A blog for aging services leaders, homeless services providers, and the practitioners bridging both worlds.
Homelessness in America is not getting better.
It is getting older.
In January 2024, approximately 770,000 people experienced homelessness on a single night — the highest number since federal reporting began in 2007. Among them, more than 104,000 were aged 55 to 64, and over 42,000 were 65 or older. Nearly half were unsheltered — sleeping in cars, encampments, or places never intended for human habitation. The U.S. Department of Health and Human Services has called older adults the fastest-growing age group experiencing homelessness, composing nearly half of the single-adult homeless population. Without intervention, that number is projected to nearly triple by 2030.
These are not abstractions. They represent real people, many of whom spent decades working, raising families, and contributing to their communities, who are now navigating the loss of stable housing at the most vulnerable point in their lives.
A Health Crisis and a System Design Failure
For too many older adults, homelessness does not begin with a single catastrophic event. It is the cumulative result of intersecting pressures: fixed incomes that cannot keep pace with rising rents, the death of a spouse or caregiver, an unexpected hospitalization, or the quiet erosion of a support network. According to the UCSF Benioff Homelessness and Housing Initiative’s landmark Toward Dignity report, 41% of older adults experiencing homelessness in California became homeless for the first time after age 50. These are not people with lifelong histories of housing instability. They are people for whom the system simply did not hold.
Once housing is lost, the consequences for older adults compound quickly. Adults experiencing homelessness in their 50s and 60s present with health profiles similar to housed individuals 20 years older. Chronic disease, functional impairment, cognitive decline, and repeated hospitalizations are all significantly more prevalent — and all significantly harder to manage without a stable home. The median duration of homelessness for older adults is 25 months, compared to 20 months for younger populations. Older adults get stuck, and the systems designed to help them too often were not built with their needs in mind.
This is not just a housing problem. It is a health crisis, a social services failure, and — at its root — a system design failure. When aging services, homelessness response, healthcare, and public benefits operate in separate silos with separate data systems, separate eligibility criteria, and separate accountability structures, the person at the center of all those systems falls through the gaps between them.
Breaking Down the Silos
Aging services providers know their clients. They know who is isolated, who is struggling with nutrition, who has missed transportation pickups, who has a caregiver on the verge of burnout. What they often do not have is visibility into the housing and economic instability that may be quietly accelerating beneath those presenting needs. And homelessness response systems, for their part, frequently lack the geriatric expertise and long-term service planning infrastructure that older adults require.
The recognition that these worlds must converge is growing. In North Carolina, Governor Josh Stein relaunched the Interagency Council for Coordinating Homelessness Programs (ICCHP) in September 2025, bringing together DHHS, veterans affairs, housing finance, community-based organizations, and local government to align strategy across systems. With more than 11,500 North Carolinians experiencing homelessness in 2024, a 19% increase from the prior year, the Council’s cross-sector mandate reflects a clear understanding: no single agency or system can solve this alone.
In Maryland, the Longevity Ready Maryland initiative takes a complementary approach by embedding housing stability and homelessness prevention into a 10-year, multisector plan for aging. The plan recognizes that older adults are overrepresented among people experiencing homelessness in the state and explicitly calls out affordable housing, aging in place, and creative models like home sharing and shared multigenerational living arrangements as key strategies. By pairing aging policy with concrete housing and service goals—including stronger coordination between the Department of Aging, housing agencies, and local partners—Maryland is treating older adult homelessness as a cross-system challenge rather than a niche issue.
These are encouraging examples. But cross-sector governance and innovative programs only work when the underlying infrastructure supports them. And that is where technology becomes foundational — not as a buzzword, but as the connective tissue that makes collaboration real.
From Data to Information: The Role of Interoperable Technology
Whole-person care is not a marketing phrase. It is the ability to effectively leverage collaborative case management to address the different dimensions of health and social services that meet the whole human need. You cannot deliver it when a client’s housing history lives in one system, their meal delivery records in another, their Medicaid eligibility in a third, and their behavioral health notes in a fourth. Siloed systems do not just create inefficiency, they retraumatize vulnerable people by forcing them to reshare their story at every door, slowing the progression from need to stability.
