medical issues going on,” she said.

In early 2023, Wilson helped Hilton find a spot in a local shelter with private rooms. But after five months living in his truck, Hilton’s health had gone too far downhill, too fast.

Hilton had several fainting episodes at the shelter, said Sona Blue, who manages that shelter.

“It scared us because we have no medical care in this facility,” she said.

That’s standard for shelters like this. Finally, Hilton took a bad fall, and shelter staff sent him to the ER.

The doctor who treated Hilton discovered he had developed pressure wounds from sitting for months in the same position in his truck. Because of the neuropathy in his limbs from his diabetes, Hilton couldn’t feel the pain. Those wounds never healed and became infected, another common complication of diabetes.

Hilton had to have one leg amputated. Later, he had to have this other leg amputated as well. Returning to the shelter in a wheelchair wasn’t an option: there were no shelter staff or medical personnel available to help with his basic needs.

A handful of homeless service providers, including shelter staffers and other medical case workers, tried to help Hilton find another place to go. They put him on waiting lists for the limited supply of subsidized housing in the area.

Wilson secured one of the few slots in a Medicaid program that helps pay for assisted living for Hilton. But it can take a year or more for units to open. So Wilson crossed her fingers that Hilton would get lucky before he was released from the hospital after his second amputation.

Homeless solutions designed for seniors

Many seniors across the country are stuck playing the same dangerous waiting game, said Caitlyn Synovec with the National Healthcare for the Homeless Council.

“Sometimes they can’t be safely served in a shelter because they have issues with incontinence or cognition. Then they’re more likely to be on the streets and their conditions will worsen quite a bit,” she said.

Communities are looking for solutions.

To serve aging people with complex medical needs, homeless shelters for seniors are cropping up in some cities like Salt Lake City and Ft. Lauderdale.

Montana recently got approval from federal health officials to use Medicaid funding to temporarily help people with medical conditions make rent.

But that’s not enough, according to Synovec. She said the real solution is building more affordable housing so older Americans don’t become homeless in the first place.

That housing will need to be accessible too. Older homeless people like Hilton need homes they can safely navigate. Because of his new wheelchair, he needed a ground floor apartment.

A new home, and new hopes

This fall, Hinton finally got a spot in a facility that would take his Medicaid waiver. He was also able to get an electric wheelchair that would make it easier to get to doctor’s appointments in town.

Hinton said he hasn’t pushed his new wheelchair to its top speed yet. “It goes fast for a wheelchair. I’m going to find out when I go down to dinner. I’ll stretch it out, break it in,” Hilton said with a laugh.

Hilton is grateful to finally have stable housing. Wilson is grateful too. She said it was one of the few times she’s been able to help a senior regain housing.

“It was a woo-hoo moment,” she said.

As long as the facility stays open and the Medicaid waiver program isn’t cut, she’s confident he’ll have made it through homelessness.

This story comes from NPR’s partnership with Montana Public Radio and KFF Health News.