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Dignity and care for the poorest among us

Something unexpected, and quite unthinkable, happened to Marlene von Friederichs-Fitzwater, in 2014. The founder of the Health Communication Research Institute and former professor/director at the UC-Davis Cancer Center, was notified that her 34-year-old grandson had died homeless while living on the streets of Omaha, Nebraska. His death came five months before his twin sons were born.

With the pain and shock of loss still fresh, and with tears in her eyes, Marlene says, “My grandson Joshua was a truly wonderful human being. Even though we were very, very close, I had no idea he was living on the streets.” She was aware that he had some health issues, and a few brief encounters with substance abuse, but never imagined that he would be among the homeless.

“He was someone that everyone wanted to be around,” she says. “He didn’t have a judgmental bone in his body, and he had a crazy, almost genius, sense of humor.” One of Marlene’s favorite memories of Joshua is linked to his appetite for reading and learning. He never went to college, but Marlene says, “He would always ask me if I had any books he could read. So, being a professor, I would give him what I had on hand. Usually they were high-level philosophical books that I used when teaching my graduate classes. He devoured them like a pro and always wanted to talk about them after he was finished.”

When he died, Marlene says, “It was as if a bright light was just turned off. I decided that I had to do something to prevent other homeless people from dying alone on the streets. I was first interested in homelessness when I was on faculty at the UC-Davis School of Medicine, but this very personal experience with my own grandson changed everything.”

In January of 2016, Marlene began the formation of an advisory board that would help create California’s first and only hospice home for the homeless. She decided it would be called Joshua’s House.

Over time, her board filled with leaders from Sacramento’s faith community, health organizations and representatives from Yolo Hospice, UC-Davis Medical Center, Sutter Health, Kaiser Permanente, Dignity Heath and the Coalition for Compassionate Care of California. The board also includes five extremely engaged and intelligent homeless people who call the banks of the American River their home because they have no other home.

Within a few months Marlene convinced the owner of an old vacant warehouse in Sacramento to donate his property for Joshua’s House. “When I told him about my vision he was immediately excited about the project,” she says. The building is on the campus of Loaves & Fishes, an urban oasis that is run by a Catholic nun and provides food, hospitality and shelter for homeless men, women and children.

As the vision for Joshua’s House began to crystalize, other donors stepped up to help out. An architect, space designer, builder, asbestos testing and abatement company, plumber and other tradespeople and contractors have now volunteered their services too.

To help inform the design, look and feel of Joshua’s House, Marlene thought it would be important to solicit input from Sacramento’s homeless communities. So she and Jose Martinez, who is also a Yolo Hospice volunteer and former executive director of the Yolo Food Bank, conducted interviews and focus groups with 150 homeless men and women. Some of the information they gleaned from the interviews was startling.

More than 40 percent of the interviewees rely on hospital emergency rooms to access routine care. “Many of them said they know with certainty that they will be seen by a doctor if they go to the ER, but not necessarily so if they go to a clinic,” she explains. Homeless people also have challenges storing medications that need to be refrigerated or used with a syringe.

The focus groups proved to be a valuable tool for bringing definition to Joshua’s House. “Our homeless brethren want a space that brings the outdoors inside. Lots of natural light, water features, greenery and open space will be important for this project,” according to Marlene. One man told her, “I don’t want this home to be in a place that reminds me every day that I’m poor.”

The interviews also revealed that a main concern that homeless people have is facing the end of life alone and being forgotten. Some of them said they are afraid of “being vaporized” or “just disappearing.”

There is one homeless woman that Marlene says she will never forget. Her name was Anna. She was a single mother who worked fulltime and took care of her children. She was having some health issues and was eventually diagnosed with epilepsy. Then Anna lost her job and couldn’t pull her rent money together. She was evicted, and eventually had her children taken away. She was working hard to stabilize her health and to find another job. But then she received a stage-four lung cancer diagnosis. Anna ended up dying on the street along the American River. Before she died she told Marlene, “I don’t want it to be like I never lived.”

Describing herself as someone who wants to leave her tiny corner of the world better than when she found it, Marlene says she has learned a lot about the resilience of homeless people. “These folks are smart, eager to share their stories, and they frequently stay positive in the face of huge challenges.”

According to Marlene, even though Joshua’s House will be infused with her grandson’s spirit of love, acceptance, and joy, “the project is about the brotherhood of all humans.”


Joshua’s House could open by the end of 2017. Recently, Sacramento Mayor-elect, Darrell Steinberg, endorsed the project through a letter of support. He said, “I am aware that, on average, one homeless person dies on the streets every week in Sacramento County. Approximately 38 percent die alone on the streets and another 35 percent die in emergency rooms. Homelessness is going to be a top-tier priority for my administration and I believe a hospice house is a much-needed addition to Sacramento’s continuum of care. No person should ever be forced to live their final days, weeks or months living on the streets without adequate access to services that provide comfort and dignity.”

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