Document Type

Technical Report

Publication Date



Sustainable urban development -- Oregon -- Portland, Older people -- Housing -- Oregon -- Portland, Housing policy -- Oregon -- Portland, City planning -- Oregon -- Portland


As the U.S. population ages, the availability of workers with a basic understanding of aging and health-related services has not kept pace. This is true in traditional health care organizations such as hospitals and primary care clinics as well as in long-term care settings and senior housing, including subsidized housing, the focus of this report. Nearly 1.8 million older persons receive some form of publicly-subsidized rental assistance. Some subsidized housing providers, including those that operate buildings designated for older persons, are developing new systems of service delivery that would either coordinate or provide health screenings, physical activity programs, nutrition programs, health monitoring, adult day health, and home care. Such efforts are intended to deliver health related services that allow older adults to remain in their apartment for as long as possible while also reducing their use of hospital emergency departments or nursing facility placement. However, because housing providers have not traditionally hired or contracted with health and social services workers, neither the specific job tasks, nor the qualities of workers, have been studied.

This report describes the findings from a study designed to identify the characteristics of subsidized housing employees who work primarily with older residents. The study took place during 2011- 2012 and included interviews with housing providers, health and social services professionals who have clients in subsidized housing, current residents, and resident service coordinators who work in subsidized housing. A systematic job analysis, including a national survey with 87 service coordinators from 23 states, was conducted in order to identify the specific job tasks and the knowledge, skills, and abilities required of subsidized housing employees whose job would entail supporting aging in place for older residents.

Based on this study, it is clear that significant numbers of older residents of subsidized housing have a variety of unmet needs that place them at risk of eviction, hospitalization, and premature nursing home admissions. Four broad categories of supports identified by study participants include information and referral, health, social and personal care services, case management and care coordination, and building-specific supports. While most residents are independent and want to remain so, many need assistance on a short-term basis, such as during an acute illness or after a hospitalization. Others need on-going supports such as personal care, medication management, and health monitoring. Currently, few housing providers have a means of assessing or monitoring the health status or needs of residents. Most study participants believed that a designated staff person who could assess and monitor resident health would be beneficial, though some cautioned against creating an institutional environment or forcing services onto residents who do not want such assistance.


This report was funded by the Northwest Health Foundation and was published by Institute on Aging, Portland State University.

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