The Inn Between in Salt Lake City offers a revolutionary program: hospice care for homeless individuals. We visit to see what resistance they have met — and what hope they've inspired.
The Inn Between in Salt Lake City offers a revolutionary program: hospice care for homeless individuals. We visit to see what resistance they have met — and what hope they've inspired.
Read the full transcript here.
Host: Gustavo Arellano
Guests: L.A. Times California politics reporter Mackenzie Mays
The place where homeless people come to die with dignity
Column: He was homeless and in hospice. His recovery is a lesson in what it takes to save a life
Column: Stalked by death, they are gathered off the streets and cared for by an army of angels
Gustavo Arellano: More than 150,000 people are currently living unhoused in California. And every year thousands of those Californians who live on the street also die on the street.
Gavin Newsom: It's a disgrace that the richest state in the richest nation succeeding across so many sectors is falling so far behind to properly house, heal and humanely treat so many of its own people.
Gustavo: A proposed homeless hospice center in Sacramento wants to offer terminally ill and sheltered people a place to die with dignity. But nearby residents aren't happy about it.
Parent (opposed): I'm not anti-unhoused in any way, shape or form. I think it’s a great project. But before I vote to put this near our school, I need some answers.
Gustavo: I'm Gustavo Arellano. You're listening to “The Times: Essential News from the L.A. Times.” It's Monday, November 21, 2022. Today, why everyone wants to solve California's homelessness crisis, but no one wants those solutions to be anywhere near them.
Gustavo: My colleague Mackenzie Mays covers state government politics. Mackenzie, welcome to The Times.
Mackenzie Mays: Thanks for having me.
Gustavo: There’s just so many approaches to trying to help homeless people from offering housing, to finding folks jobs, to even offering showers to their pets. But until I read your story, I had never heard of efforts to make homeless folks die easier. How do you find out about this?
Mackenzie: Yeah, so I'm based in Sacramento and there was this big argument in a community not far from me, a school board.
Board meeting: Meeting will be called to order.
Mackenzie: In July, I watched this school board meeting play out online on Zoom.
Board meeting: Next is Agenda Item A3, opportunity of the public to address the board.
Mackenzie: So these centers are trying to create a home for people living on the streets to die, and they call it transitioning. Um, Joshua's House, this facility that's supposed to be the first homeless hospice center in California and on the West Coast. It's supposed to be up and running in January.
Board meeting: Thank you, uh, board members. Um, I'm here this evening representing the community surrounding Garden Valley Elementary School. We urge the board to adopt Resolution 1093 opposing the placement of Joshua's House in front of Garden Valley Elementary School.
Mackenzie: So Joshua's House will be located, uh, next to an elementary school. And people were really angry about it. They didn't want their children to walk by it, essentially.
Parent (opposed): It's unacceptable to build something right across from school.
Parent (opposed): What's to say that individuals are not gonna be hanging out outside. We, we don't even know what's gonna happen there.
Mackenzie: And on the other side of the debate, people were really appalled by that argument saying these people can barely walk, let alone, um, you know, get out and hurt someone.
Pres of Neighborhood Assn (pro): They're there to receive care in their last moments of life. and they're not gonna be walking around. They're not gonna go out and stab anyone. They are there, to receive end-of-life care.
Mackenzie: And they said, “Hey, this is a good idea. We just don't want it in our community and we don't want it near our schools.”
Parent (opposed): Having a hospice for the unhoused is a service that is commendable and needed. We appreciate the thought of Joshua's House. No one is stating that the hospice or the organization is a bad thing and the facility would be much better suited in a different location, not across the street from an elementary school.
Mackenzie: And it was really an emotional debate.
Parent (opposed): The rhetoric coming from the city that anyone opposed to this facility is afraid of unhoused people or doesn't care about unhoused people or is just a part of the not-in-my-backyard mentality is false, demeaning and downright condescending.
Mackenzie: And it wasn't your traditional NIMBY sort of story, because in this case, this neighborhood – Twin Rivers – does, you know, have less parks than a nearby ZIP Code. It is lower income than some of the surrounding areas.
