At a recent meeting with members of the Serving Seniors health and social services team, our staff shared a troubling story. An older adult had been discharged from the hospital with nowhere to go. They ended up on the street and eventually came to us for help.
What concerned me most was what our team said next: “We are seeing this more and more.”
This isn’t because people aren’t trying to help. Hospitals, recuperative care programs, shelters and service providers across our region are doing important work every day. But as the homeless population ages, we are seeing older adults whose needs do not always fit neatly into the options available.
Adults 55 and older now represent 33% of San Diego County’s unsheltered population, up from 29% just one year ago — even as overall unsheltered homelessness declined 11% in the 2026 Point-in-Time Count.
Older adults are also staying unhoused longer. According to the Regional Task Force on Homelessness, adults 55 and older experienced an average of 234 days of homelessness in the 2025 fiscal year, the longest of any group measured. The average is 193 days.
Our homeless population has changed. San Diego’s response needs to evolve with it.
Some older adults need more than a bed
Homelessness looks different at 70 than it does at 30.
An older adult may use a walker, need assistance with daily activities, or have multiple medications and medical appointments to manage. These realities make living on the street especially dangerous and can make traditional shelter settings difficult to navigate.
San Diego has resources addressing parts of this challenge, including recuperative care and shelter programs. Hospitals and providers work hard to find appropriate placements. But a gap remains for some older adults who no longer need hospital-level care, but need more support than a traditional shelter is designed to provide.
For some, recuperative care or medical respite is the right option. Others may need an accessible place to stay, assistance with daily activities and focused support finding permanent housing.
The healthcare impact is real
The consequences extend beyond the homelessness response.
Research at Zuckerberg San Francisco General Hospital found that older age and homelessness were associated with delayed hospital discharge. Researchers documented 1,147 delayed patient-days in a single year, with an estimated opportunity cost in the millions of dollars.
When the appropriate next setting does not exist, hospitals have limited options. An older adult may be medically ready to leave the hospital but still have nowhere appropriate to go.
Serving Seniors offers a solution
As a limited pilot project, Serving Seniors opened Seniors Landing, a 33-room, non-congregate bridge shelter designed specifically for adults 55 and older.
Residents had private rooms, meals, case management, housing navigation and connections to healthcare. From its opening through the 2025 fiscal year, Seniors Landing served 190 older adults and reported a 90% placement rate into permanent affordable housing.
I think about one woman who came to Seniors Landing after experiencing homelessness. Once she had a safe room of her own, she could stop focusing on where she would sleep each night and begin focusing on what came next. With stability and support, she ultimately moved into permanent housing.
Our experience with this pilot project gave us proof of concept with a higher success rate than we anticipated. It illustrates our belief that an investment in age-appropriate shelter, paired with strong services and housing navigation, can help more older adults reach permanent housing, and get there faster and at a lower cost.
Similar programs across the country are also successful. Boston Medical Center’s Elderly Residential Assessment and Placement Program combines shelter for older adults with intensive assessment and case management focused on permanent housing. More than 75% of participants move into permanent housing.
In San Francisco, caregiving support is being brought directly into an older-adult shelter so people who need help with daily activities have an appropriate place to stay.
No single model is the answer. But these approaches show what is possible when services are designed around the realities of aging.
A better response to older adult homelessness
Serving Seniors knows this challenge will grow as our overall population grows older, and more older adults experience homelessness. We also know more about what works.
We have the opportunity to build on programs already in place while determining what an age-friendly response to homelessness requires. Healthcare, housing, aging services, government and homeless service providers all bring expertise to this conversation.
Communities across California are facing the same demographic shift as San Diego. Future local and state investments should reflect the changing needs of people experiencing homelessness and support approaches that help older adults move into permanent housing more quickly.
Housing remains the ultimate solution, and prevention is critical. But we also have to address the needs of frail older adults sleeping on our streets today.
They need the right setting, the right support and the shortest possible path to a permanent home. They need a response now with a clear path home.
Melinda Forstey is president and chief executive officer of Serving Seniors.
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