Interoperability—the real capability of organizations across the social safety net to collaborate effectively in support of those they collectively serve, is what turns fragmented care into coordinated care. And data-informed practice is what ensures that the services being delivered are actually driving outcomes, not just generating activity.
CaseWorthy’s purpose-built platform was designed around these principles, informed at every stage of development by practitioners who have done this work themselves.
For aging services providers navigating the growing intersection with homelessness, this means a platform that supports cross-program client records spanning housing, meals, transportation, health, and benefits, so staff see the full picture, not just their piece of it. It means HMIS-compliant interoperability with housing systems, health records, and state platforms, enabling the kind of real-time data exchange that cross-sector collaboration demands. It means collaborative case management with role-based access, shared care plans, and secure referrals across agencies — so a case manager at an Area Agency on Aging and a housing navigator at a Continuum of Care can coordinate around the same client without duplicating effort.
And it means analytics that translate data into actionable information: identifying risk patterns like rent burden, repeated emergency department visits, or functional decline that may signal an older adult is on the path toward housing instability — before a crisis occurs.
What Coordination Looks Like in Practice
Consider this scenario: Margaret, 72, has just been rehoused after six months of homelessness following an eviction she could not contest on a fixed income. She is now in a small apartment, but she is malnourished, socially isolated, managing diabetes and early-stage cognitive decline, and has no reliable transportation to medical appointments. Her housing case manager closes the file. By traditional metrics, she is “housed.” By any meaningful measure, she is still at risk.
In a coordinated system, Margaret’s rehousing triggers a warm referral to the local senior nutrition program, which enrolls her in both congregate meals at a nearby senior center and home-delivered meals on days she cannot travel. Her transportation needs are flagged and scheduled. Her care plan, visible to authorized providers across agencies, reflects her medical conditions, her social isolation risk, and her housing stability indicators. When she misses two consecutive meal pickups, the system alerts her case coordinator, who follows up and connects her with a home visit. The data does not just track what happened. It informs what should happen next.
This is not hypothetical. In North Carolina, CaseWorthy supports 41 organizations across the state, impacting more than 501,000 lives through aging, nutrition, Medicaid, and broader health and human services programs. In Union County, the Senior Nutrition Program used CaseWorthy’s ServTracker to move from fragmented spreadsheets to a unified system — reducing their waitlist by 55%, securing nearly $424,000 in additional funding by demonstrating impact with accurate data, and saving 10–15 staff hours per week that were reinvested into direct service delivery. In New Hanover County, the Senior Resource Center leveraged ServTracker to eliminate data silos across social, nutrition, behavioral, and transportation services, reducing reporting time from 2–3 days to 30–60 minutes while growing their congregate nutrition program by 775% and increasing social work services by 16.6%.
These outcomes were not achieved by adding more staff or more funding alone. They were achieved by giving practitioners the right infrastructure — a single source of truth that connects case management to service delivery and translates data into the information needed to drive decisions.
The Path Forward
Older-adult homelessness is not a problem that aging services can afford to treat as someone else’s responsibility. And homelessness systems cannot continue to serve a rapidly aging population without the geriatric expertise and long-term planning that aging services providers bring. The convergence of these two worlds is already happening — in policy, in practice, and in the lived experience of the people both systems serve.
The question is whether our technology and our data infrastructure are keeping pace.
If your organization serves older adults and you have not yet assessed your capacity to identify housing instability risk, share data with housing and health partners, or coordinate case management across agencies, now is the time. Audit your data and technology gaps. Have honest conversations about what your systems can and cannot do. And if you are ready to explore how a purpose-built, interoperable platform can support your aging services strategy, reach out to CaseWorthy. Our team — many of whom come from the very fields we serve, is ready to help you build the infrastructure that whole-person care demands.
About the Author
David is an accomplished human services professional with many years’ experience in HMIS administration, data management, and social services partnerships. As VP of Strategic Growth and Community Relations at CaseWorthy, David leads the effort to expand our products’ and services’ potential to improve human lives, through educating organizations and bringing together new partnerships in service of care coordination across the United States. He also serves as VP of the Board for the National Human Services Data Consortium (NHSDC), which provides information, assistance, peer-to-peer education and lifelong learning to human service organizations via in-person and virtual events, as well as self-learning resources.