Parent (opposed): The community has been clear with Councilmember Harris that what our community needs are facilities that will benefit our children who attend Garden Valley Elementary. Facilities such as a community center, a library, a childcare center or any combination of these.
Mackenzie: They felt like they were being dumped on, that more affluent communities would not accept this place.
Parent (opposed): Unfortunately, Councilmember Harris only sees homeless uses for lower-income, low-resource community.
Mackenzie: The City Council member, Jeff Harris, who supported it, to me swore that that was not the case, that he saw it as a positive gift to the community and to teach kids, hey, everybody deserves to be treated with dignity, no matter what. And he said that he helped his own mother die in hospice care with cancer. And he just couldn't stop thinking about someone like her, being sick and puking in a bush and being alone out on the streets.
Mackenzie: And I couldn't really stop thinking about it because, like you said, in California, we're constantly talking about homelessness solutions. The governor is coming up with ways to combat homelessness. Voters are always naming it as an issue. We're always talking about how homeless people are living on the streets, but not so much about how they're dying on the streets.
Mackenzie: But we do keep a lot of data around that. So in Sacramento County, about 200 people died who were homeless, and more than half of those people, I believe it was 55%, died outside.
And then of course, in Los Angeles County, numbers are way greater, like around 2,000 died on the streets as opposed to a shelter. And when you talk to the people that I've been talking to for the story, shelter is not a great place for end-of-life care either. You don't have the things that you need to, sort of die in a comfortable setting a lot of times.
Mackenzie: So Joshua's House is trying to be a solution to a problem that has existed for a long time. So whether you are homeless and you go to the ER or go to the hospital and find out that you have a serious medical condition, you can't really heal well if you're living in a tent or you're living on the streets. So with hospice, usually people come to your home and they make sure that you die comfortably and with dignity. If you don't have a home, hospice can't really operate. So these centers are trying to sort of create a comfortable space for people to die with dignity.
Joshua’s House commercial: On average, one or two homeless people pass away on the streets of Sacramento each week. At Joshua's House, we can change that.
Mackenzie: Marlene, who is the founder of Joshua's House, her grandson's name was Joshua. He died of an overdose in 2014 while living on the streets. And even as he was homeless, he stayed in contact with his grandmother, Marlene, and she's a public health expert anyways, so after he passed, this became her whole life. You know, she's doing all the research. She's conducted so many interviews and studied all of this to figure out like, hey, this is actually something that benefits everyone.
Gustavo: After the break we look at a homeless hospice center already in operation.
Gustavo: So Mackenzie, you spoke to Marlene, the founder of Joshua's House. What did she have to say about this school debate?
Mackenzie: When I was talking to Marlene, you know, about this debate playing out, Marlene's rebuttal was, would you rather your kid step over a dead body on the way to school? Because that could happen. The alternative is that they're still gonna die on the streets, and your kid might see that. She felt, like, really hurt by it. Californians have gotten, like, so far gone on the homelessness issue that we won't accept a center where people die.
Gustavo: Are there a lot of them across the United States?
Mackenzie: No. No, there are not. There's only a handful. And I actually had to fly to Salt Lake City, Utah, to get to the closest one I could observe.
Mackenzie: I really wanted to tell this story about what a homeless hospice center does, why people were upset about it. But the closest place I could find was in Salt Lake City, Utah. And it's called the Inn Between. So we flew there to see what it's all about.
Mackenzie: I haven't spent a lot of time in hospice centers. So I was preparing for a really emotional, maybe quiet, closed-off place.
Mackenzie: And that's not what it was like at all.
Inn Between Audio: B-9.
Inn Between Audio: N-32. Bingo.
Mackenzie: There was bingo, there was a salon where people could get their hair done. There was a big dining hall, you know, there was a smoking patio.
Inn Between Audio: Nice to meet you. This is Mackenzie from the L.A. Times. We're roaming around. Nice to meet you. Nice to meet you too. Thanks for coming out.
Mackenzie: People were really welcoming. Everybody wanted to tell me their story. And sometimes you almost forgot that it's a place where just about everybody is actively dying or could be soon.
