Partnering to Support Needs-Appropriate Housing for Older Veterans

October 20, 2026

Takeaway: his project produced a novel implementation blueprint, informed by community partners, for strengthening a HUD-VASH initiative for aging and/or physically disabled Veterans experiencing housing instability. Findings were disseminated VA-wide via a presentation for the National Center on Homelessness Among Veterans; the blueprint also has been shared with HUD-VASH teams to help inform on-the-ground practice.

Background

According to the National Alliance to End Homelessness, 5 million Americans ages 65 and older live below the poverty line, and more than 138,000 Americans ages 55 and older experience homelessness on any given night. Homelessness can exacerbate pre-existing physical and mental health conditions and increase social isolation among aging Veterans. Further, a report from the U.S. Interagency Council on Homelessness -from counts conducted in January 2017 in communities across the country-shows nearly one-quarter (24%) of Americans experiencing chronic homelessness were individuals with disabilities.

Homelessness among older Veterans (aged 55+) rose 150% from 2010 to 2023, reflecting a critical housing crisis. While Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH) offers support, older and/or disabled Veterans may require a more tailored approach. To address their needs, the HUD-VASH program offers specialized support and care coordination to facilitate permanent housing for older and physically disabled Veterans (VA Homeless Programs, 2024) and offers home-based care, as needed.

Implementation Blueprint for Optimal Partnerships to Support Aging-in-Place

Drs. Nathan Boucher and Jenny Palmer, and colleagues, led a pilot initiative (2023-2024) to improve services for older and/or disabled Veterans experiencing homelessness. They analyzed national assessment data, conducted interviews with 18 HUD-VASH Geriatric Specialists, and facilitated user-centered design sessions with VA staff and community partners in the areas served by VA Bedford Healthcare and the Durham VA Medical Center. They found that challenges included communication barriers, administrative complexity, resource gaps, unclear roles, geographic diversity, and limited information sharing.

These findings informed a blueprint to enhance collaboration and housing stability for aging and disabled Veterans. Addressing barriers discovered in the project, the blueprint was disseminated to HUD-VASH teams at individual VA medical centers. The blueprint was designed as a worksheet with questions that help guide individual teams, covering issues such as how to overcome barriers and developing relationships with community partners. The worksheet emphasizes tracking performance, engaging Veterans, and ensuring long-term sustainability.

Implications

This project produced a novel implementation blueprint, informed by community partners, for strengthening a HUD-VASH initiative for aging and/or physically disabled Veterans experiencing housing instability, filling a gap between policy design and on-the-ground practice. Findings were disseminated VA-wide via a presentation for the National Center on Homelessness Among Veterans (NCHAV); the blueprint also has been shared with HUD-VASH teams to inform practice, if they so choose.

Partners

Housing and Urban Development-Veterans Affairs Supportive Housing (HUD-VASH), the National Center on Homelessness Among Veterans (NCHAV), and VA medical centers within VISNs 1 and 6.

Investigators

Nathan Boucher, DrPH, PA, MS, MPA, CPHQ, is an investigator with HSR's Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), and Jenny Palmer, PhD, MS, is an investigator with HSR's Center for Health Optimization & Implementation Research (CHOIR).

Citations

1. Sista A, Palmer J, and Boucher N. Supporting age-friendly, supported housing for aging and disabled Veterans. Journal of Applied Gerontology. May 15, 2026; online ahead of print.