the former Soviet Union during the subsequent decades. (4) The number of Holocaust survivors living in the United States at the end of 2018 was approximately 80,000 individuals, down from an estimated 127,000 in 2010. (5) Every Holocaust survivor is now at least 74 years old, most are in at least their mid-to-late eighties, and many are in their nineties and beyond. (6) One-third of all Holocaust survivors in the United States live at or below the official poverty threshold (as defined by the Bureau of the Census), including more than half of the Holocaust survivors who emigrated from the countries of the former Soviet Union. (7) Holocaust survivors continue to live with the unique mental and physical scars of the unconscionable trauma caused by the Holocaust, and while institutionalized settings are beneficial for some, certain aspects of institutionalization may have particularly adverse effects on Holocaust survivors. (8) For many Holocaust survivors, institutionalized settings produce sights, sounds, smells, emotions, and routines that can induce panic, anxiety, and re-traumatization as a result of experiences from the Holocaust. (9) Holocaust survivors are more economically and socially vulnerable, report poorer health and more health problems, and have greater social service needs, than other older individuals. (10) In comparison to most other older individuals, low-income Holocaust survivors are more reliant on social service programs that provide services such as personal care, provision of home-delivered and congregate meals, transportation, counseling, and mental health support to promote health and quality of life. (11) Community organizations serving Holocaust survivors report that approximately one-quarter of Holocaust survivors live alone, and living alone is a risk factor for hospitalization and nursing home admission, poverty, falls, depression, poor nutrition, social isolation, and loneliness, which have been associated with poor health outcomes and an increased risk of death. (12) Community