Inn Between Audio: And then this is a meditation room chapel. It's kind of a multipurpose.
Mackenzie: Pretty immediately I'm introduced to the blue butterflies. They're these little plastic blue-and-white speckled butterflies. And when someone's dying, you pin a butterfly to the door to signify the no-one-dies-alone policy, which is an invite for someone to come inside, so that people know, like, hey, it is this person's time, and you know, we would love to have you inside to, to be with them on that day. But I was told that I was there on a lucky week, that the week prior, they had three or four people dying or on the cusp of dying. And that's just how things ebb and flow at a center like that.
Gustavo: So how does someone qualify to enter the Inn Between. Like, what's a criteria?
Mackenzie: So you either have to be terminally ill and unhoused. Or in some cases there were a few folks who had been severely injured and are living homeless, and so need somewhere to heal. So I met a few different folks there.
Patti: My sock monkeys. There's these two and then we have a little kitty and we have the St. Paddy's Day Bear.
Mackenzie Mays: Patti is the president of the resident council at the Inn Between. She loves it. She loves her room. She was very happy to show us around. She is really great at bingo and has so many, stuffed animals that she has won from her bingo winnings. She is just really thriving here. Um, she's a hugger.
Mackenzie: They call the Patti before the Inn Between “Patricia,” to sort of signify the before and after. And Patricia lived on the streets for more than 20 years.
Patti: I think from being so dehydrated, it was in the summer and I went instantly blind.
Mackenzie: She had all kinds of health problems, including Stage 4 lung cancer.
Health aide: Coffee can, coffee can dehydrate you, right? She's not much of a water drinker.
Mackenzie: She has a colostomy bag that she had been caring for with duct tape. She came here to heal and she's, she's healed sort of beyond everybody's expectations.
Mackenzie at The Inn Between: Yeah. How is it different here compared to this?
Patti: You're accepted, you know, you're not homeless and we don't look homeless anymore and, you know, we can clean up and take showers and ... something you don't get to do out on the street.
Mackenzie at the Inn Between: Right.
Mackenzie: The Patti now at the Inn Between is apparently so different than who she was before. And you can try to come up with all these different reasons why, but a lot of the staffers will say, hey, she just has a bed, or she has a shower, or, food and nutrition. And it really made you think about some of the things I think everybody takes for granted.
Patti: And they take good care of us here. You know, just because you're homeless doesn't mean that you're not worth anything or that, you know, you're gonna cause ruckus in a neighborhood or something, because that's not who we are. That's very few .…
Mackenzie: It's kind of weird, like, when you're sitting there and talking to folks, you sort of forget why they're there. Because even though death is this consistent thread between all of them and the reason why everybody's there, they're not necessarily talking about it all the time. It's kind of like they forget why they're there too.
Gustavo: You also met a death doula.
Mackenzie: Yes. So Kimberly Peterson is not only a resident at the Inn Between, but also a staffer now.
Mackenzie: Yeah. When did you get your diagnosis?
Kimberly: Um, I got February 18 of 2018.
Mackenzie: Her heart condition sort of came out of nowhere. I think she was already struggling a little bit. She was paying rent with a roommate and she just couldn't keep up. She couldn't work anymore.
Kimberly: My cardiologist had no clue where to send me. And then someone pointed me to a community connection, which pointed me to the Inn Between.
Mackenzie: She had a doctor say why don't you go to the Inn Between? And it's become a huge part of her identity.
Kimberly: I took all the stress of everything away, ’cause all of a sudden I found myself not able to work. And they just provided a safe home, safe place to be. And if people take advantage of it, like, they can thrive and be better, you know, so it's amazing.
Mackenzie: She is dying. But she got certified to be a death doula so that she can sit and help others die. And she has done that with several of her friends.
Mackenzie at the Inn Between: What's, what is a death doula? How do you explain it to people who you've never heard of it before?
Kimberly: Um, yeah, someone that provides a safe space. So, like, if you like midwife, keeps them like a mom called and the space.
