Misty Nomberto: Utah can’t ignore the correlation between dementia and homelessness

Homelessness among older adults is rapidly increasing and is expected to grow to 2.5-3 times the current rate by 2030.

(Rick Egan | The Salt Lake Tribune) Workers clear the area during the abatement of Fort Pioneer, on Thursday, Feb. 17, 2022.

They call it the silver tsunami. The Boomers are aging into retirement and beyond. We see them everywhere — in our politics, helping our school-aged children cross the street and greeting us at big box stores. They prepared for this by buying their home, saving and investing.

But what happens when an emergency arrives? The death of a spouse, cancer, being priced out of housing due to a fixed income, fraud or worse yet: the onset of dementia.

More and more seniors are becoming homeless, and dementia is exacerbating the problem.

I work in the field of private long term dementia care. I recently took a call about helping one woman find housing for her husband who had dementia. They couldn’t afford private care or a private pay facility. We discussed the New Choices Waiver, a long term care Medicaid benefit available to some Utahns, and contacting aging and adult services and the Alzheimer’s Association for assistance — but she hung up without many options.

Another woman I spoke to worked two jobs and refinanced her home to pay for her husband’s dementia care.

This isn’t as uncommon as you may think, but what if they don’t have a home to sell? Or family to help care for them? Homelessness among older adults is rapidly increasing and is expected to grow to 2.5-3 times the current rate by 2030. There are local agencies offering solutions like Switchpoint, a low income senior housing program designed to promote dignity and give unhoused seniors a housing option, but most of the available solutions appear to assume some level of independence for the resident.

The Alzheimer’s association reports that there are about 34,000 people in the state of Utah living with Alzheimer’s and even more who have other types of dementia. About 10% of Utahns above age 45 are experiencing cognitive decline. A recent study examining associations between homelessness and dementia found a high risk of homelessness following a dementia diagnosis. The same study also found that the risk of dementia increases after someone becomes homeless. This correlation needs to be examined as we consider the homeless crisis among our older generation.

When someone is experiencing dementia, their executive function is affected early on, making complex reasoning — like bill paying or replacing lost identifying documents — incredibly difficult, if not impossible. As the disease progresses, being able to provide basic care for themselves decreases until they can’t care for themselves without assistance.

In Arizona, some homeless shelters are hiring caregivers to help take care of the needs of the older residents but dementia care requires training to understand how to communicate and care for someone with dementia. The Washington Post reported about a homeless gentleman with dementia who left the shelter and was eventually found waiting at the airport for a flight that he had no ticket for. He didn’t even know how he got to the airport. Another family received a call from a hotel where their father was found. Nobody knew how he got there either. He, fortunately, had a family who could help. Not everyone is so lucky.

In Utah, the first thing we can do is expand dementia training among first responders. Until a better system is in place, first responders will be the initial contact for homeless individuals with dementia and if they don’t know how to communicate with and redirect someone with dementia, it could be dangerous for the older adult.

I would also call upon for-profit assisted living communities to start a grant program for unhoused individuals with dementia. There are 126 assisted living communities in Utah. If each one housed two underprivileged residents through grants, it would go a long way towards helping this crisis.

Misty Nomberto

Misty Nomberto is a local memory care director in assisted living, a dementia dialogues instructor and a master of social work student at the University of Utah.