Housing crisis is forcing more seniors into shelters, doctors say

More older adults are becoming homeless in Canada and relying on shelters, straining an already under-resourced system, a group of Toronto doctors says in a new report published by the Canadian Medical Association Journal (CMAJ).

They say greater collaboration between public health, housing and community agencies is urgently needed to help seniors who are homeless — as they have complex health needs due to aging that shelters are not equipped for.

Experts and shelter workers in Toronto say they're witnessing the trend play out firsthand.

"It's a very big and complex problem," said Jillian Alston, a geriatrician at Saint Michael's Hospital in Toronto and co-author of the CMAJ report that examined the issue nationally. 

"We're actually seeing an alarming rise in the number of older adults who are turning to emergency shelters," she said.

Geriatricians classify older adults in the shelter system as aged 50 and over, as they experience the symptoms of aging faster than those who are not homeless, according to a 2017 study the CMAJ authors point to.

The doctors also cite data from Statistics Canada published last year that found 32 per cent of people using shelters in 2021 were over the age of 50. In 2005, 13.5 per cent of people using shelters were people over age 50.

Overall, the number of people using shelters in Canada has dropped since 2005, when 150,030 people were using the system compared to 93,529 in 2021, according to Canada's National Shelter Study. It says shelter use may have declined due to avoidance the pause of evictions during the pandemic.

Alston said the housing crisis and the affordability crisis make it more challenging for people to remain housed if they are older and have a health crisis that impacts their income.

"Especially if there's isolation and no family advocate for the individual, then they end up not paying their bills and being evicted," she said. 

Toronto seeing more seniors in shelters

Gord Tanner, the general manager of Toronto Shelter and Support Services, said the city is seeing an increase in older adults using the shelter system.

According to Toronto's Street Needs Assessment report from 2021, 15 per cent of people using shelters in the city were seniors aged 60 and older. That's up from 10 per cent in 2018. The survey also noted that there was a greater representation of seniors in Toronto's shelters compared to other age groups.

The city divides older adults in the shelter system into two categories, those over 65 and those between the ages of 45 and 64, said Tanner. About 500 people in Toronto fall into the former group while about 3,000 fall into the latter.

There are several shelters in the city that cater only to seniors — but they need more health-care support services on site, he said.

"We need specific programs to meet the needs of people that are aging in the shelter system," he said. 

"That's another gap in the system, for some folks with a history of homelessness, they don't necessarily fit well into the streaming or intake process of traditional long-term care homes," he said.

A spokesperson for the city also told CBC Toronto in an emailed statement that the province has provided $15 million for the current fiscal year to support health, mental health and harm reduction services for the city's homeless population. While they are "grateful" for the support, the spokesperson said, more connections are needed to provincially run long-term care homes.

The Ministry of Long-Term Care directed CBC Toronto's questions to the Ministry of Health, which has yet to reply.

Seniors losing secure housing

Good Shepherd Ministries, which is a shelter in Toronto that has programming specifically for people aged 55 and older, said they have been seeing a steady increase in seniors using their services in the last few years.

Aklilu Wendaferew, executive director of Good Shepherd, said he estimates about a quarter of their clients are over 50, and that increases to about 40 per cent if refugees are excluded.

These seniors are experiencing poverty, he said, and the main factor driving them to homelessness is the increased cost of housing in the city, he said. 

"People lose their job and suddenly they don't have enough … so they end up on the street," he said. 

Those in their shelter who are older are experiencing dementia and other health issues that their staff are not equipped to deal with, said Wendaferew.

"Shelters are currently becoming an alternative to hospitals and to long-term care. So that's not really what shelters are set up for," he said. 

"For example, from a need to support them with their feeding, bathing, toileting and things like that. We don't have that kind of infrastructure," he said. 

Christine Sheppard, a researcher at the Wellesley Institute who specializes in aging, said older adults need many supports in the home as they age, and that gets lost without secure housing. This can include everything from housekeeping, to helping pay bills and medical and mental health assistance, she said.  

"It ensures that people are able to stay in their home and that they're able to age with dignity and safety in that space," she said. 

The issue is urgent and getting worse — and indicates that the housing crisis is affecting more older people who are living in poverty, Sheppard said. 

The lengthy long-term care wait-list in the province is making the issue worse, she said.

"We really need to develop a housing strategy that is focused on the needs of older adults," Sheppard said.