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This story was produced with support from the Economic Hardship Reporting Project.

The doors of the Mission Neighborhood Health Center in San Francisco don’t open until 7 am, but on the Saturday morning I was there, a dozen or so people were already lined up by 5:30. The group included a middle-aged white man who had lost his job managing a high-end restaurant and a black man wearing a crisp security guard blazer because he had to be at work by noon. Each was there hoping for a bed for the night. The city assigns most slots in its homeless shelters on a first-come, first-served basis by computer. The people had shown up here so early because they know through experience that every last bed will be claimed by 7:10 am.

A 56-year-old woman named Marcia, who has been homeless for six years, was one of the unlucky ones. She arrived while it was still dark, but not early enough to secure a bed. Because it was the weekend, her bad luck also meant two days of killing time. “Saturdays and Sundays are hell for those of us who are homeless, because most walk-in centers are closed,” she told me. “I especially hate Sundays. That’s when I ride BART.” For Marcia, riding the Bay Area’s commuter rail system is a relatively cheap way to get some rest during the day. She often falls asleep on the train, and it’s not uncommon for her to wake up and find herself an hour or more outside San Francisco.

When Marcia has no bed, she is left with precious few options, none of them good. She can ride the city bus, hoping for a kind driver who won’t boot her into the street. That’s what a 55-year-old woman I met named Dorothy used to do until she deemed that strategy too risky. “If you don’t get a nice driver, you have to get off every hour or so and wait for another one,” Dorothy said. “If you have to wait for a bus at three in the morning, you’ll be waiting a long time. Anything can happen.”

And then there were the plastic chairs at the Oshun Drop-In Center, a public facility run by the San Francisco Department of Public Health. Marcia usually chose the plastic chairs at Oshun. It was hardly ideal, but at least she felt safe there and could try to get some sleep. “You can’t lie down on the floor,” she said. “You try, but you’re not allowed.” After a night spent contorting herself into an uncomfortable chair, her back would be killing her. “But I try not to think about it,” she said. “After a while, you get used to it.”

It used to be that homeless women over 50 were blessedly rare. Marie O’Connor began helping seniors find housing in San Francisco’s Mission District in 1992. “To see homeless elders back then was shocking,” said O’Connor, a volunteer coordinator with the St. Anthony Foundation, a nonprofit providing the homeless with housing, meals and medical care. “Today, it’s the norm.”

How widespread is the problem? Every homeless advocate and shelter monitor I spoke with told me the older homeless population in San Francisco is exploding. The problem is bound to get worse as the price of housing reaches new heights. San Francisco is the most expensive city in the country for renters, according to a March 2012 report by the National Low Income Housing Coalition. Small studio apartments are going for as much as $2,000 a month, which requires a salary of at least $70,000 a year.

And it’s not just San Francisco. The cost of living in most major metropolitan areas is on the rise, while wages are down. In states like California, ongoing budget cuts to services like the Supplemental Security Income, In-Home Supportive Services and adult day healthcare centers are making it harder for elderly people to pay for housing. According to the latest numbers from Hearth, an organization working to end elder homelessness, the country had 40,750 homeless people 62 or older in 2012. As the nation’s population ages, that number is expected to more than double by 2050.

To homeless advocates in San Francisco, those numbers sound way too low, given the problems they see just inside the city limits. But whatever the figure, there’s no doubt that life is miserable for older people without a home. Lugging suitcases or bags for dozens of blocks to and fro, from a shelter to a reservation center to the place that serves free lunches, can be incredibly taxing if you’re young and able. Doing so with the disabilities and ailments common to those in their 50s or older, from chronic back pain and arthritis to swollen ankles and gout, is that much harder. And then imagine those women’s lives, when feeling safe meant another night spent contorted into a hard plastic chair.

Longtime advocate for the homeless James Powell seemed relieved when I mentioned that I’d seen the plastic chairs: maybe now someone would do something about them. “We’re talking about women sleeping in chairs. It’s a travesty,” said Powell, a case manager with the Canon Kip Senior Center in San Francisco. Bevan Dufty, San Francisco’s homelessness czar, told me people sleeping in plastic chairs was “not optimal, but we have to have places where people can go. It’s not an optimal place, but it’s safe, which is important. There are people who thrive in shelters; there are people who refuse to go in shelters. It’s complicated.”

Sometime after I talked with Powell and Dufty, the plastic chairs were quietly replaced at Oshun (now officially known as A Woman’s Place) by more comfortable cushioned chairs.

Located in the Mission District, the drop-in center is basically two large adjoining rooms, the otherwise bare walls brightened by a single big-screen TV. When I visited Oshun, I found a diverse group of forty-five women, each sitting or sleeping in a chair surrounded by her belongings. Some had old suitcases with broken zippers, while others had stuffed their things into ripped garbage bags. The lucky ones found a spot near a wall. They’d at least be able to rest their heads by putting a blanket against the wall behind them. The rest had no choice but to let their heads hang.

Yet what choices do older homeless women have? Despite a spike in older homeless clients, says O’Connor of the St. Anthony Foundation, there are still precious few services to help women like Marcia and Dorothy. “If you’re a homeless woman, you’re guaranteed to be assaulted on the streets,” said Paul Boden, organizing director of the Western Regional Advocacy Project (WRAP), a West Coast coalition of homeless organizations. Boden, who was homeless himself at 16 after the death of his mother, also served as executive director of the city’s Coalition on Homelessness. “Women try to double up with guys to be safe, but they usually get beaten up by those guys, so their options are limited.”

