News and Press Releases

Winning Programs Aid Homeless Elders, Ease End of Life

Excerpt from Aging Today, July - August 2005

The 2005 Healthcare and Aging Awards honored seven exciting and innovative programs around the United States offering solutions to problems ranging fro serving elders in the Alaskan wilderness to preventing homelessness among urban elders in Boston . . . . In this issue, Aging Today, profiles . . . additional Healthcare and Aging Award winners, one [of which is] from Boston . . . . The kudos are presented annually by the American Society on Aging's Healthcare and Aging Network and sponsored by the Pfizer Medial Humanities Initiative.

ENDING ELDER HOMELESSNESS
"We are astonished at the dedication and efficiency of this small group," said Blanca Ramirez. "Their had work actually put us a full day ahead of schedule!" Ramirez, volunteer coordinator for Boston's Committee to End Elder Homelessness (Hearth), sang the praises of four volunteers from the city's Executive Office of Elder Affairs, who stripped the kitchen and living room clean, packing everything neatly in the basement by 10:30 a.m. Their supercharged effort was part of a massive volunteer push to refurbish Hearth's Bishop Street home for nine older women who were homeless or at risk of homelessness.

The volunteer blitz was organized and videotaped last spring by WCVB-TV Channel 5's new Extreme Makeover: Boston Edition, the station's local version of ABC-TV's hit program, Extreme Makeover: Home Edition. The station selected Bishop Street, one of five Hearth service-rich sites for homeless Bostonians, following construction of a new addition to the building, including a completely renovated communal kitchen. Channel 5 helped bring together volunteers from local businesses, nonprofits and education institutions, who logged in nearly 450 volunteer hours striping wallpaper; painting six rooms and two hallways; demolishing the old kitchen; tearing up flooring; cleaning the large Victorian windows; cleaning, packing and unpacking items from the kitchen and living room; decorating the rooms;' and providing meals for the residents while their kitchen was out of service. Corporate donors contributed new furniture and appliances.

Five Sites
Hearth, a national research-based program, was also honored last spring with a 2005 Healthcare and Aging Award. The nonprofit agency, started in 1991, now provides five affordable, permanent housing sites with supportive services, an extensive outreach program, and integrated health services and wellness programs.

Hearth President and CEO Elisabeth Babock explained that the organization's model integrates housing, mental health, medical and social-services supports in a manner that permits even very frail elders to live with considerable independence in their own apartments. She added, "The cost of Hearth housing is less than one-third the costs of institutional alternatives such as nursing home care."

At its five locations, Hearth houses about 115 residents, men and women age 50 or older who are homeless or at risk of homelessness. Most are very low income, frail and have complex mental, physical and substance abuse problems, Babcock said. Slightly more than half are men, 48% are African American, 47% white, and the rest are Latino, American Indian or Asian.

In addition, the Hearth outreach program is working with more than 200 currently homeless elders to locate, secure and stabilize them in permanent housing. The outreach team has identified that 71% of clients have a physical disability, 55% suffer from a mental illness, 28% abuse alcohol and 5% have a drug abuse problem. Babcock said that Hearth's Outreach Team has identified more than 1500 elders who are eligible for subsidized housing programs under the U.S. Department of Housing and Urban Development and has facilitated more than 600 placements. To ensure a successful transition, she said, "Hearth's outreach case managers work with each individual for entire year after placement." A key measure of their success has been that 97% of those placed in such housing remain there after one year of placement.

Besides obvious problems around affordability in one of the most expensive housing markets in the United States, poor health is a very important precipitant to homelessness among elders, Babcock stressed. A Boston-area survey of homeless people age 50 or older showed that 43% suffered from heart disease, 34% from arthritis and 22% from diabetes, she said. Also, more than four in 10 reported limited mobility and had stopped working due to health problems, and six of 10 respondents said health issues disrupted their ability to care for or provide for themselves.

Outcomes Research
Babcock continued, "We have conducted outcomes research that has shown that our model increases the cognitive functioning and stabilizes the physical functioning of our residents, helping them to become stable in the community. In addition, our services help identify early signs of mental or medical dysfunction or relapse, thus saving the state thousands of dollars in unnecessary emergency room visits and possible nursing home placement--both of which are cost prohibitive to the state." Hearth has also identified seen other Massachusetts cities and towns with substantial pockets of individuals who would benefit from the program's integrated service model, she said.

Hearth also demonstrated evidence of the effectiveness of its housing programs, including its first-if-its kind assisted living residence on Ruggles Street. A 2002 report, "Keeping Elders Home: New Lessons Learned About Supporting Frail Elders in Our Communities," describes outcomes including lower hospitalization rates than projected for the high-risk population of Medicaid elders Hearth serves, as well as statistically significant improvements in cognitive functioning among residents as compared with when they previously lived in nursing homes. The report showed that the care offered at Ruggles Street saves the public #13, 575 a year per resident compared with the cost of a nursing home. Such savings could be critical to the state's resources, Babcock noted: "The expense for instructional care is rapidly creating a major budget crisis for federal and state government." In 2003, she said, the largest portion of the Massachusetts Medicaid budget went to nursing home costs. Although only 3% of Massachusetts elders on Medicaid reside in nursing homes, they use 20% of the Medicaid budget, she added.

"It is much harder to assist homeless elders to find a home than it is to prevent them from becoming homelessness in the first place," Babcock emphasized. "The way we prevent even the most complex elders from becoming homeless or needlessly institutionalized is by bringing the services they need to where they live as opposed to making them find, get, coordinate and maintain these services themselves."

For more information about Hearth's integrated-support service model, contact Annie Garmey at (617) 369-1550.