Marvin Boyd, 67, cried last week when talking about homeless senior citizens like himself living on the streets of Honolulu.

Boyd never thought he would be homeless. He was paying $300 a month to live in subsidized housing in Kapolei but thought he could “do better” in town, only to end up at the Institute for Human Services’ Sumner Men’s Shelter in Iwilei for the past two years.

He appreciates the help he’s been getting through IHS for his stage 4 prostate cancer and kidney and heart problems, urging those who are unsheltered to seek help like he did — especially homeless kupuna.

“You know, things could be a whole lot better for you if you would just cooperate with the system,” Boyd would tell them.

Connie Mitchell, IHS’ executive director, and Honolulu Mayor Rick Blangiardi worry that even more seniors will become homeless as the cost of living and housing continue to rise in one of the most expensive cities in the country.

In the last three months of 2023, IHS outreach workers found that 25% of homeless kupuna on the streets were homeless for the first time.

“They’re homeless after having a whole lifetime of working and paying rent,” Mitchell said.

On the weekend of Jan. 28, 114 adults over 55 lived at IHS shelters, and 46 of them were over 65. Kupuna comprised 33.6% of all shelter guests.

In 2023, IHS counted 593 adults over 55 years old in all of its shelters — 73 more than in 2022.

Blangiardi, himself a senior, sympathizes with homeless kupuna who had “worked really hard throughout their lives.” He acknowledged the difficulties with living on a fixed income while rents increase.

He particularly worries about homeless kupuna who suffer from declining health.

“Some of the population, we know, suffer from dementia, making it even more challenging,” he said.

Some families, Mitchell said, “drop off” their loved ones at IHS shelters because they can’t take care of them.

“Sometimes the behaviors get to be too much, and they don’t know how to deal with that,” Mitchell said. “They don’t know how to reach out for help.

“I think it’s really providing more education and access to resources that can help families.”

IHS has been talking to the Alzheimer’s Association Aloha Chapter to help caretakers understand dementia and Alzheimer’s and determine the right course of action.

“We know that in IHS there is a high percentage of kupuna that do have Alzheimer’s or another form of dementia,” said LJ Duenas, executive director at the Alzheimer’s Association.

Duenas said it’s a “growing issue” of homeless kupuna with dementia or other cognitive deficits.

“Services and spaces are going to be needed as our population ages and as the dementia population increases year over year,” Duenas said.

Mitchell hopes to see a push for public assisted living facilities and kupuna kauhale this year to get more homeless seniors off the streets.

Kauhale are tiny-home communities, and Mitchell likes the idea that seniors could interact and look out for one another.

New homeless state coordinator John Mizuno told the Honolulu Star-Advertiser in January that he wants to see kauhale for kupuna become reality this year.

Kauhale are far less expensive to build than traditional senior living facilities on Oahu, which are all privately owned.

Blangiardi told the Star- Advertiser last week to expect discussions to increase around developing or renovating buildings for more affordable senior assisted living facilities that include on-site care.

“We can start building or making use of existing facilities, but we have to get the right kind of care,” Blangiardi said. “We have the capability.”

The city and state are working together to find more health care and social service workers to help homeless people on the streets and develop the most appropriate course of treatment.

The long-term solution would be to get kupuna into permanent housing that includes treatment, Duenas said.

“Medicaid pays for assisted living and long-term care programs like adult foster homes,” Duenas said. “But the challenge is there may not be enough beds available.”

Options are even more limited for kupuna on Medicaid, which doesn’t reimburse long-term care programs at as high a rate as private insurance, Duenas said.

Kalakaua Gardens, a private senior assisted living community on Kalakaua Avenue, has a starting price of $6,000 a month for independent living with basic facilities including meals, transportation and grocery shopping.

Residents in the memory care unit have a starting price of $7,700 a month, which includes medical technicians to ensure they take medications, eat properly and deal with behavioral problems including wandering away from the facility.

Higher-skilled health care and hygiene needs could range up to $19,000 a month, according to Tom Eustace, director of sales and marketing at Kalakaua Gardens.

“You would have to be able to afford to move here,” Eustace said. “There’s so many seniors that need help and they’re just surviving, doing what they can to get by.”

Mitchell said, “When people have modest means and the cost of living is just so out of reach, it just makes it so difficult.”

The Department of Community Services listed 11 properties dedicated to senior affordable housing, totaling 591 units across Oahu.

“There is senior housing in Hawaii that is subsidized, but it’s not a care home or a senior care facility,” Eustace said.

Eustace has been in the senior assisted living hospitality industry for 35 years.

While he worked in Illinois, he was involved in “supportive living” that provides seniors with subsidized assisted living facilities.

He would like to see “some kind of a committee or a planning commission” in Hawaii to look at how to build care facilities for low-income seniors who need extra support.

At IHS’ Sumner Men’s Shelter, Boyd hopes to save up his Social Security income to be able to rent a studio apartment on his own someday.

Ideally, he wants to live in a complex where seniors can have their own private rooms and can socialize with other residents.

He’s putting his hopes in government officials to do more to help.

“I would suppose that they are doing whatever they can do,” Boyd said.

While living on a fixed income, Boyd can’t resist using a portion of his Social Security to help other homeless people — like buying a friend a shirt from Ross — and donating to charities such as St. Jude Children’s Research Hospital.

Boyd has a particular soft spot for homeless senior citizens just like him.

“It’s God’s money,” Boyd said. “I’d like to assist them with anything they need, get them to laugh and talk about the good and bad things going on in their lives.

“I’m game for the government helping out old homeless people.”