supportive housing: overview

What is supportive housing?

Older adults can select from a growing number of housing options when seeking assistance with activities ranging from meal preparation to bathing and dressing. Some choose to stay in their own homes and rely on social services available in the community to meet their needs. For others, supportive housing provides a more appropriate alternative.

Supportive housing [1] is an umbrella term for residential settings that have been specifically developed to provide an array of supportive services on site - from group meals and housekeeping assistance to monitoring of chronic health conditions. Supportive housing communities provide care in a residential, rather than an institutional setting, enabling older adults to live comfortably and maintain their independence and autonomy as they age.

Courtesy of Dakota County CDA

How are services provided in supportive housing?

There are a range of ways to structure the delivery of housing and services in supportive housing. In some cases, a single provider manages both the housing component and the delivery of supportive services. This arrangement can simplify information-sharing and coordination of care but can also result in added training and staff costs for agencies lacking experience in one of these areas.

Alternatively, a growing number of housing developments, including some receiving federal subsidies, have entered into formal contracts with outside service providers. This approach takes advantage of expertise already available in the community and thus can reduce staff costs and enable more efficient service delivery.

In both scenarios, care managers and service coordinators play a key role connecting residents with available supports and facilitating communication between housing and services staff. Care managers also evaluate tenants as they enter the community and on an ongoing basis to ensure that they have access to the services that residents themselves identify as important.

How do residents pay for supportive housing?

Despite rapid expansion in the supportive housing market in recent years, the widespread availability of affordable options has yet to be achieved. [2] In 2009 the annual nationwide cost for a private one-bedroom unit in an assisted living facility averaged $33,903, or more than $2,800 per month. [3] Most residents pay out-of-pocket or with assistance from family members. [4] Lacking affordable options, low- and moderate-income older adults may prematurely enter into institutional care, where Medicaid covers costs for those who qualify. [5] Thus, due to the shortage of affordable supportive housing options, the government must pick up the tab for the higher cost of institutional care, and many older adults must spend down their assets in order to qualify for Medicaid.

Learn more about various models of supportive housing

Learn more
about challenges associated with expanding the supply of affordable supportive housing

Go back to learn about other housing models geared to older adults

[1] In this section, the term "supportive housing" refers generally to housing built to provide supportive services for older adults on-site, which is consistent with AARP's definition of the term. It is important to note, however, that some practitioners exclude licensed assisted living residences when they define supportive housing because, in practice, they can have more in common with institutional, rather than residential, settings.
[2] "The Place of Assisted Living in Long-Term Care and Related Service Systems." 2007. By Robyn I. Stone and Susan C. Reinhard. The Gerontologist 47(3), pp. 23-32.
[3] Cost of Care Maps: Genworth 2009 Cost of Care Survey. Richmond, VA: Genworth Financial.
[4] An Overview of Assisted Living: 2004. By Bernadette Wright. Washington, DC: AARP.
[5] "Assisted Living: Federal and State Options for Affordability, Quality of Care, and Consumer Protection." 2001. By Sue Seeley. Bifocal 23(1).

The views expressed herein are for information, debate and discussion, and do not necessarily represent official policies of AARP.