Terry Kalahar’s job title as a City of Berkeley employee—Assistant Men-tal Health Clinician—tells you little about his job. You are likely to see him arrive at work in jeans, flannel shirt, heavy shoes, helmeted on his bicycle, which he parks inside a shared windowless office at one of the city’s senior centers.
A sturdy upbeat bear of a man, decades younger than most of the Berkeley residents who frequent the three Centers, he works with individuals most in need of, and generally most difficult, to help among adults 55 years and older.
His clients are homeless, often suffering longstanding mental illness, abuse of alcohol and/or drugs. Terry’s job is to identify needed health and social services, with an ultimate goal of helping them find and stick with a decent place to live. Among the variety of concerns that come before the Commission on Aging, none is more troubling than the fact of people in our community spending their older years living on sidewalks, sleeping in doorways and parks, or particularly in winter, standing in line each day to secure an indoor shelter cot. And nothing is more satisfying than hearing Terry report a good result—an individual successfully housed, perhaps even turning his life around.
Although the face of Berkeley’s homeless has long appeared predominantly young—the hippies and flower children, the runaways, neglected teens—we now increasingly see older homeless at the senior centers, public libraries, city parks. If previously less numerous or visible, once you begin to notice wrinkled skin and gray thinning hair, you can see that the city’s homeless are indeed growing older. Individuals who arrived as street kids may have aged beyond their 50s as the chronically homeless. (Ironically, they are “aging-in-place,” a desired geriatric goal unless your place is a park bench or homeless shelter). More generally, an aging population—the latest mark of baby boom demographics—swells the homeless count as well. Add on the current economic crisis, and older adults who were teetering on the edge or not even so close—those who lost a job, a pension, their mortgaged house or rented apartment—suddenly face the rudest of awakenings, tossed into the homeless mix.
Terry’s job did not exist until 2007, when Judy Izzo, the Berkeley Division on Aging’s lead social worker, carved the position from a small reserve of funds. Nor did the Division have any housing vouchers—for rentals subsidized by the federal government through grants to cities and counties—as do, for instance, the Departments of Public Health and Mental Health and certain nonprofit organizations. By 2008, Terry’s caseload reached, and at times stretched beyond, the limit of 30 he feels able to handle. And, for the first time the Division gained seven vouchers of its own. The task then became to assign each voucher to a person—to help him (so far all are men) complete an application, find an available apartment and willing landlord (willing, that is, to consider someone with minimal if any regular income, no rent history if not prior evictions, no current address), begin and then continue to pay rent, move in and remain housed.
Terry knows the task inside and out, and gladly explains the requirements, obstacles, successes and failures. Unlike a standard rent subsidy, the Division’s vouchers—known as Shelter Plus Care—target homeless individuals who suffer serious mental illness, alcohol or drug abuse and/or HIV infection/AIDS. A voucher recipient must be willing to work with Terry on an individual plan to establish and progress toward set goals regarding mental and physical health, substance abuse, money management, housing, employment and other personal goals. Terry’s clients include the quiet loners, largely unseen by the public, as well highly visible homeless who may have, for instance, repeated ER visits and hospitalizations, numerous police encounters, time spent in jail. To fill the Shelter Plus Care niche, Terry tries to balance two differing factors: a client’s need and his readiness to successfully use a housing voucher. That is, how desperate is the individual’s current situation (his health, age, ability to manage as is)? Will the client accept the care required? Does he have a reasonable chance to do what a tenant must do—pay rent regularly, behave in an acceptable manner? The Division cannot risk the few vouchers and affordable, available dwellings, or the months of efforts needed to find housing, if an individual is unlikely to benefit in the longer term—to remain in town, in touch and in the apartment—compared to those whose situation may not appear quite so dire (on a scale where “better off” is still dire).
