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Providing housing and services to allow seniors to live independently


Jackie Mayo, President and CEO, HomeSource East Tennessee

Challenge: Many affordable housing developers provide inexpensive, safe, healthy housing and assume that their residents have access to other vital services- such as healthcare, food and transportation. But many of their residents do not receive the medical services, home health services or mental health services that they need. Housing developers and their staff are rarely equipped to address these complex health and aging-related issues.

Two white women wearing colorful shirts

In 2010, John was wandering aimlessly around Knoxville. Suffering from the early onset of dementia, he had forgotten where he parked his car and where he lived. Local law enforcement eventually picked him up, scared and alone, and brought him to a local church. While he was unable to tell them his name or where he lived, he remembered the name of the property manager at his home. After some investigating, the church was able to contact LaShawn, the HomeSource east tennessee (HomeSource) property manager. John was so excited about seeing a familiar face; he immediately gave her a hug and let her drive him home.

John’s story was not unique to the residents at HomeSource’s senior properties. Like many affordable housing developers, HomeSource provided affordable, safe, healthy housing, assuming that their residents would have access to other vital services- such as healthcare, food and transportation- through other social service providers. But they came to realize that many of their residents were not receiving the medical, home health or mental health services they needed to age with dignity. In addition, many suffered from food insecurity and financial stress.

HomeSource’s mission is to strengthen communities by providing sustainable housing. But the board and staff realized that the traditional model did not go far enough to fulfill their mission of providing “sustainability.” They realized that they needed to expand the scope of their services to address the mental, physical, and emotional well-being of their tenants.

HomeSource hired a senior care coordinator to help manage services, provide workshops and training, and promote healthy living for their residents. After just eight months, the care coordinator had signed up over half of the residents to participate in the program. Working with two students from the University of Tennessee College of Social Work, the coordinator helped many of their customers access transportation, in-home care, and other critical services. In addition, their onsite workshops helped educate the customers on nutrition, the importance of physical activity, and mindfulness techniques. The students, while not serving as counselors, were able to dedicate a significant amount of time to provide the customers with a “listening ear,” a practice that validates and empowers the residents.  

Perhaps equally important, the care coordinator helped the residents access the in-home services that they needed to live independently. For instance, many of them have difficulties with one or more Activities of Daily Living (ADLs). The common reaction of adult children when their mom or dad has difficulty living on their own is to put them into a nursing home. This is rarely the desire of the seniors and is an expensive drain on the taxpayer-funded healthcare system. A more appropriate solution is to identify in-home care resources that can help the customer with their ADLs, often with just 1-2 home visits a week.

In addition, HomeSource researched senior services outside the housing sphere and discovered that the network of services is inefficient, underfunded and disjunctive. There are simply not enough services available and that many services (such as those provided by the healthcare system) are ineffective. Therefore, they also began to focus on promoting smart policies that would address the full-range of their residents’ needs.

On the regional level, HomeSource partnered with Fahe, a member-led non-profit that consists of 50+ housing developers in six central Appalachian states. Working with Fahe, along with groups in West Virginia and Kentucky, HomeSource is promoting policies that improve service delivery. In the last 12 months, Fahe has convened regional and state meetings around senior housing and services, throughout the Appalachian region. They are working on turning these coalitions into instruments to promote more effective senior housing policies.

HomeSource is also part of a state-wide group looking at policies around affordable senior housing and the connection of services. On the national level, HomeSource’s CEO was invited to participate in a focus group discussing rural senior housing.

On all levels, existing stakeholders have been surprised to find housing organizations coming to the table. Traditionally left out of the conversation, housing organizations are being recognized as an important contributor to the conversation. Stakeholders now realize that housing organizations can play a big role in the well-being of their residents, by providing safe, healthy housing, being cognizant of their residents’ situation and managing services and programs for their residents.

This project illustrates four important lessons learned:
  1. Housing developers cannot assume that their residents are getting all the services they need.
  2. Hiring an onsite care coordinator can help to promote healthy living.
  3. But there also needs to be change on the state and national policies.
  4. Working with partners, it is possible to begin to make a difference.

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