My Reflections: 10 Years of Working to End Elder Homelessness

by Kathy MacDonald
March 07, 2012

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Kathy MacDonald, LICSW, is a Clinical Social Worker for Hearth in Boston, Massachusetts. Hearth’s model of service-enriched supportive housing provides elders experiencing homelessness not only with a place to live, but the services and supports to keep them housed. In this blog post, Kathy shares her reflections upon approaching 10 years of service at Hearth, considering what is at the core of the organization’s work in ending elder homelessness.

In just a few weeks, I will celebrate 10 years of working at Hearth. This has made me think a lot about the work that we do, why we do it the way that we do, and what keeps me here. Although homeless services organizations around the country serve elderly people, Hearth is the only one with a sole focus on and comprehensive approach to ending elder homelessness.

Our clients are not always easy to help. We often house people who no one else wants to house. Sometimes our clients make me laugh, and sometimes they tell me stories about their lives that break my heart. Many struggle with mental illness, intellectual disabilities, medical issues, substance abuse, or all of the above. Because of all of this, some have what one might call “behavior management issues.”

But I am constantly impressed by their strength and resilience.

At Hearth, we believe that it is not enough just to find a place for an elder experiencing homelessness to live. Many elders need additional supports in order to stay housed and to thrive. This is why our model is one of service-enriched supportive housing. Each of our six residential programs has a site director, a licensed social worker, and a registered nurse, as well as personal care homemakers and numerous paraprofessional staff.

There are so many elders we have helped over the years.

Bill* was 70 years old when he came to Hearth after living 25 years under the Massachusetts Avenue Bridge with untreated Schizophrenia. He lived there year round because he did not feel safe in the shelters. To say that it’s cold under a bridge in Boston in the winter is an understatement. At Hearth, we gave him housing and helped him turn his “junk food junkie” diet into a healthier one. We also gave him a new community of peers and friends (with whom he could often be found joking in the lobby). We made him feel safe.

Another elder, John*, struggled for years with substance abuse and mental health issues, then had several small strokes. He was often victimized on the street and suffered from terrible anxiety as a result. But the structure Hearth’s program and staff gave him has helped him to recover, and to feel secure. He now goes to Adult Day Health twice a week, and - not one to sit around in his room all day - participates in every activity we offer, including Bingo, Art Therapy, and Wii Bowling.

In April, Hearth will open a seventh site that will house 59 elders experiencing homelessness. It will expand our capacity by 40 percent and offer the same service-enriched housing environment as our other sites.

And as both Hearth and I turn a new corner, I think about what has kept me here. It’s knowing that the work my colleagues and I do every day matters. It’s knowing that from the Board of Directors down, people here truly care about the elders, and we care about each other, too. And it’s knowing that our programs translate into fewer elderly folks who are cold, hungry, alone, without the care they need, or sleeping under bridges every night.

*Not their real names. Their names have been changed to protect their privacy.

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