Life and dying at a hospice for homeless folks


Hanging on a wall on the Inn Between is a photograph of John Cal Robb, the word he wrote earlier than he died and the blue plastic butterfly that signaled to his pals that it was his time to go.

Robb’s dying was particularly onerous on the inn. He was a jack-of-all-trades, helpful with instruments and all the time providing to offer fellow residents a trip to medical appointments. His chubby mutt, Boo Boo, nonetheless roams the ability — one in all solely a handful of institutions within the nation devoted to end-of-life take care of homeless folks.

“In case you are studying this, I’ve ridden off into the sundown with my fishing pole in hand. Thanks for serving to me get up to now,” wrote Robb, who, within the photograph, wears a contemplative smile, a cigarette hanging from his mouth. “I got here in a damaged man with no hope and left a stronger, extra compassionate and pleased man. I owe this all to you.”

When Robb was dying of abdomen most cancers in January, the butterfly was affixed to the entrance of his room door.

A blue plastic butterfly affixed to the door of a room on the Inn alerts that an Inn Between resident is “transitioning” and displays the ability’s coverage that “nobody dies alone.”

(Francine Orr / Los Angeles Instances)

Resembling monarchs however blue and speckled with splashes of white, the butterflies signify that somebody is “transitioning” and mirror the ability’s coverage that “nobody dies alone.”

The official mission of the Inn Between, positioned on a quiet avenue in Salt Lake Metropolis, is to “finish the tragic historical past of weak folks dying on the streets.” However there’s debate concerning the true which means of its identify: Is it in between the streets and the hospital? Or in between heaven and Earth?

Patricia “Patti” Larsen believes it’s the latter. She has discovered peace there that she didn’t know whereas residing on the streets.

Larsen has Stage 4 lung most cancers. When she entered the ability, her consumption photograph captured an individual barely recognizable now. Within the photograph, she’s thinner, and her face droops. Her hair is slicked again tight. She has a clean expression, mouth agape.

Right this moment, her face is fuller and sometimes smiling. Her nails are painted sizzling pink. She lets her thick, grey hair down.

When she arrived on the Inn Between, she had a prognosis of six weeks. That was a yr and a half in the past.

“We don’t look homeless anymore. We will clear up and take showers,” she affords as a form of rationalization for what healthcare and social staff have described as a outstanding transformation. “That’s one thing you don’t get to do out on the road.”

Nevertheless it’s greater than that.

Rosalba Aguilera, right, hands medication to Patti Larsen, left, at the Inn Between in Salt Lake City.

Rosalba Aguilera, an authorized nursing assistant, proper, fingers remedy to Patti Larsen. When she arrived on the Inn Between, she had a prognosis of six weeks. That was a yr and a half in the past.

(Francine Orr / Los Angeles Instances)

The Patti earlier than the Inn Between — jokingly referred to by workers as “Patricia,” as a sort of destructive alter ego — was notorious for her outbursts; she as soon as ripped out her colostomy bag and slung it at a employee who she stated wasn’t listening to her considerations.

Right this moment’s Patti is a hugger. She affords guests the comfier seat on the patio, the one with a thicker cushion, regardless of fixed ache blunted by fentanyl patches caught to her skinny arms. She is president of the resident council, and not too long ago pushed for extra espresso within the eating room on behalf of her neighbors. She gushes about her nieces, who name her “Aunt Cake,” as in patty-cake.

Column One

A showcase for compelling storytelling from the Los Angeles Instances.

The modifications in Larsen, who has a quiet room of her personal for the primary time in many years, conjure up research about how new child infants show to be more healthy when they’re held and cherished.

“It’s completely different right here. You’re accepted,” Larsen stated, arranging a line of stuffed animals she’s received at bingo atop the small sofa in her room. “You’re protected, .”

Jillian Olmsted, volunteer-turned-executive-director of the inn, just isn’t stunned. Time and time once more, folks come right here to die, and find yourself selecting to stay.

