Housing Solutions for an Aging America

As America’s aging population continues to grow, the supply of affordable and accessible housing has not kept up, leading to a shortage of stable housing options for older adults. Adults age 50+ are the fastest growing segment of the U.S. population experiencing homelessness, and the number of homeless older adults is expected to triple by 2030. This presents an urgent need for housing solutions that can support adults through their changing functional and economic needs as they age.

With one in 10 older adults living in poverty, a lack of affordable housing leaves older adults vulnerable to housing instability and homelessness. According to 2023 Census Bureau data, 57% of older adults (age 65+) who rent and 27% of older adults who own their homes are housing cost burdened, meaning they spend at least 30% of their income on housing costs (see above chart). This leaves them with less income for other necessary expenses like food and medical or personal care and can force them to relocate or forgo other necessities if these other expenses become too high.

Older adults and people with disabilities also struggle to remain in their own homes due to unmet needs for assistance with everyday tasks like eating, bathing, dressing, and running errands. In 2023, about 14% of adults age 60+ reported difficulty with self-care or independent living, which increased to 35% among adults age 80+ (see above chart). Accessibility of a person’s home also hinders their ability to age in place. While 14% of adults age 65-74 and 29% of adults age 75+ had an ambulatory disability as of 2023, less than 6% of the nation’s housing stock is designed to be accessible, and less than 1% is accessible to wheelchair users. When these basic needs go unmet, people are at risk of losing their housing and entering institutional care settings or becoming homeless. 

Below are a variety of existing housing options that, if widely implemented with affordability and accessibility in mind, have the potential to close these housing gaps

Aging in Place: Making Current Homes Work 

In-Home Care Services: These services help adults remain in their existing homes by having direct care workers aid with daily tasks and/or medical care in the person’s home. However, affordability and availability of these services often make them out of reach for many adults, especially those in rural areas and with moderate incomes that don’t qualify for Medicaid-funded services. Genworth estimated the national average cost of in-home care (40 hours per week) was $5,720 per month in 2024, or as high as $24,024 per month for 24/7 care. 

Home Modifications: There are a variety of programs that help coordinate and fund home modification projects that make an existing home more accessible or safe and enable a person to live there longer. Examples of home modifications include removing clutter or rearranging furniture, adding assistive devices like grab bars or railings, installing roll-in showers or front door ramps, and fixing unstable stairs and floorboards. Cost to the resident varies based on the intensity of the modification and the extent to which a program will provide financial assistance. 

CAPABLE: The CAPABLE (Community Aging in Place – Advancing Better Living for Elders) program is a person-centered model that provides coordinated in-home care and home modification services from a registered nurse, occupational therapist, and handyperson over a four- to five-month period. It enables older adults to remain in their own homes with greater capacity for performing activities of daily living and managing health conditions, and less risk of falls and other injuries. The model is currently provided through a variety of funding entities including Medicaid HCBS waivers, Medicare Advantage plans, PACE organizations, the Veterans Affairs health network, Meals on Wheels, primary care clinics, and home care agencies. 

Home Sharing: The Home Sharing model matches people seeking housing with people who have housing but need additional income or support to remain there. For example, an older adult who lives alone and has a spare room may be matched with another adult who needs affordable housing and can help out with household tasks and errands. Home Sharing programs are typically operated locally with a more grassroots approach and can be a more affordable option for people with lower care needs. 

The Village Model: Villages are grassroots, community-based organizations that bring neighbors/community members together to provide or connect each other to social programs and supportive services in their existing communities. For example, neighbors may run errands for each other, provide rides, help with household tasks, and organize social events. They enable older adults to remain in their own homes by increasing access to affordable (or no-cost) services and resources while reducing social isolation. Residents can either join an existing village nearby or start their own with help from their neighbors. 

Tailored Supportive Housing Options 

Assisted Living: These communities provide a home-like environment where residents pay a monthly fee to live in a private, semi-private, or shared bedroom or apartment and receive services like social engagement programming and assistance with activities of daily living (dressing, cooking, medication management, etc.). Some communities offer additional health care services, and some are specialized to support residents with specific needs like dementia or behavioral health. Cost of care and services for qualifying communities are covered under most states’ Medicaid programs, local public programs, or private insurance plans, but most residents pay out-of-pocket for both care and room and board. Genworth estimated the national median cost for assisted living in 2024 was $5,900 per month.  

Continuing Care Retirement Communities (CCRC): CCRC’s provide a continuum of care all in one location including independent living, assisted living, and skilled nursing so residents can progress through different levels of care as their needs change without having to relocate to a new community. Most CCRCs involve a large upfront fee and ongoing monthly fees, while some operate on a rental model with no upfront fee. Some states’ Medicaid programs cover costs of personal care and healthcare services provided in qualifying CCRCs, and Medicare and private insurance plans may cover some costs as well, but a large majority are private pay. The National Investment Center found that entry fees for CCRCs ranged from $50,000 to $500,000, and average monthly fees for the independent living segment (least costly) were $3,873 for rental communities and $4,285 for entry fee communities in 2025.  

Permanent Supportive Housing (PSH): PSH provides help finding and paying for affordable housing and delivers supportive services like ongoing case management and transportation to households with at least one member with a disability who are experiencing chronic homelessness. Some PSH programs are designed for specific populations like older adults, people with disabilities, and LGBTQIA+ older adults. Programs are often funded by a combination of nonprofit, city/county, and Medicaid funding. Residents contribute a certain portion of their income to rent, and the program subsidizes the rest. 

U.S. Department of Housing and Urban Development (HUD) Programs: HUD offers two major supportive housing programs. The Section 202 Supportive Housing for the Elderly program offers financial rental assistance to adults age 62 and older to live in housing units built specifically for older adults. These housing units are accessible and offer social engagement programs and supportive services like transportation, housekeeping, and health and wellness programs to help residents age in the community. Participants pay a fixed 30% of their adjusted income to rent, and the federal government subsidizes the rest.  

The Section 811 Supportive Housing for Persons with Disabilities program is similar to Section 202 but targeted to people with disabilities with very low or extremely low incomes. This program also provides financial assistance to state housing agencies who work with health care agencies to identify and refer potential tenets to the program. 

The Integrated Wellness in Supportive Housing (IWISH) model is a pilot program that funds a full-time Resident Wellness Director and a part-time Wellness Nurse to provide services in HUD-assisted housing developments that primarily or exclusively serve households headed by people age 62 or older.  These staff perform proactive person-centered interviews and assessments of residents and develop individual and community healthy aging plans to coordinate services that meet the communities’ needs. 

Supply of HUD units, however, is limited and varies significantly by state, with Western/Southwestern and Southeastern states having the least supply. No state currently has enough units to meet the demand for affordable housing among older adults, and there are very long waitlists for these programs. 

Universal Design Principles: Universal design refers to “the design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.” In regards to housing, there are common universal design principles that builders can follow to ensure a new building or remodel of an existing building is accessible throughout a person’s lifespan. These include things like no-step entryways, one-story living, wide doorways and hallways large enough for wheelchairs, non-slip floors and surfaces, lever door handles, and rocker light switches. States and local governments can require universal design principles be followed in any new residential buildings or remodels to make the housing stock more accessible.  

Investment is Necessary 

In order for models like these to make an impact on the nation’s housing crisis, all sectors including nonprofits, private developers, service providers, and local, state, and federal governments must work together to allocate more funding and resources to implement and sustain these promising programs so that more older adults can live in their residences of choice as they age.