Disabled seniors Claudy Pierce and Franklin Fishler are scrambling to find low-income housing since the Waikiki rental that they could barely afford was sold to a Japanese buyer.

"We are applying for senior housing, but we just don’t know what’s going to happen," said the 61-year-old Fishler, who sought help last week from the Waikiki Community Center. "We are in limbo land. If you ask us how worried we are about finding housing it’s about a 10 out of 10."

The couple has struggled to make ends meet since debilitating illnesses caused Fishler to retire his pharmacist’s license and Pierce to quit her delivery job. They said their one bright spot was the 250-square-foot studio that they rented for $900 a month in the Hawaiian Monarch building, which is centrally located, so they don’t need to own a car. However, they say the transaction could render them homeless because they cannot afford to pay more than their current rent, which is about 63 percent of their $1,420 combined monthly disability payments.

"We don’t have family and friends that we can turn to for support," said the 69-year-old Pierce, who speaks slowly as if each word requires more effort than she can manufacture. "About 10 years ago, we slept in the park for three days while we were trying to find housing. This time, I’m older and sicker. … I don’t think I could survive that."

Caroline Hayashi, executive director of the Waikiki Community Center, said the couple’s housing crisis is not unique, as more people are seeking the nonprofit’s assistance with obtaining adequate food, health care and housing.

"I’d say that we get a few cases like this every month," Hayashi said. "The real estate market in Waikiki is really strong again and a lot of buildings have been turning over."

While the recent pickup in Waikiki real estate values has been good for some property owners, it has created problems for senior renters displaced when long-term owners raise rents or sell. Leasehold evictions, expected to grow in Waikiki as owners take back their more valuable assets, could displace more seniors.

The neighborhood’s status as a world-class resort also makes its residential market more susceptible to price spikes. If the cycle continues as projected by independent housing consultant Ricky Cassiday, the average Waikiki residential condominium that traded for $476,000 in 2012 could soar 272 percent over the next decade to $1.27 million.

"We’ve already seen rent go up about 5 to 20 percent and it could go higher," said real estate analyst and longtime Waikiki resident Stephany Sofos. 

AS A RESULT of these economic strains, the Waikiki Health Center also has seen an uptick in seniors seeking assistance from its low-cost clinics or from Friendly Neighbors, a volunteer program that provides seniors with companions, checks on them and runs errands.

Social service providers statewide are growing more concerned that Hawaii’s elderly homeless are keeping pace with rising national projections, which estimate the number of homeless seniors will grow 33 percent between 2010 and 2020. About 37.5 percent of the 1,295 unsheltered adults encountered on Oahu during this year’s Homeless Point in Time Count were over 50.

Affordable elderly housing is a growing statewide concern, said state Homeless Coordinator Colin Kippen.

"I think the national projections for elderly homelessness are spot on," Kippen said. "What we know from our state data is that there is this huge mountain of people who are homeless in the 40-to-59-year-old cohort, so what we can expect is that as they mature they’ll slide into the elderly group. We are going to need a lot more service-enriched housing for this population."

But Waikiki social service providers say that it’s even more critical in their district, which has a higher percentage of seniors over the age of 65 than the rest of the state and tends to attract more visitors and transients. Sofos said the phenomenon has created challenges because many living in the neighborhood are without nearby family support to help them cope with changes in health, income, cost of living or housing.

"More people are becoming homeless and we’ve got condo boards that are increasingly coping with issues like dementia, incontinence in the elevators and public spaces, and falls," she said.

The lackluster economy and the high cost of living, especially housing costs, are taking a toll on the most vulnerable of Waikiki’s seniors, said Dr. Ahoora Payam, a physician at the Waikiki Health Center.

"A lot of the patients that I’m getting at the Ohua Clinic tend to be older, and some of them lack housing," Payam said. "When I worked at Care-A-Van, which takes care of our homeless patients, I was surprised that the vast majority of my patients were elderly. I’d say lack of housing for these people is a huge medical problem like severe lung or heart disease, but it’s harder to solve because we still don’t know exactly how to treat it."

Payam said seniors are at greater risk for psychiatric problems and medical conditions like high blood pressure, diabetes and heart disease, and if they are homeless that only exacerbates the complications.

"It’s already challenging for a homeless individual to take medication and keep track of it, but it’s much more challenging when they are under duress, like not knowing if someone will steal their belongings or where they will sleep tomorrow," Payam said. 

Recently, the Waikiki Health Center staff mourned the death of an elderly client who lived alone and refused to take her medication, said Kelly Joseph, Waikiki Health’s chief marketing and development officer.

"Her death was sad and tragic, but it really validates the need for the services that programs like Friendly Neighbors provide," Joseph said.

Payam said his clients also need more opportunities for affordable senior housing with comprehensive services.

The 2011 Hawaii Housing Planning Study, prepared by SMS Research, estimates that 19,200 more affordable rentals for lower-income households need to be built by 2016, said Janice Takahashi, chief planner and interim director for the Hawaii Housing Finance and Development Corp.

"That works out to a need for about 3,800 new affordable rental units per year. With existing resources, HHFDC typically finances the development of about 150 new rental units a year," Takahashi said. "There’s a big need for affordable senior housing, since seniors are the fastest growing segment of our population."

Takahashi said a 164-unit affordable senior housing project was recently completed in Pearl City. A 60-unit project is planned for Kauai, and there are two others under construction, including a 160-unit project in Honolulu and a 60-unit project in Hilo.

"There are hundreds of units coming when we need thousands," Takahashi said. "Still, the planned projects will make a small dent."

In the meantime, providers like Waikiki Community Center and the Waikiki Health Center say they are working to keep seniors who have housing independent and to bring the most vulnerable in from the streets.

Rhoda Cook, a 75-year-old Waikiki resident, said she can attest to the effectiveness of these programs in her community. Cook said that Friendly Neighbors helped her to stay independent after a hip replacement so that she could remain in the condominium that she loves.

"Waikiki is a happening place. I wouldn’t want to live anywhere else," she said. "Sure, there are challenges. … When they happen, I just call Friendly Neighbors. They’ve been a godsend."