Editor’s note: This is part 11 of a series that explores the housing crisis affecting Port Townsend and Jefferson County

As Jefferson County’s population ages, the overlap between stable housing and public health has become a pressing concern for hospitals and service providers.

“Aging brings inherent challenges, and when chronic medical conditions are compounded by housing insecurity, those challenges become exponentially greater,” said Dr. Shayna Lemke, associate chief medical officer of hospital operations for Jefferson Healthcare.

The hospital is seeing more admissions and longer stays from older adults who no longer need acute medical attention but have nowhere safe to recover. Patients remain not due to a lack of treatment, but a lack of options.  

“In Jefferson County, where nearly 40% of residents are age 65 or older, the lack of resources for individuals facing this dual burden is especially concerning,” Lemke said. “Too often, patients remain hospitalized for extended periods—not because the hospital is the right environment, but because it is the only safe option available.”

Jefferson County, among the nation’s oldest counties by median age, is confronted with the pressures where aging, health and housing collide. 

On the edge

“For many older adults, the math doesn’t work,” said Laura Cepoi, executive director of the Olympic Area Agency on Aging. “According to census data from 2023, 28% of folks rely on their Social Security income. For an individual, that’s $938 a month and for a couple, $1,450. That’s their sole income.”
Cepoi identified two main groups.

“There’s the first-time homelessness that happens after 50 and then there’s the homelessness that happens before 50,” she said. Those who became homeless earlier often carry the scars of trauma, while “that first-time population, now they’re aging.”

She added: “That latter half of the baby boomers, those folks born between 1955 and 1965,” Cepoi said. “It’s an interesting little group … that came of age during a recession. There were fewer jobs, and a lack of protections set them up with really bad luck. It’s just this one particular cohort. And it’s usually men.”

As these populations approach retirement, the economic pressures continue to rise.

“Usually, older adults did not have mortgages, but that’s changed now,” Cepoi said. “Older adults are increasingly taking on mortgages to fund their retirement.”

The cost of aging

The Elder Economic Security Index, developed by the University of Massachusetts Boston and used by the National Council on Aging, estimates what older adults need to meet basic expenses.

In Jefferson County, a single homeowner without a mortgage needs $25,860 a year to get by; with a mortgage, that figure rises to $39,744. For couples, costs range between $40,000 and $60,000 annually — slightly higher than national averages and higher than what most retirees receive through Social Security.

Health costs can raise expenses by another $3,000 to $6,000 a year, underscoring Cepoi’s point about the steep price of aging without stability. Port Townsend’s high living costs and limited housing options leave little room for error.

“For affordable aging, you need to be in the best health you possibly can be in,” she said. “Because the difference of living comfortably in Port Townsend — it’s basically $10,000 a year if you’re in excellent health or if you’re in poor health.”

Eric Jones, communications strategist for Housing Solutions Network, said that economic strain extends beyond medical bills.

“Locally, we are seeing a lot of seniors who are essentially house-rich but cash-poor,” he said. “Many of them would consider downsizing, but there are very limited options in our area to do so. The result is many people living late into life with more house than they need and frankly, at some point, more than they can reasonably take care of.”

Effects on the ground

The human costs show up regularly for FIRE CARES, a partnership between East Jefferson Fire Rescue and Believe in Recovery. Launched in 2023 as a community crisis response program, FIRE CARES pairs a firefighter or paramedic with a community support specialist to follow up on non-emergency calls and connect clients to housing, medical or behavioral health services.

“We’ve seen an influx in homeless elderly folks,” said Aaron Wasson, a community support specialist with the FIRE CARES program.

The team is often called by shelters or outreach workers to check on seniors with medical or cognitive conditions.

“We’ve helped some of them get housed, but that’s only through working with Department of Social and Health Services (DSHS), giving them an application, and then they have to have a medical necessity to get into an assisted living or a memory care facility, like they can’t feed or bathe themselves or they have cognitive decline and can’t remember where they are to take their medication.”

Most of the team’s cases involve residents who are still in their homes but struggling to stay there. However, Wasson said the team is seeing a shift.

“We have more homeless elderly than I’ve seen in the past. Which was basically never,” he said. “But then again, they could have been there, and nobody was calling us and asking for help.”

Senior housing stretched

Viola Ware, director of housing and community development for Olympic Community Action Programs (OlyCAP), tracks homelessness in Jefferson County through a coordinated “By-Name List” used by local providers.

Ware said older adults now make up a growing share of those without stable housing, including those living in cars or shelters and those at risk of losing homes they can no longer afford or maintain.

“We’ve seen a growing number of seniors in crisis,” she said, “including individuals in their eighties and nineties.”

OlyCAP is working towards solutions for seniors, but she said the process is “tough work to say the least.”

“The need has grown, as predicted, and appears significant enough that we are embarking on a feasibility study to see if our communities … could support a regional memory care/hospice care for our senior neighbors experiencing homelessness,” she said. “We are going to be engaging the whole of our community, providers, lived experts and stakeholders, as we consider this.”

An aging safety net

For Lemke, inaction and an uncertain future lead to gaps in an already fragile system.

“Current local options are limited,” she said. “Serenity House in Clallam County provides a small number of medical shelter beds, and Jefferson Healthcare partners with OlyCAP to support difficult discharges. However, OlyCAP’s capacity is very limited, leaving many patients without adequate support. With the future of Medicaid itself uncertain, this safety net cannot be relied upon as the sole solution.”

The challenge, she added, is even greater for older adults with cognitive impairment or dementia. “Washington state does not currently provide appropriate community-based solutions for this vulnerable population.”

Her appeal is direct: “We call on state and local policymakers to prioritize the development of sustainable resources for older adults who face both medical complexity and housing insecurity. Jefferson County, with its uniquely high proportion of seniors, underscores the urgency of this issue,” she said.

“Our elders deserve more than a hospital bed as their only safety net; they deserve a system that ensures safe housing, appropriate care, and dignity in their later years.”

In Jefferson County, hospitals, housing agencies and people on the ground are confronted with a growing reality: where the population ages, more are falling through the cracks between health care and housing. For those stuck in between, the question is less about where to go and more about whether the system can keep up.