One of the regulars at Oshun is an Argentine woman named Zulema. She’s a 65-year-old who, when I met her, had been sleeping in the plastic chairs there for six years. “I stayed in shelters for four months, but the process is inefficient and I never felt safe,” she said. “The shelters are very bad for women, especially older women.” She told me she had become accustomed to sleeping sitting up on hard plastic. “You have no control of your life at the shelter,” she said. “At Oshun, I can come and go.”

You’d have no idea Zulema was a homeless woman who slept in a chair each night if you saw her on the street. She has flawless golden brown skin and a shiny gray bob. She often wears burgundy lipstick, khaki pants, a white button-down sweater and a jean jacket. She rides her bike for exercise and earns $400 a month selling flowers she buys from a wholesaler. She often drinks tea and reads the Bible at Starbucks. Advocates describe her as one of the few Oshun regulars who haven’t had the spirit beaten out of them.

A case in point is the older woman I spoke with who had served in the military and said she’d been homeless for several decades. She warned me that every person I was talking to was lying. “Why would you believe any of them?” she screamed. “Not a damn thing has changed since 1931. It never will. You’re wasting your time.”

Then there’s the physical toll the streets take. “Most homeless women in their 40s or 50s look like they are 70 or 80 because homelessness takes such a toll,” said O’Connor. “I no longer know if a homeless person is 50 or 80.”

Marcia, the homeless woman I met in front of the Mission Neighborhood Health Center, is 56 and looks her age. Maybe that’s because she only became homeless at 50. She’s a black woman who walks with a cane. She throws a large backpack over her thick green jacket and often wears jeans and a black bandanna. She learned the hard way about navigating the chaotic and stressful world of homelessness in 2005, when her mother died. She and her sister were supposed to share the money from the sale of their family home, but Marcia had a stroke that left her visually impaired, and her sister took the money and left the state. Talking about her life since that time, she paused, shook her head and admitted that she’s still shocked to find herself living on the streets.

“I didn’t even know this world existed before I became part of it,” she said. “When you’re homeless, you lose control of your environment. Most of the people I meet have mental illnesses. You never know when they’re going to snap. A quiet room can turn into chaos within minutes. I don’t sleep much.” Last year, Marcia testified in front of the city’s Shelter Monitoring Committee and offered a lengthy prescription for improvements, including an end to co-ed shelters so women feel safe. She also argued that the mentally ill should be kept separate from everyone else. But nothing changed. “Right now, we’re all lumped together,” she said. “It makes no sense.”

Marcia lived in a single-room occupancy hotel for six months. But the rent ate up half of her $900 Social Security check, and because SROs generally don’t have kitchens, she spent much of the rest on prepared meals. By the third week of the month, she often had less than $10 left on her debit card. “I’ve never been that poor,” she said. “I couldn’t deal with it. I also didn’t feel safe on the same floor as men. The walls were thin and it wasn’t clean, so I left.” Life got much worse when she was hit by a car and injured in 2009. She reached out to relatives and friends but never got a response.

“When you need something, everyone disappears,” Marcia said. She told me her goal at that point was to muster enough cash to buy a bus ticket to Reno, where she hoped to find an affordable place. Meanwhile, she tried not to think about suicide. “You get so depressed,” she said. “I’ve been able to maintain my sanity because I know how to withdraw. Like most homeless women I’ve met, I was molested as a child, so I know how to go inside of myself.” According to the National Center on Family Homelessness and the National Low Income Housing Coalition, a staggeringly high percentage of homeless women have experienced severe physical or sexual assault at some point in their lives.

Homelessness czar Bevan Dufty told me he was willing to talk with the women I’d met over the past few months, to explore their cases and contact their case managers about permanent housing options. The real problem, though, is the lack of affordable housing. “I can show you 27,000 individuals on the public housing list,” he said. “We’re dealing with a very big problem. We’re talking about a city that’s very expensive.”

Of 155,000 seniors living in San Francisco, according to a report by the city’s Department of Aging and Adult Services, roughly 19,000 live below the federal poverty line: $10,326 per year for a single person age 65 or older, or $13,014 for a two-person household. Based on the Elder Economic Security Standard Index, 61 percent of San Francisco’s seniors don’t have enough income to meet their basic needs. Meanwhile, the country has endured years of trickle-down economics, welfare cutbacks, rising income inequality, attacks on unions and the privatization of public services. Those are only some of the factors WRAP spelled out as causes of homelessness in its report “Without Housing.” And perhaps the biggest factor affecting older homeless women: the government turned housing over to the private market in the 1970s, and the Department of Housing and Urban Development’s budget was slashed by 77 percent between 1978 and 1983.

No wonder Paul Boden of WRAP said that the situation for the older homeless population has gotten progressively worse since the 1980s. “Back then, I could get a senior a nice room in an SRO hotel within the Section 8 program,” he told me. “Today, you can’t get them shit.”

The city is now looking into ways to house homeless individuals with medical needs that exceed the capacity of the emergency shelters to handle. “The most vulnerable can’t stand in line for hours at a time,” said Amanda Kahn Fried, policy director at HOPE, the city’s Housing, Opportunity, Partnerships and Engagement office. Some of these people, she noted, “are at the point in their life where they can’t take care of themselves. They’re either too old or too sick and can’t get out of bed or get to the bathroom.”

The city’s current efforts have some homeless advocates feeling hopeful. But for others, like James Powell at the Canon Kip Center, they’re a reminder of earlier attempts that ended in frustration. Ideas would be floated, meetings held, solutions discussed—and then nothing would happen. Maybe that’s the silver lining in a situation that has gotten so bad, Powell said.

“This is getting above the point of focus groups and closed-door meetings,” he added. “We’re on the verge of an implosion. We can’t continue to ignore all of these people who are suffering. We have no choice but to listen and act.”