10 years ago, on a sunny but cold afternoon of December 15, 2014, Debbie Thorpe, Ruth Zollinger, and I set up a community outreach tabletop display in front of the old convent on Goshen Street in Salt Lake City. Our purpose was to meet the neighbors and share our plan to open The INN Between, a hospice for the homeless, in the convent.
We waved passers-by over for a cup of hot cocoa and took turns explaining our plans. Debbie would share that she was a Nurse Practitioner (APRN) at Huntsman Cancer Hospital, and she was tired of having to discharge terminally ill cancer patients from the hospital, knowing they had no home to go to. And she was determined to create a solution. Sometimes, her patients were in the early stages of cancer, and being homeless meant they had multiple barriers to receiving life-saving treatment. Lack of insurance was on the list. Utah did not adopt the Affordable Care Act's Medicaid Expansion component, meaning that people who earned below a certain threshold (which included most homeless people) didn't qualify for Medicaid. Living in crisis mode makes it extremely difficult for people in crisis to make and keep appointments. Lack of transportation is another factor–the Huntsman Cancer Hospital is over 4 miles, uphill) from Pioneer Park, the downtown area adjacent to the Fourth Street Clinic, which serves the homeless, and The Road Home shelter. The lack of a place to recuperate was yet another barrier. Chemotherapy and radiation take a toll on the mind and body, and the effects can last days. Most patients get to go home to their bed or couch and have family or friends to look after them. But the homeless have nowhere to go. People staying at the shelters had to leave during the day, except for about 10 "medical beds;" however, even these beds needed to be vacated while the rooms were being cleaned.
Some of Debbie's patients had late-stage cancer, and being homeless meant they couldn't receive hospice care, a medical service that is delivered in the home and cannot be delivered in shelters or on the streets. She knew that without stable housing and hospice care, late-stage patients would suffer from increasing pain and anxiety on the streets. And, she knew they would most likely die alone, in fear, on the streets.
Debbie had the idea to start a hospice for the homeless in 2010 and had since been hosting a monthly committee meeting to further the cause. Ruth, a chaplain at a hospice agency, was a member when I started attending in late 2013 (learn how I came to be involved). Around October 2014, we learned about the vacant convent and shared our plans with Deacon George Reade, who managed the Roman Catholic Diocese of Utah's properties. It had most recently been used as a residence for women and children fleeing domestic violence. George was very moved by our project, and even though we didn't have start-up money to sign a lease, we all had faith that this would become the future home of The INN Between.
The neighbors trickled by, some walking, others stopping in their cars. We met the woman who lived across the street, some neighbors who lived a few houses down, and many who lived on surrounding blocks. One super friendly and talkative gentleman walked by several times, and we assumed he was homeless (we later learned that he lived at the end of the street).
Most of the folks we spoke with had no idea that people actually died on our city streets. Like me, before getting involved with this project, they assumed our society and our medical system had a medically sound way of dealing with terminally ill homeless people who. Many of the neighbors hadn't made the connection that people living on the streets suffer from the same four predominant chronic illnesses as the general population–cancer, diabetes, heart disease, and lung disease–and that with proper care and a stable living situation, they could have a good prognosis. And most people we spoke with didn't know that 52 was the average age of death for someone who has been chronically homeless (homeless for more than one year) because the lack of a warm, clean environment, sanitation, and nutrition exacerbate their disease.
Debbie, Ruth, and I stayed out well past dark, wanting to speak with people coming home from work. We must have spoken to more than 50 people, and in every case, we heard words of praise and compassion. People told us we were angels for doing something like this. Their hearts went out to the people suffering on the streets. The overwhelming support of the people in the neighborhood gave us the strength to move forward to make Debbie's dream a reality. We honestly thought we had done an excellent job at outreach and that our program would be welcomed with open arms. However, little did we know that a storm would soon start to brew.
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