The key, she stated, is offering easy human requirements like meals, shelter and neighborhood.

The Inn Between just isn’t a homeless shelter; it feels extra like a nursing house or condominium advanced. Residents have been referred to the inn by native docs as a result of they’re homeless and searching for consolation care or medical respite.

A resident is wheeled out on a gurney at the Inn Between to an ambulance in Salt Lake City.

A primary responder wheels out a resident from the Inn Between to an ambulance. The Salt Lake Metropolis facility offers end-of-life care and medical respite for folks experiencing homelessness.

(Francine Orr / Los Angeles Instances)

On this specific week in September, it doesn’t really feel very similar to a hospice middle, both.

There’s bingo and karaoke and a chaperoned journey to the native Greek pageant. There’s a chapel, and a small room that’s been remodeled right into a salon, the place stylists volunteer to offer free haircuts each few weeks.

There have been two weddings held right here, after just a few residents hit it off.

Olmstead is a steadying presence who by no means stops pacing the beige hallways of the 50-bed facility, seemingly unattainable to upset. She confirmed no indicators of exasperation as she checked on nurses and volunteers and juggled requests for laundry detergent, a brand new leaf blower and an ambulance name.

“Wanting good,” she stated to a resident who was taking vacuum duties very critically. “Be sure to don’t overdo it, you’ve been operating round this morning.”

He complimented her outfit, and advised her she appeared good at present. “What do I normally appear like?” she joked.

It’s not all the time bustling like this, although. Some days, there are a whole lot of blue butterflies.

“Three weeks in the past, we had three folks actively dying and others on the cusp,” Olmsted stated. “It was a unique feeling round right here.”

James Haley, a resident at the Inn Between, shaves before work.

James Haley, shaving on the Inn Between earlier than he heads to work, was concerned in a automobile crash and severely injured his left arm. Residents are referred to the inn by native docs as a result of they’re homeless and searching for consolation care or medical respite.

(Francine Orr / Los Angeles Instances)

Greater than 700 miles west, simply exterior of Sacramento, plans for a facility very similar to the Inn Between have divided a neighborhood.

“It’s unacceptable to construct one thing like this proper throughout from a faculty,” Victor Alvarez, a father of two younger daughters, stated at a Twin Rivers Unified College District board assembly in July.

The varsity board voted to oppose the constructing of Joshua’s Home, which is predicted to be the primary hospice middle for homeless folks in California and on the West Coast. Board members anxious that the ability — involving six, small, manufactured houses — would at some point increase past hospice care; its proximity to an elementary faculty, the board stated, “could end in impacts that impede the tutorial progress and setting” of scholars.

Annoyed board members and oldsters pressed Joshua’s Home planners a couple of wrought iron fence, the visiting coverage and the way drugs could be saved. A web based petition with greater than 600 signatures referred to as it “a noble trigger” however in a “mistaken” location, and signatories warned of “predators.”

“They preserve saying they don’t need their youngsters to stroll by Joshua’s Home, and I remind them that now, persons are dying on the streets. Would you slightly your little one step over a lifeless particular person to go to high school?”

— Marlene Von Friederichs-Fitzwater, govt director and founding father of Joshua’s Home

However some native residents defended the hassle. On the July assembly, a annoyed Marbella Sala, president of the native neighborhood affiliation, shot again at critics. “They’re there to obtain care of their final moments of life,” she stated. “They’re not going to exit and stab anybody.”

The varsity board has no authority over the placement of the undertaking, and plans are on schedule to open in January at the same time as it’s nonetheless quick $400,000 in fundraising objectives.

Marlene Von Friederichs-Fitzwater, the chief director and founding father of Joshua’s Home, named for her grandson who died of an overdose whereas residing on the streets in 2014, stated she doesn’t perceive the opposition, emotionally or intellectually.

Jesse Gallegos arranges a vase of flowers at the Inn Between.

