Elder homelessness is a growing concern in the U.S. Yet, many providers may be unaware of the factors that place older adults at risk of becoming homeless. John* is a newly housed older adult who—until recently—experienced homelessness for the past six years. He shares his struggles and triumphs, as well as the assistance he has received from the Boston-based organization Hearth, which connects elders experiencing homelessness with affordable housing and the supports necessary for long-term housing success.

At first glance, John* may seem like any other 57-year-old man. He reaches out to shake hands with an easy smile, his wide eyes crinkling down from the top of his tall frame. He wears a clean, blue windbreaker and a pair of tan pants. He is friendly and talkative.

But one thing about John that might not be obvious at first is his incredible resilience. He has experienced homelessness off and on for the last six years—and now, with help from Hearth, he is newly housed. Hearth is a Boston-based organization that connects elders experiencing homelessness with affordable housing and the supports necessary for long-term housing success. Their mission is simple: to end elder homelessness.

John grew up in Boston and exceled in sports and writing in school, winning a journalism scholarship when he was still in high school. He was solidly employed from the time he was 14 years old and went into business with his father right out of school. He raised three children and worked hard to support them.

So when he found himself homeless in 2006, he was shocked and did not know where to turn. He found himself out on the street, where he was forced to learn an entirely new set of survival skills.

For John, it was a combination of factors that led to his experience of homelessness. He says he had been a drinker for much of his life, although he had maintained sobriety for four years once before. But he had fallen back into using alcohol in 2001 while grappling with the death of his father. This led to problems in his relationship with his girlfriend and estranged him from members of his family. The situation worsened until 2006, when he was finally forced to leave the apartment he shared with his girlfriend. Alone and ashamed, he had no place to go and spent that first night wandering the cold streets.

This type of complex series of events is fairly common among elderly individuals who become homeless, says Dr. Kelly Mills-Dick, Adjunct Faculty at Boston University School of Social Work specializing in elder homelessness. And it’s not just individual-level factors that are at play. She describes it as a complicated interaction of personal struggles, relationships with others, and broader issues like the economy and availability of housing and other services.

Although some service providers may not think older adults are likely to become homeless, Kelly says that this population is particularly vulnerable. For many, a health care catastrophe, change in income, or disruption in a key relationship could be all it takes to propel them into homelessness.

This was certainly true for John. For a short time after initially becoming homeless, he stayed “doubled up” with a friend in Boston. But when that relationship became toxic, he was forced back onto the streets and ended up bouncing from one shelter program to the next.

John spent the next several years in detox programs, transitional housing programs, and shelters. Through his involvement in these programs, he was diagnosed with bipolar disorder and depression, along with a host of serious physical health problems, including Chronic Obstructive Pulmonary Disease (COPD), asthma, and sleep apnea. Kelly says that multiple physical and mental health diagnoses are typical of elders experiencing homelessness, whose bodies tend to age at an accelerated rate.

While homeless, John says he tried to stay away from alcohol, and he never used drugs. But he explains the irony of his situation was that sometimes, in his desperation to access housing, he would start drinking again just so he would qualify for certain housing programs and have a place to sleep at night.

John’s pathway out of homelessness was just as complicated as his pathway into it. Hearth’s social workers helped him get on wait lists for a number of housing units. Finally, the apartment where he currently lives opened up a few months ago, and he was able to start living independently again.

It wasn’t just a matter of getting John into housing, explains Emily, one of John’s case managers at Hearth. It was also important to connect him with other community resources, as well as to physical and mental health services. And because many older adults experiencing homelessness have little family or peer support, it is also essential to link them with social supports to minimize their sense of isolation.

“This stabilization piece is extremely important after people are housed,” Emily explains. “And it’s important to have patience and to appreciate what people have gone through, because nothing will be accomplished with judgment. People don’t choose this for themselves, and you do what you can to help them.”

John agrees that the Hearth program has worked for him. He says the services available to him have made all the difference, and he is proud of the fact that he has been sober for the past five months. He sees his future as more certain these days, and he has hopes and dreams he is striving to attain. “I want to help people somehow,” he says. “I just want to find some way to give back.”

It has taken an enormous amount of strength and resilience for John to get to where he is today. And now, he says, he wakes up feeling safe. He takes hot showers in a clean bathroom. He has a place to call his own. And most importantly, he has regained his sense of dignity.

*Not his real name. His real name has been changed to protect his identity.