As we talk, Terry waits for a phone call from St. Mary’s, an Oakland shelter that serves only older adults. Despite its blighted, poverty-ridden neighborhood, St. Mary’s remains an especially valuable contact in that many homeless seniors avoid Berkeley shelters, as well as shelter waiting lines, where they will be surrounded by people younger, stronger, louder, perhaps strung out on drugs. Terry had called earlier seeking a bed for the man he found in the morning sitting in the Senior Center’s TV room, a new face, a person about whom Terry knows little, though apparently this man spends much of his time riding the bus. A typical phone call on a typical day—along with calls to link clients with various social service agencies, treatment programs and self-help groups, calls to building managers who may have a vacancy, to PG&E for a client’s subsidy, to Highland Hospital or the Over 60 Health Center for a client who is ill. He may have two or three client appointments to work on housing applications or the required Self-Sufficiency Plan or Social Security paperwork. Assuming the client shows up, that is, not so easy to encourage when there is no phone, no address.
With older age, let’s face it, we feel more aches, less energy. Our sight and hearing fade, our wounds take longer to heal. We are just not as strong as during our younger years. Now imagine all that with nowhere to live, not enough to eat, dilapidated shoes and clothing, no doctor to see nor family that cares, let alone that helps us face a terminal illness and decisions about end-of-life care. It is Terry who, at times, must deal with such late life realities in working with this segment of Berkeley’s homeless population. Currently, to cite one example: A man in his mid-70s, a writer homeless on and off for 20 years, past drug use, several serious health problems and frequent hospital stays. This client is hoping to live independently with an attendant, a friend who also lives on the verge of becoming homeless. Terry sounds excited that they are poised to rent a 2-bedroom apartment. Medicare will pay for a visiting nurse and, at some point, perhaps, hospice care.
Based on years of seeing clients battle alcohol or drug abuse, Terry emphasizes a harm-reduction approach, not necessarily total abstinence, at least as a short-term goal. He thinks most improvement during recovery, and mental health more generally, come after people are settled in a home. Then, perhaps, abstinence becomes a more plausible ideal. Thinking about clients who have done well, Terry says he has no “magic set of words” to help someone battle whatever their demons. But from his early volunteering at the Berkeley Free Clinic and homeless shelters through his current City of Berkeley job, Terry appears to have found his niche. He appreciates well his happy childhood—his single, working mom’s love and attention (she graduated high school after he did), a good education. He also values what contents him now—his bike, a library card, and work that helps people who are in very great need.
As a mental health clinician, Terry focuses person-by-person to address a major community problem. So, too, do other Division on Aging staff, who not only provide social services for the larger population of Berkeley’s older adults, but who also keep the senior centers running. Terry has the luxury of a total focus on homeless clients. This problem of homelessness, showing up daily at our senior centers, raises immediate yet broader questions of how best to respond: How maintain the inviting environment and activities for all center participants yet help those men and women, barely hanging on, who arrive seeking a meal, a shower, a place to sit or sleep indoors out of a chilly rain or heat wave. And how reach out to provide essential services for the greater number of homeless seniors who stay away? Clearly, the problem is larger than the Division on Aging, or City of Berkeley, though it requires attention from them every day. It requires increased resources to hire and support case-management staff; discretionary funds for an emergency motel stay or food or transportation; ongoing funds for the city’s eviction-prevention efforts providing time-limited assistance to cover, for instance, a month’s rent, so that particularly during these times of economic decline, lost jobs and pensions and savings, Terry’s caseload does not continue to climb. And just as Terry’s clients are required to work toward future goals, Berkeley needs to look ahead, focusing city and nonprofit services that can help avert homelessness within our aging population and respond effectively-including, for instance, supportive senior housing-for those who slip through.
P.S. The man needing shelter the day I talked with Terry eventually found space at the Berkeley Food and Housing Project’s Men’s Shelter. Terry learned that he did have a nearly expired housing voucher from a different department—just nowhere to live. They were able to find permanent housing, and sign a lease, before it was too late.
The 74-year-old client passed away, suddenly, before he and his attendant could move into the apartment.
Judy Turiel is chair of the Commission on Aging.