Advancing Housing Outcomes for Low-Income Seniors

The lack of appropriate housing with support programs can make it difficult for low-income seniors to age in place. Older adults with disabilities or chronic health conditions are especially vulnerable. These issues are made worse by a lack of coordination between services, such as:

• housing
• health care
• community services

The City of Toronto’s integrated service model for Toronto Community Housing was designed to break down silos. Making evidence-informed decisions on implementing and evaluating this model, however, is challenging. The Advancing Housing Outcomes for Low-Income Seniors project will help the City of Toronto develop, co-create and evaluate this new model for low-income seniors. This feedback will help optimize the City of Toronto’s efforts to improve the overall wellness of older adults.

Project scope and expected outcomes

The current organization of housing and support services in Toronto is not meeting the needs of older adults in social housing. Many seniors and caregivers have expressed frustration at the complex and siloed health and community care system. Furthermore, older adults in social housing are at higher risk of:

• poverty
• social isolation
• other health challenges

Older adults are a significant and growing part of the population in the City of Toronto. Many are aging in place in social housing: over 14,000 seniors live in the 83 designated Toronto Community Housing Seniors buildings.

The City of Toronto worked with Toronto Community Housing and the former Toronto Central Local Health Integration Network to create an integrated service model. Working with seniors and other stakeholders was an important part of the model’s development. The model improves the delivery of housing services and access to health and support services for older tenants. The ultimate goal is to enable older adults to age in place with dignity and in comfort.

Addressing the health and social care needs of vulnerable older adults

Deciding how to implement the recommendations — and measuring their effect — is crucial for ensuring the model achieves its goals. With support from the National Housing Strategy Research and Planning Fund, the Advancing Housing Outcomes for Low-Income Seniors project aims to:

• Improve the overall wellness of vulnerable older adults, including those with a disability or chronic health condition.
• Support older adults to safely age in place.

To that end, it will do the following:

• Support the City of Toronto and their partners in designing, implementing and evaluating the integrated service model for seniors housing.
• Create a toolkit to help other Canadian cities find solutions to their own housing challenges for low-income older adults.

This will create a more integrated service delivery model that addresses the health and social care needs of low-income older adults.

Sharing information in real time

The project will use a collaborative and consultative process that reflects the philosophy of “nothing about us without us.” It incorporates the perspectives of stakeholders, including:

• older adults
• health-care and community agencies
• housing and city staff

The project will involve the following steps:

• Identifying key stakeholders to provide input into the new housing services model.
• Gathering evidence and data to inform the development of the new model. Methods include a literature review and environmental scan and qualitative interviews with older adult tenants and service providers.
• Co creating an implementation and evaluation plan.
• Implementing a pilot version of the action plan and collecting further data on the implementation processes. This includes qualitative interviews with older adult tenants, service providers and housing and city staff.
• Revising the plan and continuing to collect data. This will be repeated as often as needed.
• Reporting the conclusions.

Evidence and data will be used to revise policy and practice, with new information shared in real time. This constant feedback ensures that the interventions are put in place quickly and effectively.

Sharing with other communities

The housing services model fills an important gap by working to care for older adults by integrating health and social services and approaches. The Advancing Housing Outcomes project will raise the profile of the City of Toronto’s efforts to improve housing for seniors. It will also assist with its continued efforts to become a leader in providing age-friendly services.

A major goal for the project is to create a toolkit to support interested parties to develop their own housing strategies. This includes housing programs for seniors and other vulnerable populations in other communities. They can potentially learn how to foster effective research–policy partnerships to support evidence-based decision-making. Partnerships for future research projects are being planned with Mississauga and Alberta.

The project’s findings will be generalizable to other types of programming for seniors and other vulnerable communities. Lessons learned are expected to be applicable in any situation where multiple agencies are collaborating to deliver programs. For instance, the research will demonstrate opportunities for more effective collaboration between housing providers and health-care agencies.