Mackenzie: She describes it as like midwifery. So instead of bringing people into the world, she's helping bringing them out.
Kimberly: It has a lot to do with, like, legacy and last wishes and to listen to them … ’cause you want them, you want them to find their peace and sometimes you just have to guide it. But they need a really safe space so they don't, they're not agitated
Mackenzie: She has sat and held the hand of several people as they left. And when I was talking to her about it there she cried, and I was kind of surprised by that. It was like, I, you know, I thought you'd get so used to this, that you wouldn't cry or be emotional anymore, just kind of become part of the job. And she said no, that, you know, if she does stop crying she'll be disappointed in herself.
Kimberly: It still, if I stop crying, then I'm not in the right line of work. If I stop having emotions. But to me I cry because it's so beautiful. ’Cause I think I just, I think about someone dying on the streets and it just breaks my heart.
Mackenzie: It wasn't all what I thought it would be. I thought I was going to leave really sad, um, because death is hard for most of us to talk about. And I was sad. But there was a lot of sort of like hope and, and happiness in it too, because these people's lives changed, even if it was at the end of their life. Things have really changed for them in a positive way.
Kimberly: This place is amazing and, um, it makes me really sad to see how close-minded people are because, um, when you see someone pass away with, uh, dignity, respect and knowing they were loved and they find peace, that's the most beautiful thing in the world. So it breaks my heart that people wouldn't accept a place like this. Yeah, so, yeah.
Gustavo: After the break, what lessons the Inn Between might have for Sacramento.
Gustavo: So Mackenzie, the homeless hospice you visited in Utah sounds like it's pretty established now, has a proven track record and it seems accepted now. But were locals there in Salt Lake City also concerned when it opened back in 2018 the way, uh, people are concerned right now in Sacramento for the proposed hospice there.
Mackenzie: Yes, it's uncanny, actually. It's– I was reading through old newspaper clips and it's exactly what's happening here near Sacramento. And I actually was able to find one of what they call the NIMBYs. There were the NIMBYs and the YIMBYs — the not in my backyard and yes in my backyard. They had the exact same issues and people were scared. They said it was going to ruin the neighborhood. They worried that it would, quote unquote, spiral out of control and be this huge traditional shelter and not just a place where people were getting healthcare and comfort care.
Gustavo: Yeah, how does the community feel about it now?
Mackenzie: So I was able to actually talk to somebody who had a change of heart in Salt Lake City. Susan Stevenson was the head of the NIMBY group, she lives four houses down from the Inn Between. It was really interesting because they have her on speed dial, they talk to her all the time. But she went from being the mouthpiece of the NIMBYs to now, when I spoke with her, she said there aren't really any NIMBYs left. They got kind of tired of the fighting about it. She thinks it's really well run now. She said that some people still are just never going to be comfortable with a facility like that on their street, but that as far as she's concerned, she thinks it's actually doing a good job at what it's supposed to do.
Gustavo: Do you think the same acceptance might happen in Sacramento for Joshua's House? What's the latest there?
Mackenzie: It could, you know, um, it's hard to predict until things are up and running. You know, in the beginning it seemed like people had all these safety concerns, especially when it comes to the nearby schoolchildren. But if you talk to the staff there, they don't think there are gonna be any real problems once people see what it actually is supposed to do.
Gustavo: Mackenzie, thank you so much for this conversation.
Mackenzie: Thank you.
Gustavo: And that's it for this episode of “The Times: Essential News from the L.A. Times.”
Maya Kroth was the hefa on this episode along with Alex Higgins and Jazmin Aguilera, and Mike Heflin mixed and mastered it. Our show's produced by Shannon Lin, Denise Guerra, Kasia Broussalian, David Toledo and Ashlea Brown. Our editorial assistant is Madalyn Amato. Our engineers are Mario Diaz, Mark Nieto and Mike Heflin. Our editor is Kinsee Morlan. Our executive producers are Jazmin Aguilera, Shani Hilton, Heba Elorbany, and our theme music is by Andrew Eapen. I’m Gustavo Arellano, we’ll be back Wednesday with all the news and desmadre.