VA homeless programs evolving to support aging Veterans

Today, nearly half of all Veterans enrolled in Veterans Health Administration (VHA) programs are aged 65 years or older. By 2035, the number of VHA users aged 85 years or older is projected to increase by 66%.

This month on VHA’s Ending Veteran Homelessness podcast, we examine how VA homeless programs are evolving to help aging Veterans get housed and stay housed—and why such changes are urgently needed.

Listen to “S1EP10: Growing Older Together: How VA is Evolving to Support Aging Veterans” on Spreaker.

Veterans are living longer

“As with the general population, homeless Veterans are living longer and experiencing the challenges with aging that most of us are experiencing,” explained Deborah Lee, regional coordinator for the Housing and Urban Development-VA Supportive Housing (HUD-VASH) program at the VA Homeless Programs office.

But the challenges of aging are exacerbated for Veterans experiencing homelessness. Veterans experiencing homelessness often have long-standing histories of a lack of engagement with services and support, come from backgrounds of intergenerational poverty, and have multiple chronic health care conditions.

Furthermore, research demonstrates that prolonged exposure to economically adverse conditions such as homelessness can intersect with racial marginalization to age individuals faster, compared with those who have not experienced homelessness or racial marginalization.

While America’s Veterans are aging, those who have experienced homelessness may be aging faster than their peers.

Increasing age = increasing support

No matter their age, VA homeless programs strive to deliver equitable and comprehensive services to every Veteran in need of support. When VA homeless programs began in the late 1980s, the average age of Veterans served was between 30-50 years old.

Today, as the average age of Veterans receiving VA homeless programs support is increasing, the level of support needs to increase, too.

“We’re listening”

VA homeless programs have one priority when it comes to serving aging Veterans: provide them with the options and independence they desire while also offering them the comprehensive range of services they need.

“We are paying attention to what Veterans are telling us,” explained Lee. “We’re listening better and we are using our resources to create options for these Veterans in a way that we had not before.”

Using HUD-VASH vouchers to pay for the cost of housing in more settings is one such way HPO is providing older Veterans with more options to receive care in the way and place they prefer.

For example, HPO and VA’s Geriatrics and Extended Care have partnered to support Veterans who need medical care at the highest levels. Qualifying Veterans may now use their HUD-VASH voucher to live in Medical Foster Homes, which are alternatives to nursing homes in which a trained caregiver provides services to a few individuals.

Medical Foster Homes are often appropriate for Veterans like William Peterson, who requires nursing home care but prefers a non-institutional setting with fewer residents.

For those Veterans with less intensive medical needs but who cannot live alone, Community Residential Care (CRC) programs offer a range of shared housing options, congregate care, and 24/7 support. Through CRC, Veterans can choose a VA-approved setting where they feel most comfortable to receive the services they need.

No place like home

Still, for many Veterans, the most comfortable place to receive care is right at home.

To help Veterans age in place in their homes, VA funded additional programs dedicated to aging and disabled Veterans, including 51 new staff members across 18 VA medical centers in 2022.

“What we’re finding is that Veterans are very happy when the services are provided to them where they live and they also enjoy regular communications with the people that are providing these services to them,” said Lee.

Trustworthy teams

To aging Veterans and their families, perhaps no detail is more important than who is providing them care.

In addition to VA’s highly competent and compassionate social workers, VA homeless programs also have funded new positions and ensured they are staffed by individuals that older Veterans can relate to and trust.

Peer support specialists are trained members of VA’s clinical teams—and Veterans themselves who have shared lived experiences, such as overcoming homelessness or health challenges.

“They are crucial to the success of our program,” said Jia Son, HUD-VASH director at VA San Francisco. Son also cites VA’s geriatricians—medical doctors specifically trained to serve older adults—as critical to providing expert care.

Adriana Durr, HUD-VASH supervisor at VA San Francisco, highlights the importance of occupational therapists and community integration specialists in providing comprehensive care to Veterans at Colma Veterans Village, a project-based HUD-VASH facility providing wraparound services for Veterans experiencing homelessness.

“Veterans are able to age in place with dignity at Colma Veterans Village with the increased access of care,” Durr shared.

Making the years count

While VA team members are dedicated to helping Veterans live longer and healthier lives, they also find that this work changes their own.

“There is no better way to live a fulfilled life than serving Veterans,” said Lee.

Learn about VA programs

• If you are a Veteran who is homeless or at risk for homelessness, call the National Call Center for Homeless Veterans at 877-4AID-VET (877-424-3838).
• Visit the VA Homeless Programs website to learn about housing initiatives and other programs for Veterans exiting homelessness.
• Check out the Ending Veteran Homelessness podcast to learn more about what VA is doing about Veteran homelessness.
• Learn about how to get involved with housing homeless Veterans.
• For more stories like these, subscribe to the Homeless Programs Office newsletter to receive monthly updates about programs and supportive services for Veterans experiencing or at risk of homelessness.