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Department History
Established in 1986 with a three-year demonstration grant from a consortium of national and
local foundations, Boston Medical Center's Elders Living at Home Program (ELAHP) provides homeless
and at-risk elders with access to safe, affordable housing and to the supportive services which
will allow them to maintain that housing and remain independent. Since the program's inception,
more than 3,000 elderly individuals have been referred for help with housing problems.
The particular need for a housing program for elders was discovered by the staff of Boston
University Medical Center's Home Medical Service, currently know as Boston University Geriatric
Services. When Boston's housing market underwent its first "boom" in the mid-1980's, the Home
Medical Service encountered increasing numbers of frail elderly patients who were unable to
maintain their independence because they were being displaced from their rooms or apartments
or paying exorbitant rents. Many of these vulnerable elders eventually had nowhere to turn but
emergency shelters or the streets.
In May 1988, ELAHP implemented its temporary housing component, utilizing vacant units in Boston
Housing Authority (BHA) elderly/disabled developments to house homeless clients while helping
them to find permanent rooms or apartments. Over the years, ELAHP's temporary housing has
expanded to its current capacity of 28 units at four different sites, and has served as a model
for collaborations between the BHA and other providers of services to homeless individuals.
In 1997, ELAHP and BHA began a transitional housing program, which allows participants to remain
in the same apartment after a transitional period of at least one year. The temporary and
transitional components have served 437 homeless elders. Of the 403 participants who have
exited the program, more than 80% had successful outcomes; that is, they were living in safe,
affordable permanent housing at the time of their exit. Of those, fewer than 10% have again
become homeless.
In March 2000, ELAHP was awarded a contract by the Massachusetts Executive Office of Elder
Affairs to establish the first-ever emergency shelter and service program for homeless elders.
The Elder Residential Assessment and Placement Program, or ERAPP, provides intensive assessment
and case management services in a safe residential setting to elders who have recently become
homeless. In its first three and a half years of operation, the ERAPP served 205 homeless elders.
Of the 169 individuals who have left the program, 74% have moved on to the appropriate
next-step placement, such as permanent housing, a transitional program, or reunification with
family. ELAHP staff played a critical role in the advocacy that secured the funding allocated
by the legislature to establish the ERAPP, and helped to raise awareness of the issue of elder
homelessness and the special needs of this most vulnerable population.
ELAHP has also participated in collaborations with academic institutions in a variety of
ways. For example, ELAHP regularly provides a unique community health experience for senior
nursing students from the University of Massachusetts-Boston. More than 125 UMass students
have provided health promotion and education and disease prevention services through ELAHP
sponsored clinics at a number of community based sites. On a less regular basis, ELAHP hosts
students from Boston University School of Medicine, School of Social Work, and Sargent College
of Health and Rehabilitative Sciences, Boston College, Northeastern University, Forsyth
School of Dentistry, and Pine Manor College, who participate in a variety of health and
social service activities. Since 2001, ELAHP has been a partner in a three country comparative
study on the causes and contributing factors in elder homelessness, led by a noted researcher
in this field from the United Kingdom.
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