Jesse Gallegos arranges flowers, donated by Dealer Joe’s, earlier than delivering the vases across the Inn Between.

(Francine Orr / Los Angeles Instances)

“They preserve saying they don’t need their youngsters to stroll by Joshua’s Home, and I remind them that now, persons are dying on the streets. Would you slightly your little one step over a lifeless particular person to go to high school?” stated Von Friederichs-Fitzwater, who visited the Inn Between for inspiration. “It’s simply so mistaken. How do you get them to grasp?”

In 2020, at the least 137 folks died in Sacramento County who have been homeless, and greater than half of these folks died outside, based on a report launched by the Sacramento Regional Coalition to Finish Homelessness.

In Los Angeles County, the numbers are larger: 1,988 folks residing homeless died final yr, based on a report launched by public well being officers in April.

Whereas Utah and California have each launched bold applications to curb homelessness, end-of-life-care for the inhabitants remains to be largely uncharted territory, stated Debbie Thorpe, founding father of the Inn Between.

“Most hospice care takes place in people’ houses supported by relations however with the homeless, that’s simply not potential,” stated Thorpe, who has labored as a palliative care nurse for 40 years.

In Sacramento, misinformation spiraled uncontrolled concerning the intentions of Joshua’s Home, at the same time as its future residents are unlikely to usually depart the ability of their final days of life, stated Metropolis Councilman Jeff Harris, a proponent of this system.

A female cat named Rodger rides on Kimberly Peterson

A feminine cat named Rodger rides on Kimberly Peterson’s shoulder on the Inn Between in Salt Lake Metropolis. Peterson, who has congestive coronary heart failure, lives and works on the facility.

(Francine Orr / Los Angeles Instances)

Harris, who cared for his mom whereas she was dying from most cancers, was accused of dumping on a low-income neighborhood as a result of different, wealthier ZIP codes wouldn’t enable it there.

He insists he doesn’t see the ability as a detriment to the neighborhood, however a present.

“Once I take into consideration folks being discharged from the hospital, retching within the bushes as a result of they’ve been on chemotherapy, I simply can’t stay with that,” he stated. “No person ought to die with out dignity out within the wild like that, it doesn’t matter what situations introduced them into homelessness. They need to not must undergo the top of life with no person caring for them.”

The Inn Between confronted opposition too.

Opponents of the Inn Between, just like the critics in Sacramento, have been satisfied it might be a conventional shelter in disguise and would develop to serve extra than simply these in medical want — and trigger issues for the neighborhood.

After the ability opened, the workers obtained calls anytime a resident on the inn — or anybody, for that matter, who appeared unfamiliar to neighbors — was noticed exterior the constructing.

Suzanne Stephenson, who lives 4 homes down from the Inn Between, was the mouthpiece for what turned referred to as the NIMBYs — the “not in my yard” crowd.

Kimberly Peterson helps to carry food from a delivery truck into the Inn Between.

Kimberly Peterson, carrying meals from a meals financial institution supply truck to the Inn Between, is an authorized dying doula. “I’m like a midwife, however as a substitute of serving to carry folks into the world, I assist carry them out,” she says.

(Francine Orr / Los Angeles Instances)

“We have been made out to be the worst folks on the planet, however we have been simply anxious about security. Any individual truly got here up the road of their wheelchair and went down the driveway throughout the home from me and hung round,” she stated. “It made everyone very uncomfortable.”

However Stephenson has come round.

“I feel it’s run so nicely now. All of the NIMBYs form of simply went away,” she stated. “There’s nonetheless a few residents within the neighborhood who’re leery and who will simply by no means ever settle for and adapt. They nonetheless get a little bit bit nervous about it.”

On the identical day that the world was transfixed on the passing of the Queen of England, dying was simply one other a part of life on the Inn Between.

“She was 96,” one resident, who’s greater than 30 years youthful than Queen Elizabeth II, stated crudely over a dinner of beef and candy potatoes within the eating corridor, as if to say, “duh.”

