Skip to main content Accessibility help

Homelessness among older people and service responses

  • Maureen Crane (a1) and Anthony M Warnes (a1)


This paper reviews the limited evidence on the causes of homelessness in old age and on the circumstances and problems of older homeless people, and it describes the few services dedicated to the group. Health care and social care professionals rarely encounter homelessness among the many problems of older people that present to them, but in many developed countries there is evidence that the number of older homeless people has recently been growing. Some among them have been homeless intermittently or continuously for years, but many became homeless for the first time in later life. The reasons for becoming homeless and the problems and needs of the group are exceptionally diverse. Many have been estranged from their family or have no living relatives, and they have a high prevalence of health problems and functional limitations. Although services for homeless people in general have improved since the early 1990s, few have targeted the needs of older people.


Corresponding author

Address for correspondence: Dr Maureen Crane, Sheffield Institute for Studies on Ageing, University of Sheffield, Samuel Fox House, Northern General Hospital, Sheffield S5 7AU, UK. Email:


Hide All
1Cohen, CI, Sokolovsky, J. Old Men of the Bowery: Strategies for Survival Among the Homeless. New York: Guilford, 1989.
2Crane, M. Understanding Older Homeless People: Their Circumstances, Problems and Needs. Buckingham, UK: Open University Press, 1999.
3Kavanagh, K. The Battlers: Elderly People Residing in Insecure Housing. Sydney, Australia: Mercy Family Centre, 1997.
4Hightower, HC, Hightower, J, Smith, MJG. Out of Sight, Out of Mind: The Plight of Seniors and Homelessness. Vancouver, British Columbia: Seniors’ Housing Information Program, 2003.
5McDonald, L, Donahue, P, Janes, J, Cleghorn, L. In From the Streets: The Health and Well-being of Formerly Homeless Older Adults. Toronto, Ontario: Institute for Life Course and Aging, 2006.
6Aoki, H. Homelessness in Osaka: globalisation, yoseba and disemployment. Urban Studs 2003; 40: 361–78.
7Hasegawa, M. Economic globalization and homelessness in Japan. Am Behav Scientist 2005: 48: 9891012.
8Okamoto, Y. A comparative study of homelessness in the United Kingdom and Japan. J Social Issues 2007; 63: 525–42.
9Shelter Partnership. Homeless Older Adults Strategic Plan. Los Angeles, California: Shelter Partnership Inc, 2008.
10Watson, DP, George, C, Walker, C. ‘Falling through the cracks’: health care needs of the older homeless population and their implications. Res Sociol Health Care 2008; 26: 187204.
11Crane, M, Warnes, AM. Single Homeless People in London: Profiles of Service Users and Perceptions of Needs. Sheffield, UK: Sheffield Institute for Studies on Ageing, University of Sheffield, 2001.
12Broadway. Street to Home Annual Report for London 2005/06. London: Broadway, 2006.
13Broadway. Street to Home Annual Report for London 2007/08. London: Broadway, 2008.
14Applied Survey Research. 2007 Santa Clara County Homeless Census and Survey. Watsonville, California: Applied Survey Research, 2007.
15Baltimore Homeless Services and Baltimore City Health Department. The 2007 Baltimore City Homeless Census. Baltimore, Maryland: Baltimore City Health Department, 2007.
16Homeless Coalition of Hillsborough County. 2007 Homeless Census Summary. Tampa, Florida: Homeless Coalition of Hillsborough County, 2007.
17Los Angeles Homeless Services Authority. 2007 Greater Los Angeles Homeless Count. Los Angeles, California: Los Angeles Homeless Services Authority, 2007.
18Metro Dallas Homeless Alliance. Metro Dallas Homeless Alliance 2007 Annual ‘Point in Time’ Homeless Count. Dallas, Texas: Metro Dallas Homeless Alliance, 2007.
