At 82, Roberta Rabinovitz had no place to go.
A widow, she had lost both her daughters to cancer. She’d lived with one and then the other, nursing them until their deaths. Then she moved in with her brother in Florida and helped care for him, until he also died.
“My doctor said, ‘Roberta, you cannot keep taking care of everybody!’’’ Rabinovitz recalled.
And so last fall, while recovering from lung cancer, she moved again – this time, into her grandson’s apartment in Burrillville. She was sleeping on the couch. Every time she wanted to shower, she had to climb a steep staircase. She was so frail, the stairs were dangerous, but she had nowhere else to live.
“I found myself very depressed,’’ she said, and thinking “where am I going to go?”
Like so many older adults, her only income was her Social Security check. And like a growing population of older Americans, rents for a safer place to live in Rhode Island were out of reach.
Rising housing costs are pricing out a growing number of older Americans. In Rhode Island, more than one in six people who were homeless in 2024 – 1,572 people – were 55 or older, according to an analysis for The Public’s Radio by the Rhode Island Coalition to End Homelessness. It’s why some organizations are coming up with creative approaches to help older people find housing, as well as medical care.
Before Rabinovitz’s husband died, she had lived a middle-class life in the suburbs of Boston. Her husband managed an auto parts store; she worked as a senior credit analyst for a health care company. But by age 50, she was a widow with little savings. When her husband died in 1992, she said, he had no health insurance or pension. And like many women widowed in their 50s, after children are grown but long before social security kicks in, her finances deteriorated along with her health.
“It’s a national scandal, really, that the richest country in the world would have destitute, elderly and disabled people,’’ said Professor Dennis Culhane, who specializes in homelessness and housing policy at the University of Pennsylvania.
For some older people, a single incident can tip them into homelessness – the death of a spouse; a job loss; a rent increase; an injury or illness. “No one imagines anybody living on the street at 75 and 80,’’ said Sandy Markwood, CEO of the national association USAging. “But they are.”
For Rabinovitz, signing up for a plan with an organization called PACE changed her life. PACE stands for “Programs of All-inclusive Care for the Elderly.”
PACE health plans operate in 33 states. They enroll people 55 and older who are sick enough for nursing home care, and then provide everything their patients need to stay home. PACE pools clients’ Medicare and Medicaid money and uses it to pay for housing, medical care, meals and other regular expenses. They also run centers that function as medical clinics and adult day centers, and provide transportation.
PACE organizations aim to keep frail, older people in their homes. But a patient can’t stay at home if they don’t have one. And as housing costs rise, PACE programs in places like the Detroit area and in San Diego are finding creative ways to manage them.
At PACE Rhode Island, which serves nearly 500 people, about 10 to 15 participants each month become homeless or at risk of homelessness, a rare situation five or six years ago, CEO Joan Kwiatkowski said.
The organization contracts with assisted living facilities, but its participants are sometimes rejected because of prior criminal records, substance use, or health care needs that the facilities feel they can’t handle. And public housing providers often have no openings.
And as affordable rental apartments in Rhode Island are increasingly scarce, PACE is looking to buy property to convert into senior housing. But Kwiatkowski said that, too, has been challenging. Since PACE Rhode Island is a nonprofit, they don’t pay property taxes.
“In fact, we lost a property in a town that will go unmentioned,’’ Kwiatkowski said, “because, you know, the mayor wanted the tax revenue from apartments, as opposed to us.’’
PACE helped Rabinovitz move off her grandson’s couch and into her own apartment in an assisted living facility in Bristol — one of four apartments PACE reserves for its clients.
On a hot afternoon in late June, she invited The Public’s Radio us in for a visit.
Her studio apartment (her “penthouse”) is decorated in purple, her favorite color.
Cool air blasts from her air conditioner, which . It was purchased for her by PACE.
Medicaid rules allow her to keep $120 a month from her Social Security check for personal items. She uses the rest to pay her rent.
“I wake up every morning and think, ‘Oh, I have to go to breakfast,’’’ she said, brightly. “Isn’t that wonderful?!”
And she’s found a home of her own.
This story comes from NPR’s partnership between The Public’s Radio and KFF Health News. A version of this story by Felice J. Freyer appeared in KFF Health News.
