Thousands of senior citizens are dying homeless in Los Angeles, records reveal

Thousands of senior citizens died in Los Angeles while homeless in the past 10 years, with residents age 60 and over representing a quarter of all deaths of unhoused people in that period, according to a Guardian analysis of public records.

A common misconception about California’s homelessness crisis is that the majority of people on the streets are young adults who came from out-of-state, drawn to warm weather and homeless services. But death reports obtained by the Guardian reveal more than 3,000 of the 11,500 people who died while unhoused in Los Angeles county between 2014 and 2023 were 60 and older, highlighting the vulnerability of older residents in one of the US’s most expensive regions.

The crisis has grown over time, the records indicate. Last year, the Los Angeles county medical examiner recorded a record high of 496 deaths of older and elderly unhoused people, nearly four times the fatalities from 10 years earlier.

The records also reveal that:

• More than 1,700 of the unhoused people age 60 and over who died probably lived unsheltered. They were found in alleys, tents, encampments, bus stops, parks, yards, parking lots, cars, RVs and sidewalks and other locations suggesting they may have been living outside.
  

• About 1,500 deaths of the deaths were ruled “natural”, attributed to causes like heart failure, liver disease and Covid; 1,355 deaths were labeled “accidental”, including drug overdoses and traffic collisions; 74 were homicides; and 44 were suicides.

• Elderly people far past the age of retirement died on the streets and in homeless shelters: A total of 221 people age 75 and older have died while unhoused since 2014, including dozens of people in their 80s and two 92-year-olds.

• Black Angelenos were disproportionately represented in the death toll, making up 33% of older people who died while unhoused, while only 9% of the broader county population is Black.

The data offers a snapshot of a crisis in a region that’s becoming increasingly unaffordable, where there’s not enough housing support to meet the needs of the population, and where many residents are struggling to access critical medical care and mental health treatment.

The figures emerging from the death records are an undercount, as the medical examiner only has jurisdiction over sudden, violent or unusual deaths and where the deceased had not recently been seen by a doctor. Unhoused people who were living on the streets, but were being treated in medical facilities in the days leading up to their deaths may not have been captured. The medical examiner data is also preliminary as the county’s public health department does more comprehensive tracking of deaths of unhoused people and has cataloged several hundred additional fatalities per year, but hasn’t yet released 2023 figures.

Treating the elderly outside

Amid sky-high housing costs , more than 75,000 people are now unhoused across Los Angeles county, according to a January 2024 count . More than 5,100 people are 65 and older, and nearly 3,700 people , or 72% of the older population, were “unsheltered”, the count found, meaning they live on the streets, and not in indoor programs like transitional housing.

A groundbreaking University of California, San Francisco (UCSF), study last year found 90% of the unhoused population was living in California before they fell into homelessness; nearly half of unhoused adults were age 50 and over; and many older residents were experiencing homelessness for the first time due to high housing costs. Incarceration, mental health challenges, substance use and past experiences of violence were also common factors that preceded older adults’ homelessness, UCSF found .

Dr Absalon Galat, the medical director for Los Angeles county’s mobile clinic program, who treats patients on the street, said he regularly encounters older adults who say they are temporarily sleeping outside after losing housing, but then struggle to find a way back to stability. In LA, more than one in four renters are now spending 50% or more of their income on housing, meaning they could be one emergency away from falling into homelessness.

One day in March in the middle of the remote desert in Palmdale, on the northern edge of Los Angeles county, Galat and his team met Joseph Patin, 62, who was living outside with his daughter and son-in-law in tents and their vehicle. The family said they had been there for a few weeks after being kicked out of their housing. “I’m just trying to think of it as camping, I’m not trying to get too comfortable,” said Jovan, the son-in-law. Staying warm in the cold evenings had been the hardest part so far, he added.

The medical team offered to do blood work for Patin, but struggled to find a vein because his hands were so cold. Patin, who held his small dog Mily in his lap as he was examined, explained he had been hospitalized last year for congestive heart failure and was also previously diagnosed with schizophrenia and still hears voices: “It’s crazy out here. I want to get back to normal.”

“We need to get him indoors as soon as possible,” said Galat, as his staff called a local pharmacy to order medications for Patin and his family. Galat said he detected fluid in Patin’s lungs, which was straining his breathing, and that he was at high risk for worsening heart failure, especially if he did not regularly take the correct dosages of his medication. Patin’s body was more akin to someone in their 70s or 80s due to his ailments – a common reality for people living outside.

The county’s outreach teams work hard to get highly vulnerable people like him into programs, but it’s not always a straightforward path, Galat said. In a recent interview, he said Patin was placed in a nursing home, but it was in another region of the county, and he ended up returning to the streets to be closer to family.

Dr Margot Kushel, director of the UCSF Benioff Homelessness and Housing Initiative, who led the recent research, said that many older unhoused people struggled with isolation: “They talk about how ashamed and stigmatized they feel – they know the public thinks they’re bad because they’re outside. And they just feel incredibly alone in the world.” In high-cost areas like Los Angeles and the Bay Area, sometimes the only indoors option is one that will further increase their isolation, she said: “It’s an awful choice – you can be housed, but so far away that you’ll never see your family or church, or you can stay on the streets.”

‘I’m at the end of life’

Wendell Stephens, an 81-year-old who has been living out of a vehicle on the outskirts of downtown Los Angeles, said loneliness was one of the hardest parts of being an elderly person battling homelessness: “I’ve got nobody to talk to. When your life is normal, you take for granted that you have friends and people, and then all of a sudden it’s all gone.”

Medical teams like Galat’s have been key to the survival of Stephens.

“I call him Uncle Wendell,” said Felix Rivera, a University of Southern California (USC) community health worker, on a recent morning checkup. “He knows he can call me any time if he needs anything.”

Stephens said he has had a variety of sleeping arrangements while unhoused, including a trailer at a shipping business where he used to work, and later a van when he wasn’t able to continue that job. Outreach workers have occasionally sought to place him in interim motel programs, he said, but he’s frightened to move into facilities crowded with other unhoused people struggling with mental illness and drug addiction. “I don’t consider myself a better human being than anyone else, but the last time I had a drink was 1974.”

He said he had been robbed and occasionally faced threats of violence while living on the streets, and was once hospitalized when he ran out of thyroid medication and collapsed.

Stephens used to talk daily on the phone to his older brother, a retired teacher who lived in Fremont, California, but he died last year, leaving him even more isolated: “When my brother passed away, it made me think I’m at the end of life. It’s hard. I’ve just gotta stop thinking about it.” He keeps old family photos by his side.

Stephens had a moment of good fortune in May when an activist raised enough money for him to buy an RV, which he said he plans to eventually drive to his home town in the Central valley. Inside, he has a proper bed, a kitchenette and a climbing structure for his beloved four cats, including one he named Tumbleina, after he rescued her when she was thrown out of a vehicle and tumbled toward him.

With funds donated to him, Stephens also bought an RV for his unhoused friend on the street – Angel, 55, who had long been sleeping in a tent on the same block and helped take care of him over the years. She choked up seated inside her new vehicle on a recent morning, describing her gratitude for the gift and appreciation that Stephens was finally getting off the streets.

“Some days, I wake up here and I think, ‘Is this real?’ To have something where I can lock the doors, it makes all the difference. I’m crying now, but these are happy tears.”