19Sonoma County Task Force for the Homeless. Homeless in Sonoma County 2007: the Sonoma County Point in Time Homeless Count. Santa Rosa, California: Sonoma County Task Force for the Homeless, 2007.
20Hahn, JA, Kushel, MB, Bangsberg, DR, Riley, E, Moss, AR. The aging of the homeless population: fourteen-year trends in San Francisco. J Gen Intern Med 2006; 21: 775–78.
21Sermons, MW, Henry, M. The Rising Elderly Population. Washington DC: Demographics of Homelessness Series, Homeless Research Institute, 2010.
22Chamberlain, C, Mackenzie, D. Counting the Homeless 2001. Canberra, Australia: Australian Bureau of Statistics, 2003.
23Chamberlain, C, Mackenzie, D. Counting the Homeless 2006. Canberra, Australia: Australian Bureau of Statistics, 2009.
24Greater Vancouver Regional Steering Committee on Homelessness. Still on our Streets: Results of the 2008 Metro Vancouver Homeless Count. Burnaby, British Columbia, Vancouver: Metro Vancouver, 2009.
25Homeward Trust Edmonton. A Count of Homeless Persons in Edmonton 2008. Edmonton, Alberta: Homeward Trust Edmonton, 2008.
26Burt, MR. Over the Edge: The Growth of Homelessness in the 1980s. New York: Russell Sage Foundation, 1992.
27Elliott, M, Krivo, L. Structural determinants of homelessness in the United States. Social Problems 1991; 38: 113–31.
28Lee, B, Price-Spratlen, T, Kanan, J. Determinants of homelessness in metropolitan areas. J Urban Affairs 2003; 25: 335–55.
29Cohen CI. Aging and homelessness. Gerontologist 1999: 39: 514.
30Hecht, L, Coyle, B. Elderly homeless: a comparison of older and younger adult emergency shelter seekers in Bakersfield, California. Am Behav Scientist 2001; 45: 6679.
31Chicago Alliance to End Homelessness. Homeless Over 50: The Graying of Chicago's Homeless Population. Chicago, Illinois: Chicago Alliance to End Homelessness, 2007.
32Shinn, M, Gottlieb, J, Wett, JL, Bahl, A, Cohen, A, Baron, Ellis D. Predictors of homelessness among older adults in New York City: disability, economic, human and social capital and stressful events. J Health Psychol 2007; 12: 696708.
33Crane, M, Byrne, K, Fu, R, Lipmann, B, Mirabelli, F, Rota-Bartelink, A, Ryan, M, Shea, R, Watt, H, Warnes, AM. The causes of homelessness in later life: findings from a three-nation study. J Geront: Soc Sci 2005: 60B: S15259.
34Rota-Bartelink, A, Lipmann, B. Causes of homelessness among older people in Melbourne, Australia. Austral New Zealand J Public Health 2007; 31: 252–58.
35Warnes, AM, Crane, M. The causes of homelessness among older people in England. Housing Studs 2006; 21: 401–21.
36Antonetti, E, Horn, M. Gambling the Home Away: A Study of the Impact of Gambling on Homelessness. Melbourne, Australia: Hanover Welfare Services, 2003.
37Productivity Commission. Australia's Gambling Industries. Canberra: Report 10, Productivity Commission, Commonwealth of Australia, 1999.
38Garibaldi, B, Conde-Martel, A, O'Toole, TP. Self-reported comorbidities, perceived needs, and sources for usual care for older and younger homeless adults. J Gen Intern Med 2005; 20: 726–30.
39Gorton, S. Audit of Older Homeless People September 2007: Summary of Findings. Homeless Link, London: UK Coalition on Older Homelessness, 2007.
40Warnes, AM, Crane, M, Coward, S. The FOR-HOME Study: Interim Report. Sheffield, UK: Sheffield Institute for Studies on Ageing, University of Sheffield, 2009.
41Gelberg, L, Linn, LS, Mayer-Oakes, SA. Differences in health status between older and younger homeless adults. J Am Geriatr Soc 1990; 38: 1220–29.
42Stergiopoulos, V, Herrmann, N. Old and homeless: a review and survey of older adults who use shelters in an urban setting. Canadian J Psychiat 2003; 48: 374–80.
43Washington OGM. Identification and characteristics of older homeless African American women. Issues Mental Health Nursing 2005; 26: 117–36.
44Wright, N. Homelessness: A Primary Care Response. London: Royal College of General Practitioners, 2002.
