Addressing the Urgent Treatment and Housing Needs of Older Adults

Behavioral Health News, Spring 2019

By Peter Provet, Ph.D., President and CEO, Odyssey House

In the midst of a devastating opioid epidemic, much of the attention has focused on the impact on younger populations, but there is another group struggling with substance use disorders: senior citizens. As baby boomers head towards their senior years, the number of older Americans with substance use disorders is growing dramatically, and with it, the need for specialized treatment has increased.

Odyssey House’s ElderCare program has focused on providing age-appropriate services for this population for more than 20 years by establishing specialized residential and outpatient services, developing a peer-run, community-based mentoring program, and more recently, helping seniors find stable housing in New York City after they have completed treatment.

Meeting the needs of an underserved population

Older adults represent one of the fastest growing segments of the US population in need of treatment for substance use disorders (SUD). The Substance Abuse and Mental Health Services Administration (SAMHSA) expects the number of adults aged 50 and older needing SUD treatment to double by 2020, from 2.8 million (2002 to 2006 annual average) to 5.7 million. In New York, the Office of Alcoholism and Substance Abuse Services reported a 39% increase in older adults admitted to SUD treatment from 2010 to 2016.

This data, coupled with national surveys that show older adults experience increased depression, isolation, and chronic medical conditions, point to the need for services that are age-specific and address the unique physical, psychological, and social changes that may occur during this life stage.

Odyssey House has a record of accomplishment in meeting the needs of this overlooked and underserved population. In 1997, we created the first-ever residential treatment program dedicated to treating older adults with SUDs, known as ElderCare. Since its inception, Odyssey House has increased capacity from 15 to 113 beds, reflecting the ever-growing demand for treatment among older adults.

While enrolled in the ElderCare program, residents receive specialized services and supports in addition to SUD treatment designed to help them to function independently within the community, such as life skills training, adult basic education, entitlements assistance, internal medicine, dentistry, and psychiatry.

In 2004, Odyssey House expanded services to include an outpatient SUD treatment track specifically for older adults. Because many elderly people are at risk of being cut off from their communities as they age, the treatment priorities of the ElderCare Outpatient Program, located in the Bronx, are to encourage older people to develop social support networks among their peers in recovery; provide them with individual and group therapy; and visit them in their homes as necessary. Counselors trained in geriatric care develop individualized treatment plans, incorporating age-related individual and group therapies targeting symptoms of depression and anxiety, bereavement counseling and life planning, and access to primary medical care.

To date, Odyssey House has served well over 2,500 older adults in residential and outpatient settings and serves an average of 150 ElderCare clients annually. The program consistently operates at full capacity and has a waiting list, reflecting a constant community need.

Older People in Recovery Face Housing Crisis

For older adults who have completed treatment, the lack of affordable housing is a major barrier to their ability to lead independent lives and maintain a healthy recovery.

In New York, Odyssey House is one of the only SUD treatment organizations to offer services specifically tailored to the needs of older people. Counselors trained in geriatric substance abuse provide treatment services that address underlying behavioral issues in an intensive program that helps older adults develop relapse prevention strategies, reunite with families, and build a supportive peer network. But key in helping them move on to independent, healthy lives in the community is affordable housing.

Almost half of the ElderCare population at Odyssey House (adults age 55 and older) were homeless when they entered treatment, stay in residential care for an average of 100 days longer than younger clients, and 25 percent fail to find independent housing, forcing them to cycle back to institutional living in community residences.

This is where the Fan Fox & Leslie R. Samuels Foundation plays an essential role. With their support, Odyssey House has hired a housing specialist to assist approximately 150 residents, who cycle through our ElderCare program, find, secure, and maintain independent housing.

By supporting this effort, the Fan Fox & Leslie R. Samuels Foundation is helping to serve more seniors in need by helping Odyssey House transition clients out of intensive residential care and freeing up beds for seniors on our waiting list. This grant also aligns with the mission and objectives of the Foundation’s Healthy Aging Program to improve the overall quality of life of New York City’s older adult population.

While the shortage of affordable housing affects all low-income New Yorkers, the need of this specific population to secure housing is urgent and becoming more acute as the number of older adults in recovery from SUDs increases.

In addition to their increase in numbers, the changing demographic and substance use pattern of older adults indicates that a wide array of psychological, social, and physiological needs will continue to grow, including demands for appropriate housing.