Programs that combine housing with medical services change the equation. Shelters that provide private bathrooms, wound care, medication management and visiting clinicians reduce emergency visits and keep people healthier while they apply for benefits, housing, or recovery programs. For seniors, being able to see a clinician downstairs or get physical therapy in a private room can mean the difference between returning to the street and making steady progress toward permanent housing.
Learning how these medically focused shelters operate matters for anyone interested in human potential and inclusion. They reveal what practical support looks like when systems are designed around real needs, not assumptions. Read the full article to see how this model is working in different states and what it might teach communities that want to preserve dignity, health, and opportunity for older adults facing homelessness.
SANDY, Utah — Just outside Salt Lake City sits an old, two-story, brick hotel. It’s been given new life as a homeless shelter for seniors. The Medically Vulnerable People shelter — or MVP shelter, as it’s known — is for people 62 and older or for younger adults with chronic health issues.
Residents share rooms designed to be accessible to those with mobility issues. There are also private bathrooms, which are a big deal for seniors struggling with incontinence.
Unlike the MVP, most homeless shelters aren’t equipped to help seniors, especially those 65 and older. They are the fastest-growing homeless population nationwide, according to Dennis Culhane, a researcher at the University of Pennsylvania. Not only are people who struggle with chronic homelessness aging, but many seniors are becoming homeless for the first time in their lives.
Getting in and out of bunks, managing medications, and making it to a shared bathroom in time are among the major challenges of shelter life for older adults. Staff at traditional shelters sometimes ask seniors to leave if they’re unable to care for themselves.
The MVP is unusual among shelters because it provides on-site medical care to better serve its residents as they age.
Last spring, Jamie Mangum, who is in her 50s and has lung cancer, tripped and fell in her room. To visit with an emergency medical technician, she needed only to make it downstairs. Her swollen wrist was quickly wrapped, and she returned to her room. She said that wouldn’t have been possible at other shelters she’s stayed in.
“There, I’d have to wait hours as opposed to come in here, be seen,” Mangum said.
Mangum said that in other shelters she’d likely have had to find her own way to an urgent care office or get an ambulance ride. Specialized case managers at the MVP have helped her get treatment for lung cancer as well.
“We have clients that need memory care. Maybe they were living independently before, but they were unable to maintain that and got evicted due to dementia or different things like that,” said Baleigh Dellos, who manages the MVP shelter for The Road Home, a local nonprofit.
Specialized medical case managers work at the shelter. Primary care doctors and therapists visit weekly. Residents can even receive physical therapy in private spaces on-site.
A Path to Stability
The MVP partnered with the Fourth Street Clinic to offer medical care.
The first thing most new residents need help with is medication, said Matt Haroldsen with the Fourth Street Clinic, which provides health services at the shelter.
For people living on the streets, just keeping hold of regular medications is a challenge. “Their medications get jacked when they’re in their camps,” he said.
Diabetes patients without homes often bury their insulin to keep it cold. Haroldsen said they might forget where they buried it, or the vials might get too warm and spoil.
Helping residents at the shelter get those medications can stabilize their conditions, allowing them to focus on other priorities, such as getting an ID and other documents they need to apply for disability, Social Security, and various programs that can help them secure housing.
Nonprofits and local governments have opened similar shelters in Florida, California, and Arizona to meet the needs of older unhoused adults.
Having access to specialized shelters can be the difference between life and death, said Caitlin Synovec, assistant director of the National Health Care for the Homeless Council.
In cold-weather states, denying seniors a bed because of mobility and other health issues can be especially risky. In 2022, a Bozeman, Montana, senior froze to death after he was asked to leave a shelter because of incontinence.
Complex medical needs can pose a danger to other residents that most shelters aren’t prepared to manage.
“A typical shelter doesn’t allow somebody on oxygen to come in because that’s such a fire hazard and risk,” she said.
Synovec said giving seniors better access to health care inside shelters is the best way to help them succeed once they get housing. Health issues are a common reason seniors can’t afford or maintain housing, she said.
A Growing Model
The MVP model is showing promise, both in Utah and elsewhere.
“Over 80% of the people who’ve stayed in our program this past year have moved into stable or permanent housing,” said Jacob Torner, vice president of programs for the TaskForce for Ending Homelessness in Fort Lauderdale, Florida. The nonprofit runs a shelter called Elder Haven.
The MVP shelter near Salt Lake City is also marking success. It was able to permanently house 36 seniors as of late last year.
Still, there are more seniors in need of shelter than it can accommodate. Dellos, the shelter’s manager, said the MVP’s waitlist hovers around 200 people. She said the shelter prioritizes people based on medical need, not time spent on the waitlist.
For residents who do get a room, it’s life-changing.
Last spring, 62-year-old Jeff Gregg was playing fetch with his dog, Ruffy, just beyond the lawn in front of the MVP.
An old back injury forced Gregg to hunch over as he threw the ball. It also fueled a decades-long addiction to opioids. That cycle was hard to escape, he said.
“Fighting that, having a job, insurance, then losing the job, not having insurance, going out to the streets and being back in that crap, and I’d be back in the same position,” he said.
Gregg said sobriety took a back seat to more immediate needs like finding food and a bed in a shelter. He said the MVP was the first place where he could relax and focus on recovery.
“I was able to get clean. It took me a couple months, but I just kept plucking away,” he said.
He said the experience paved the way for him to get back surgery. He hopes that with less back pain, he can eventually get a job to help him afford an apartment.
This article is part of a partnership with NPR and Montana Public Radio.
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