45Burt, M, Cohen, B. Differences among homeless single women, women with children, and single men. Social Problems 1989; 36: 508–24.
46Evans, N, Dowler, E. Food, health and eating among single homeless and marginalized people in London. J Human Nutrition Dietetics 1999; 12: 179–99.
47Richards, P, Elliott, L. The Unseen Many: A Needs Assessment of Homeless and Near-Homeless Seniors in San Diego. San Diego, California: Senior Community Centers, 2002.
48Cohen, CI, Teresi, J, Holmes, D. The mental health of old homeless men. J Am Geriatr Soc 1988; 36: 492501.
49Cohen, CI, Ramirez, M, Tersi, J, Gallagher, M, Sokolovsky, J. Predictors of becoming redomiciled among older homeless women. The Gerontologist 1997; 37: 6774.
50Kutza, E. A Study of Undomiciled Elderly Persons in Chicago: A Final Report. Chicago, Illinois: Retirement Research Foundation, 1997.
51Ladner, S. The elderly homeless. In Robertson, M, Greenblatt, M (eds). Homelessness: A National Perspective. New York: Plenum, 1992; pp. 221–26.
52Crane, M, Warnes, AM. Lessons from Lancefield Street: Tackling the Needs of Older Homeless People. London: Homeless Link, 2000.
53Fischer, PJ, Breakey, WR. The epidemiology of alcohol, drug, and mental disorders among homeless persons. Am Psychologist 1991; 46; 1115–28.
54Rich, D, Rich, T, Mullins, L. Old and Homeless – Double Jeopardy: An Overview of Current Practice and Policies. Westport, Connecticut: Auburn House, 1995.
55Wright, JD. Address Unknown: The Homeless in America. New York: Aldine de Gruyter, 1989.
56DeMallie, DA, North, CS, Smith, EM. Psychiatric disorders among the homeless: a comparison of older and younger groups. The Gerontologist 1997; 37: 6166.
57St Mungo's, . Biggest Ever Survey into the Problems of Homeless People: 50:50 The Big Stat. London: St Mungo's, 2004.
58Crane, M, Warnes, AM. Responding to the needs of older homeless people: the effectiveness and limitations of British services. Innovation: Eur J Social Sci Res 2005; 18: 137–52.
59O'Connell, JJ, Roncarati, J, Reilly, EC, Kane, CA, Morrison, SK, Swain, SE, Allen, JS, Jones, K. Old and sleeping rough: elderly homeless persons on the streets of Boston. Care Management J 2004; 5: 101–6.
60Culhane, DP, Kuhn, R. Patterns and determinants of public shelter utilization among homeless adults in New York City and Philadelphia. J Policy Analysis Management 1998; 17: 2343.
61Busch-Geertsema, V. When homeless people are allowed to decide by themselves: rehousing homeless people in Germany. Eur J Social Work 2002; 5: 519.
62Crane, M, Warnes, AM. Resettling Older Homeless People: A Longitudinal Study of Outcomes. Sheffield, UK: Sheffield Institute for Studies on Ageing, University of Sheffield, 2002.
63Hallebone, E. Homelessness and marginality in Australia: Young and old people excluded from independence, pp. 69103. In Huth, M, Wright, T (eds), International Critical Perspectives on Homelessness. Westport, Connecticut: Praeger, 1997.
64Crane, M, Warnes, AM. The outcomes of rehousing older homeless people: a longitudinal study. Ageing Society 2007; 27: 895922.
65Warnes, AM, Crane, M, Whitehead, N, Fu, R. Homelessness Factfile. London: Crisis, 2003.
66Cebulla, A, Rice, B, Tomaszewski, W, Hough, J. Profiling London's Rough Sleepers: A Longitudinal Analysis of CHAIN Data. London: Broadway, 2009.
67St Mungo's, . City and St Mungo's to open B&B-style Accommodation for Older Rough Sleepers. London: St Mungo's, 2010. Available online at: (accessed 24 April 2010).
68Rota-Bartelink, A, Lipmann, B. Supporting the long-term residential care needs of older homeless people with severe alcohol-related brain injury in Australia: the Wicking Project. Care Management J 2007; 8: 141–48.
69Gonyea, JG, Bachman, SS. Ending Elder Homelessness: the Importance of Service-Enriched Housing. Boston, Massachusetts: Hearth, 2009.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed