Seniors Struggle to ‘Age in Place’

Episode Notes

Transcript

Rhonda Cunningham Holmes:

Many of our clients help to build the community that they’re living in and they deserve to be able to age in place in it. So our focus needs to be on preserving the affordable housing that we have, creating more affordable, accessible, inhabitable housing so that everybody can live with dignity in their communities and that they will have an opportunity to just thrive.

Announcer:

Equal access to justice is a core American value. In each episode of Talk Justice, an LSC podcast, we’ll explore ways to expand access to justice and illustrate why it is important to the legal community, business, government, and the general public. Talk Justice is sponsored by the Leaders Council of the Legal Services Corporation.

Ron Flagg:

Hello and welcome to Talk Justice. I’m Ron Flagg, president of LSC and your host for this episode. Today we’re going to talk about aging in place, whether rented or owned a home is a means to health, safety, dignity and autonomy. Many seniors want to stay in their home for the years to come, but this can be hard to achieve, especially for those on low or fixed incomes. We have two experts joining us to discuss the desire to age in place, the legal challenges seniors are facing and national trends around seniors’ housing stability. Our guests today are Rhonda Cunningham Homes, the executive director of legal counsel for the elderly and affiliate of AARP. Rhonda leads a team of attorneys, ombudsman specialists, social workers and supporting staff providing direct legal and social work services to seniors in Washington DC. Rodney Harrell, vice president of family, home and community in AARP’s Public Policy Institute.

Rodney leads a team of experts on long-term services and supports, family caregiving and livable communities, and is an enterprise lead across AARP at housing and issues related to livable communities. Welcome Rhonda and Rodney. And Rhonda, let’s jump in with you. Our listeners, especially those not local to the DC area, may not know about legal counsel for the elderly and the organization’s connection to AARP. Can you tell us about what LCE is and who you serve?

Rhonda Cunningham Holmes:

Absolutely. And first of all, let me say thank you so much, Ron, for having me on your show today. I look forward to the conversation. So legal counsel for the elderly also called LCE. We champion the dignity and the rights of Washington DC older adults. So we’re talking about people who are 60 years of age and older, and we do so by providing free legal and social work services to those in need. And here we’re talking about serving those who are living at or near poverty. And for us, that means somebody who’s living an individual living alone on an income of $40,000 a year. So we approach it by addressing four key areas, housing, economic security, health and safety and self-determination. All of those things that you were talking about older people need to live with dignity as they age. As you mentioned, we are a proud affiliate of AARP.

We just celebrated our 50th anniversary last year. We were established by AARP through a grant that they applied for from the Administration on Aging, so a federal agency grant. And today our staff, together with our pro bono partners who give thousands and thousands of hours of pro bono service to us each year, together we’re able to reach more than 10,000 people annually through the work that we do.

Ron Flagg:

Well, thank you, Rhonda. And of course, as you know, but I’ll tell our listeners, I’m a big fan of LCE. I was a pro bono volunteer for many years and even was a chair of the board back in history a couple decades ago. So congratulations on the 50th anniversary and all the great work that LCE has done and continues to do.

Rhonda Cunningham Holmes:

Thank you.

Ron Flagg:

Rodney, could you describe the work that you do at AARP related to studying and promoting livable communities for seniors?

Rodney Harrell:

Sure. And thanks also, Ron, for having me. And I’ll say first as a DC native, I’m also a long fan of the work that LCE does for older adults in our community. And I’m equally excited about the work that the broader AARP does on creating livable communities and helping provide the options that people need as they’re aging. A lot of our work is focused on the fact that roughly three quarters of people age 50 and older want to stay in their homes and communities. It’s what people want, but our research, other research has long shown that there’s challenges that can prevent people from doing that. As we age, as our income changes, as our ability level might shift, there are many factors that kind of get between people having their best life outcomes and where they are today. And I’d like to think about our goal as creating more options, more ability for people to have the places that work for them.

And that starts with our homes, our communities, the long-term care options, the other supports and services that can help people thrive in the places where they want to be. One other thing I’ll just note is this isn’t a new problem or a new challenge. It’s one that’s inherent in us. We just celebrated the nation’s 250th anniversary and we’ve long been building our homes and communities with this assumption that we have mostly younger people. Well, that doesn’t work anymore. We have 10,000 people turning 65 every day. By the next decade, we’ll have more people over 65 than under 18 for the first time in US history. So we’re changing as a society, but our housing, our communities, they haven’t caught up with our needs as we’re aging. And that’s a lot of the work we do is trying to help people, community leaders and others try to make communities more livable and provide more options.

Ron Flagg:

Well, Rodney, you may have covered some of this already, but let me ask anyways. When AARP has studied Americans’ desire to age in place, have you found that that’s a major concern for people? And then relatedly, what factors are people considering when they think about aging in place and their ability to age in place?

Rodney Harrell:

Well, I mentioned that three quarters of folks 50 and older want to stay in their homes and communities, but 44% don’t believe they’ll be able to do that often because housing costs are a challenge. Affordability is a huge concern for many of us. And also because they may be in communities that aren’t designed to support them as they age. So if something changes, if their ability to drive shifts, if their ability to get up and down stairs shifts, if their spouse passes away and they need a smaller place to live or something more manageable, they may not have that. So those are the kinds of challenges that make people not think that they can do that. And frankly, many of them will have to make compromises if they’re willing to stay in their communities or if they want to stay in their communities. A Harvard Joint Center study says that less than 1% of our homes have all of the features that people need to support them as they’re aging.

And more than half of the people we talk to recognize that their homes need to have modifications for them to stay there. So when we’re thinking about all of the things that can help us either thrive in a neighborhood or prevent us from being there, many more of us are facing challenges than frankly we should be.

Ron Flagg:

Rhonda, thinking about this from, and I know LCE does both social services as well as legal services, but putting my legal thinking cap on, I see really kind of two major categories for legal issues that impact housing. First, there are those cases which really start and end as housing legal issues. Often they involve eviction. And then there are other non-housing civil legal issues such as employment or indebtedness that aren’t housing related initially, but transform themselves and create financial strain or other instabilities in a person’s life resulting in housing challenges. Does that comport with your experience and your work and what you see at legal counsel for the elderly?

Rhonda Cunningham Holmes:

I would say yes. As an initial matter, it definitely comports to what we’re seeing. We have a lot of legal issues. In fact, between in the last five years, I would say 20 to 22% of the cases that we address are housing related. And then we have other issues that we are dealing with and the other 80% or so. But then even some of them end up being in housing related issues. So you may have a health related issue or you may be financially exploited and these can lead to you having a housing related issue as well.

Ron Flagg:

And of course, what we saw nationally, and I’m sure you saw it here in DC in your work with a pandemic when there was a spike in unemployment at the outset of the pandemic and you lose your job, you lose your ability to pay rent. So housing became an enormous issue for many people and the risk of losing housing became enormous. And that’s where things like eviction moratoria and rent assistance programs came in and were actually quite successful in tamping down on what would’ve otherwise been a huge spike in evictions. But those things were not automatic. It required organizations like LCE to help people enforce the eviction moratorium to help people get emergency rental assistance. All of these data and descriptions at a high level are interesting and compelling, but I always find, and I’m sure you find Rhonda, that it’s the client’s experience and stories that are most telling.

So could you share a client story that illustrates how LCE is able to serve seniors who come to you because they’re at risk of being evicted?

Rhonda Cunningham Holmes:

Absolutely. And there are several reasons for an eviction as you know. And thank you for mentioning all the things that were done during the pandemic. Some of those laws that were temporarily passed became permanent, but there’s still a great need out there to help the people that we serve. You may have a lease agreement that is breached that may lead to eviction, but I would say the most common that we are seeing is nonpayment of rent. And the nonpayment of rent is for a number of reasons. Most of our clients, I should say at the outset, want to pay their rent. That is something they absolutely want to do. But as you mentioned, many of our seniors are living on fixed incomes while the cost of housing is rising. And then there are health conditions that can lead to a loss of a job. And so in this first example that I’m going to share with you, this first story, we’ve talked about Ms. M.

She was 61 years old, she is 61 years old, a bus driver. Unfortunately, she had a stroke. And as a result of having a stroke, she lost her job. She got behind on her rent and she was threatened with eviction. Now she was just 61 years old, so she wasn’t yet eligible for Social Security retirement. She did receive SSDI. And so SSDI is Social Security Disability Insurance. She received that, but it was not enough to cover her rent. So our approach is to address the whole person. And one of the problems that Ms. M was having is that she wasn’t able to accept that things weren’t going to be as they had been. Our attorney and our social worker helped her to understand that she was not going to be able to go back and have that job that she had before and that she really was living in more house than she could afford.

So we also had the landlord to deal with and we made an agreement with the landlord. We were able to get her to finally understand that she needed to move to a more affordable housing and the landlord in exchange for her moving would waive the arrearages. So we were able to settle this case fortunately for Ms. M, so that she could move to a place where she wanted and that she could afford and not have the eviction on her record. And the landlord of course was pleased that he could then go on to rent to another person.

Ron Flagg:

Two things jump out at me from your answer that I’d like you to elaborate on. One, you mentioned an eviction remaining on her record. Can you talk about why does that matter?

Rhonda Cunningham Holmes:

That matters because when you apply for a new apartment, they look to see if you had problems with paying your rent in the past and they can then choose to not rent to you based upon that. That is something that we are trying to make sure that that does not stay on people’s records and under certain circumstances it can be removed completely. So she doesn’t want that following her. And that is the reason why we try very hard to make sure that we negotiate with landlords so that individuals can move. They may be on a payment plan to pay back arrearages or it may be forgiven or they move and the landlord does not count that against them. These are things that you want to make sure you take into account in addition to making sure that they have the housing that they need.

Ron Flagg:

It strikes me the story you just shared underscores why in many cases, landlords actually appreciate the tenants they’re working with being represented by somebody who can help facilitate the dispute resolution process. It’s not just we versus they.

Rhonda Cunningham Holmes:

Right. I mean many of the landlords in the District of Columbia are aware of LCE. They sometimes will come to us when there is a problem with a tenant, particularly somebody who’s been living in one of their properties for a long time and they stop paying their rent or they’re late or they’re having housekeeping issues. They’ll come to us and we have a social worker who will work with them. We have several social workers actually that will work with them to help the tenant, to help them to get in place what they need to support them so that they’re able to continue paying their rent so that they can make sure their homes are appropriately kept. And it is in the best interest of not only the tenant, but it is also in the best interest of the landlord if they don’t have to go through the eviction process because the eviction process is a very long process.

You don’t get a notice and get evicted the next day. So they are aware of this and they appreciate whenever a tenant has representation.

Ron Flagg:

And I’ve talked to landlords over the years and they point out what business has as its business model routinely throwing out their customers. So it’s really not a very lucrative business model. You mentioned social workers and obviously the L in LCE is legal. Legal aid is a common term. I think most people think of legal aid, legal counsel as providing lawyers. Can you talk about the role of social workers and the interplay between their work and the work that your legal resources are providing?

Rhonda Cunningham Holmes:

Yes. We like for our attorneys to be able to place their attention on providing legal representation. And some of the issues that we confront with tenants and other cases that we deal with, but we’re talking about housing right now, we are facing individuals who may need to get documentation together and need to understand how to pull this documentation because they need to present it to a landlord or they may need to present it to a doctor or whatever. They need to pull together information. They need assistance in getting food. They need assistance in a lot of other things that are not really truly legal. And here’s where a social worker can come into play. They can come in and they can assess what the client may need and assist them to getting to the right resources so that they can live with the dignity and with the resources that they need and thrive basically.

We want them to all thrive. And that’s where our social workers come into play.

Ron Flagg:

Thank you, Rhonda. We talked a bit before about the other sort of legal case in which housing is implicated. That is one where a senior or somebody else faces a legal problem that is not housing necessarily an employment issue or an indebtedness issue with credit cards or other sorts of, or medical debt, for example. And then it mushrooms into affecting other aspects of their life, including housing. Do you have a particular case that comes to mind that illustrates that scenario?

Rhonda Cunningham Holmes:

Yes. Well, I guess I kind of said a little bit about losing your employment in that last one, but I will talk a little bit about a grandmother who was living in housing in an apartment building. She lived on the third floor. She lived with two young grandchildren and she was beginning to have a problem with her leg swelling. As a result of this, she was having difficulty getting up and down the stairs. And you’re wondering why is she taking the stairs when she lives on the third floor? Well, there was an elevator, but the elevator was frequently not working. And so because the elevator wasn’t working all the time, she had to navigate the stairs. And when she couldn’t, she would suffer from missing doctor’s appointments or childcare or school appointments, various things. And she even got stuck on the elevator. Well, she needed a reasonable accommodation.

She asked the landlord if she could move to the first floor. He agreed, but it was going to cost her $500 more. And that was something that she simply could not afford. And despite the situation, she continued to try and pay her rent, but the landlord did not give her a break on it. In addition, in her apartment, there was persistent mold. There were persistent moisture, lots of mold, and even a piece of the ceiling fell and hit one of the children. Fortunately, the child was not seriously hurt, but this was the kind of condition that she was living in. And she lived in this condition for four years. She finally got pretty fed up and she started withholding her rent. And as a result of that, I think you can guess, she was facing eviction for non-payment of rent. She wanted to move to a more affordable place, but she could not afford to find anything that…

She couldn’t find anything in her vicinity that was affordable. And so she came to legal counsel for the elderly. And in this instance, she is a current client. We have two cases before the court with her. First is the counterclaims to her nonpayment of rent. And the second is a tenant position to recoup overpayments based on the conditions that she was living in. And she could receive trouble damages for that. So that is where we needed a reasonable accommodation, which is a legal issue. The landlord presented something, but what he should have done was make sure that there was a working elevator and then she would never have had to move. But this is the kind of thing that our clients are regularly facing.

Ron Flagg:

Well, thank you for that sharing that story. Rodney, a lot of the circumstances that Rhonda has been describing involve people’s ability to pay for their housing. Can you tell us what your research and AARP’s research shows? How common is it for older Americans to be cost-burdened by their housing? And as you answer that, when I use the word cost burden, what does that mean to you and what do researchers consider cost burden to mean?

Rodney Harrell:

Sure. Before I jump into that, I think it’s interesting that you started this segment by thinking about COVID and we talked a little bit about financial strain and the like. And to me, one of the big lessons from COVID, one of the many lessons of COVID was just how close many of us are to having the poor outcomes. That one shift, one change, one job loss, one pandemic, one shift often took people from that stable place to the instable place. And frankly, it taught a lot of us about social isolation that comes with it and it taught a lot of us and our policymakers about how much that affordability challenge is. And so I look at it as one of those moments that made a lot of people and a lot of leaders think about affordability maybe for the first time, but the issues have been there for a long time.

According to studies, roughly one in three homeowners age 65 and older are considered cost burden. About half of older renters are. And by that I mean that they pay more than 30% of their income on housing. The idea is that’s a marker to note that it’s more than what’s stable, that if there’s another shift that happens of any negative kind, you might not be able to pay your other expenses or you might not be able to pay your housing and end up in a worst case scenario. And so I mentioned some survey numbers earlier about the people that don’t think they could stay in their community and the like. And it really reflects this environment where many of us are in housing today that works for us right now, but again, are so close to one shift making that not work. And for if your housing costs burden, that really puts a lot of pressure on the rest of your life.

Housing may be the biggest expenses, but with healthcare, groceries, transportation, home modifications you might need, saving for tomorrow. Those things are always a challenge. So one of the biggest things that we’re looking at are ways that we can help the housing affordability challenge that folks are facing while also thinking about the fact that I mentioned earlier that the housing units aren’t necessarily working for older adults. So things like maintaining subsidized housing. Accessory dwelling units are options that we could put in an apartment in your backyard that perhaps may be a smaller place to stay, a more inexpensive place or a place to stay if your home doesn’t work for you. Increasing the ability to build smaller different home types that work for people. These are things that communities can do to try to create more options for folks. And I often encourage them to do that and for us as individuals to think about what might happen if our spouse passes, if we stop driving.

If we have the ability to think for the future about what might happen to us, we can do what we need today to make the best situation for ourselves.

Ron Flagg:

And of course we’ve been talking about employment, but when you’re talking about seniors or really anybody, people with families, the additional unanticipated expenses healthcare related. Many, many people, all of the people who are cost burdened as you’ve described, or nearly all of them are one emergency surgery away from not being able to pay their rent because all of a sudden they’ve got medical bills that they didn’t previously have, whether it’s for themselves or members of their family and all of a sudden a medical issue has been transformed into a housing issue. Rodney, for the senior populations that we’re focusing on today, the alternative to aging in place is not necessarily a nursing home or living with a family member. It’s homelessness. I’ve heard that rates of homelessness are increasing for American seniors. What are you seeing at AARP?

Rodney Harrell:

Well, to your last couple of points is unfortunately the case that we have to really think about older adult homelessness in different ways than perhaps we have been in the past. I’m thinking of a gentleman who I know who had his own business. He had a health incident. I believe it was cancer, but was it stopp him from being able to run his tourism business? And then he couldn’t get in and out of his place as well and he couldn’t afford to keep it because of the job loss. And all of that trickled down into him not having a stable place to live for at least a couple of years. Eventually he was able to get subsidized housing in a neighboring county, but that happens to so many people. According to our analysis of census data, an estimated 187,000 adults, 55 and older experience homelessness in a given year.

That was from 2025 and that is anticipated to keep rising. Many of these older adults are especially vulnerable. They’re more likely to be veterans. They are more likely to have chronic physical or mental health conditions and need supportive services in addition to housing. And so the real tragedy is that the lack of housing affordability and the instability that comes from it can then lead to exacerbating some of those challenges, the health issues. Imagine being unable to withstand extreme heat, cold, unsafe living conditions, the other things that could come with experiencing homelessness. And so that’s why it’s so important to have, again, a wide range of housing solutions that are affordable for folks and some of the assistance that we’re talking about, the legal assistance to prevent evictions, but also to just create the housing that folks need so that they have more options to begin with and fewer people are in that position that they might experience homelessness.

Ron Flagg:

Thank you. Rhonda, I wanted to also highlight the services LCE provides for home-bound seniors. Kadia, please tell us about that program.

Rhonda Cunningham Holmes:

Absolutely. So we have a Project HELP and it stands for a HomeBound Elderly Legal Project. And just like in days past where doctors would come and make a house call, this is a legal house call. Our lawyers will go to a person who is home bound. And the reason we do this is because we want to make sure that they know that they are still seen and that they’re visible and that they have access. It is really important for people to feel that they are seen and that we will take care of them regardless of where they are, that they are not alone. And it helps to alleviate some of the fear they may have with aging. We go to their homes wherever they live and we address whatever their legal problem is. Any of the four areas that I had mentioned previously, we will address.

What we see most commonly is economic insecurity. We need to make sure that they have all of the benefits that they should receive. And so we help them to get those benefits. We also make sure that they are living in a safe environment. So they’re having mobility issues within their house. They may not be able to go out, but they may be able to navigate within their own house. We want to make sure that they have the safety apparatus there so that they can get around appropriately. And that we continue to look at affordability because affordability is so important. And many, as you have just stated, people don’t want to be homeless. They also many don’t want to go into a nursing home. So we’re helping them to stay in their community.

Ron Flagg:

That’s a terrific program. Thank you. Rodney and Rhonda, I want to give you both the opportunity to close here with final thoughts or recommendations for where people can go to learn more about aging in place and related issues. Rodney, why don’t we start with you?

Rodney Harrell:

Sure. And speaking of nursing homes, one of the biggest barriers to leaving a nursing home is having housing that’s affordable and that’s safe and that meets your needs. And so again, these issues are interconnected and the idea that we don’t have the right housing solutions is really challenging us in so many ways. If I was to boil it down to one takeaway, it would be this, that we as a country need more housing options and especially those that allow people to age with dignity, independence and choice. I’ve been tracking this issue for a while and there are estimates of our national housing shortfall of between one and a half and five and a half million, depending on who you ask, but there’s millions of homes shortage for this country. And then if we think about the fact that one in five of us will be 65 or older by the end of this decade and that we have not been building homes that meet our needs, les than 1% of them have all of the features that people need, you see the gaps that we’re talking about here.

We have an opportunity and a need now To create the homes that people need as they’re aging, to modify the homes that we have, to create more housing options, and to make sure that people can have what they need to be stable, to increase that stability. But we have to embrace that challenge from us as individuals to our city leaders, to our state leaders, to our national leaders. We really need to pay attention to the issues that we’re all facing here. And I think it’s just urgent that we start to really look at what we can do because this isn’t something that can change overnight. Leisures that we’re talking about today take a long time to develop and these folks that are having these challenges are, you could trace back to if only there was a different housing option for them in the first place, maybe one that was more affordable, that was safer, that maybe one that was more accessible.

And if they were in that, how much better would that story have been? Rhonda would’ve had a hard time coming up with one today if we had solutions for everybody. And that’s what I would hope 20 years or 30 years from now that we’re able to do that. So it’s a challenge that requires collaboration across all of us, something that we need to tackle. For anyone that’s interested in learning more, I’d ask them to check out our website at futureofhousing.arp.org where they can learn about the trends that are impacting our housing challenges in this country and why and how we can look at solutions and the challenges that we have. And importantly, those innovative solutions that are already in place that help communities better prepare for us as we age. But again, this challenge that we have, I think is nationwide and it really does impact all of us.

Ron Flagg:

Thank you. Rhonda, final thoughts?

Rhonda Cunningham Holmes:

Sure. And I appreciate what Rodney says because we really do want to put ourselves out of business and 20% of the time that we’re spending on housing issues could definitely be eliminated by having more options. I will say that all seniors really truly want to age in place and they should have a choice. They want to be in familiar surroundings. Many of our clients help to build the community that they’re living in and they deserve to be able to age in place in it. So our focus needs to be on preserving the affordable housing that we have, creating more affordable, accessible andhabitable housing so that everybody can live with dignity in their communities and that they will have an opportunity to just thrive. And that’s what we want for our clients. And as we’re looking forward, I would say the other thing that the other message that I want to get across, Ron, is because I know that many of your listeners are lawyers out there and they have an obligation to help.

So we need more people stepping up to take on pro bono cases. I will say that whenever you go to the courthouse, about 10% of the tenants are represented by attorneys. About 90% of the landlords are represented by attorneys. And for those who are represented by attorney, their chances of prevailing or getting an appropriate resolution to the situation is much higher when they are represented. So I would encourage those who are listening who are attorneys to think about doing some pro bono work and helping out some of the people who really truly help to build our communities.

Ron Flagg:

Rodney and Rhonda, thank you for helping to bring these critical issues impacting seniors to the forefront and even more importantly for the work that LCE and AARP are doing to serve seniors every day. Thanks to our listeners for tuning in to this episode of Talk Justice. Be sure to subscribe so you don’t miss an episode and stay well.

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