Homeless, sick and aging: Pierce County faces worsening crisis in 2025

TACOMA – Homeless-service providers in Pierce County are sounding the alarm on the need for health care among those living unhoused.

During the Pierce County Council’s Health and Human Services Committee meeting on Tuesday, a panel of homeless-outreach workers, health care specialists and social workers painted a picture of the high number of elderly and disabled people experiencing homelessness and the lack of resources available to keep them from dying on the streets.

Jake Nau is the homeless outreach manager for St. Vincent DePaul. His job is to develop relationships with people living unhoused with the goal of helping them find housing.

Nau told the committee at least 50% of the unhoused people he meets are either older than 55 years of age or are experiencing a physical or mental disability they either were living with before becoming unhoused or have incurred through their experience living on the streets.

During the 2024 survey of those living unhoused in Pierce County, volunteers counted 2,661 people living unhoused in a single night. Of those surveyed, 25% reported having a chronic health condition, and 22% reported having a physical disability.

“Homeless seniors and people with disabilities are largely from here,” Nau told the committee. “This population is not chasing benefits across counties and states. They were housed here, and now they are not.”

Nau said the normal process of aging is “harmfully accelerated” by being unhoused.

According to the U.S. Interagency Council on Homelessness , people who experience homelessness have an average life expectancy of around 50, almost 20 years lower than people who are housed.

The Center for Disease Control states that people experiencing homelessness are at a greater risk of infectious and chronic illness, poor mental health and substance abuse.

They are also more susceptible to violence, “a fact confirmed by over 20 years of reports on bias-motivated crimes,” a letter from USICH stated in 2018.

“On the street there are perpetrators of harm and victims. Seniors and people with disabilities are almost always the victims,” Nau said. “Our parents and grandparents get exploited, robbed, beaten and bullied.”

Nau said there are simply not enough shelter and housing options to get those folks off the street, specifically not enough Americans with Disabilities Act-compliant shelters. He said many shelters cannot accept individuals who are physically unable to wash themselves or use the bathroom on their own.

He also said there are not enough senior-specific permanent supportive-housing options for folks who need specialized care.

Amy Decker is a social work case manager for MultiCare Health System. Decker reported that 404 people were discharged from Tacoma General Hospital and Allemore Hospital into homelessness through the first five months of 2025.

Of those known to be unhoused at the time of their discharge, 176 were between the ages of 50-69 and 25 were over the age of 70.

One individual discharged from a Tacoma hospital into homelessness was over 90.

Recently, the county has obligated funding to increase its medical respite capacity.

Medical Respite facilities offer a place for unhoused individuals to stay while they heal after a hospital stay.

In January 2023, Pierce County awarded the Low-Income Housing Institute more than $10 million to support a new shelter project, which would eventually become the acquisition of the Oasis Inn. The former hotel will be converted into 117 units of noncongregate emergency shelter and permanent supportive housing, with at least 51 of the units capable of providing medical-respite services.

John Brown of the LIHI told the News Tribune potential clients at the facility would need to be healed enough for discharge, meaning they can still perform activities of daily living and only be in need of basic nursing services such as wound care and medicine management.

If the client regresses in treatment during their stay, they would be moved to a long-term care respite facility.

“Once the client heals and progresses through recovery, they could either be referred into one of the long-term rental permanent supportive-housing units in the building or another low-income housing building as openings become available,” Brown wrote in an email to the News Tribune.

It is unclear when the facility would open. Meanwhile, the county has made funding available for operation of a temporary medical respite facility in Parkland. The facility will have roughly 16 beds available.

Jan Runbeck is a registered nurse who provides health care at one of Tacoma’s only operating medical-respite facilities.

Runbeck previously told the News Tribune that Nativity House has 12 beds reserved for medical-respite referrals. She said patients discharged from the hospital can use a bed for 30 days before they have to be treated like everyone else who comes to the shelter and receives a bed on a first-come, first-served basis.

During the committee meeting, Runbeck said many individuals living unhoused are dying a “prolonged death,” typically resulting from unmanaged chronic diseases such as diabetes, heart disease, kidney failure and COPD.

She said the deaths would be preventable with access to primary care.

Runbeck said many individuals she met in Nativity House and in her street-outreach work became homeless in their 50s and 60s. She recalled several cases in which individuals suffered injuries and had jobs without benefits, creating financial pressures leading to homelessness.

Runbeck made the case that medical-respite facilities ultimately save tax payer dollars.

She said before Nativity House implemented a medical respite program with nurses who could provide health care, it had more 911 calls than almost anywhere else in the city, averaging more than two emergency calls a day.

After the program was implemented, it reduced calls there by 30%.

“When you have prolonged death, it is messy, it is ugly, it is nasty,” she told the committee. “You go to the (emergency room) way too many times, you go to urgent care way too many times. You have all these other complications of untreated chronic disease.”