Kimberly Peterson laughed. She has not too long ago grow to be licensed to be a dying doula, and can also be making peace together with her personal mortality.

“I’m like a midwife, however as a substitute of serving to carry folks into the world, I assist carry them out,” stated 50-year-old Peterson, who has congestive coronary heart failure.

When her well being issues precipitated her to be unable to work and fall behind on hire, a health care provider advisable the inn. When she first arrived in 2019, she was so afraid of dying that she would keep away from sure rooms. However now, she sits with residents, holding their fingers as they transition.

Peterson not too long ago stayed with a resident for 5 hours, who held onto her thumb till it was numb. She scrambled to seek out one other resident’s spouse in Vietnam in order that they might use FaceTime to say goodbye. Peterson relished the truth that when one other resident died, the nightmares from the warfare, which made him thrash in his sleep whereas she was at his bedside, had lastly subsided.

Now she describes dying as one thing sacred.

James Haley, from left, Jon O

Residents James Haley, from left, Jon O’Rouke, Michelle Talbot and Patti Larsen hand around in the patio on the Inn Between in Salt Lake Metropolis.

(Francine Orr / Los Angeles Instances)

“Whenever you see somebody move away with dignity and respect, and understanding they have been cherished, they usually discover peace, it’s essentially the most lovely factor on the planet,” Peterson stated by way of tears. “It breaks my coronary heart that individuals wouldn’t settle for a spot like this.”

Larsen, whose most cancers has unfold past her lungs, spent greater than 20 years residing on the streets of Las Vegas. Many years of maximum solar publicity present on the strains on her face. She blames the dry local weather for the lack of the imaginative and prescient in her left eye, which is glazed over with a milky hue due to an untreated scratch to her cornea.

On the inn, she has a mattress, a recliner and a mini fridge. There’s a field saved from a McDonald’s pleased meal sitting on the desk.

Photos of her now-adult youngsters after they have been in elementary faculty hold on the partitions. She misplaced most of her belongings when she might now not afford a storage constructing, together with household photographs, however her sister not too long ago despatched her these.

Volunteer Chrissy Metcalf calls bingo as Pepe Iossa dances a the Inn Between.

Chrissy Metcalf, a volunteer on the Inn Between, calls bingo as Pepe Iossa dances to have fun his win.

(Francine Orr / Los Angeles Instances)

She has taped to the partitions letters her nieces have despatched, with messages like “hope you get higher” drawn with a crayon and surrounded by hearts.

There are crops on the windowsill, not too long ago donated by the native Dealer Joe’s, and a pink picket field that she painted herself that she shops sweet in to affords to guests.

A nurse reminds her to take her drugs each two hours, and to drink extra water.

She remembers her life earlier than. She used to make use of duct tape to safe her colostomy bag. Typically she would sneak right into a parking storage to sleep in a concrete hallway at evening. The surveillance cameras gave her consolation.

“The streets are onerous. You’re all the time looking,” she stated. “I used to be robbed on a regular basis. You by no means know if you happen to’re going to be raped. The cops are all the time following you. You’ve simply gotta do what you gotta do.”

Julia Thomas, left, cleans the outdoor table where Patti Larsen, right, is sitting at the Inn Between.

Julia Thomas cleans a patio desk the place Patti Larsen, proper, is sitting. “It’s completely different right here. You’re accepted,” Larsen stated of the Inn Between. “You’re protected, .”

(Francine Orr / Los Angeles Instances)

In her room, she puzzled aloud if she would nonetheless be alive, if not for the Inn Between.

In the future, possibly quickly, a blue butterfly might be positioned on her door, subsequent to the place she’s hung a “house candy house” signal.

Individuals like Olmsted and Peterson will sit by her mattress. Perhaps they’ll maintain her hand. Perhaps they’ll inform her a narrative.

What’s for positive is that Larsen is not going to die exterior, alone. She might be house.

Supply hyperlink