Quintessential care for all. And all means all.
By: Craig Dresang, CEO, YoloCares
At one point in his life, Frank was a real estate attorney. He had a wife and two kids. They lived in an upscale suburban home with a backyard pool and a three-car garage. On weekends and some evenings, he played guitar in a local band with his old college buddies. Summer vacations, extravagant Christmas parties, and neighborhood barbeques were highlights of what seemed like an ordinary, but very comfortable, life.
The day after his 44th birthday, his wife told him she was filing for divorce. He was stunned.
With no advance notice, she packed her bags and left. He learned later that she moved out of their home and directly into a secret lover’s townhouse in southern California. Frank was devastated. To cope with the shock and anxiety, he started drinking heavily. A toxic mix of alcohol and depression began to impact his job. After several months, his employer suggested he take some time off to get his life in order. Missed appointments, a pattern of mistakes, and an increasingly combative personality resulted in Frank losing his job.
He sunk even deeper into depression. Frank’s life had become completely unmanageable . . . drinking more and eating less. Bottles of vodka were on the menu for breakfast, lunch and dinner. Attempting to simultaneously keep his house and pay for an addiction, he depleted his retirement account, sold his car and boat, and pawned off most of the contents in his home including a Rolex watch that his father gave him as a graduation gift when he finished his education at Stanford University. When those resources ran out, the bank repossessed his home.
For a while, couch surfing became a way of life, staying with old friends and a few distant relatives. When the welcomes finally wore out, he decided to set up camp near the American River, not far from the home where he once built a life. He eventually found methamphetamine to be a cheaper and more potent escape than alcohol.
Fast forward: Now 70 years old, Frank was an anomaly. Most people experiencing long-term homelessness and/or severe addiction only live to be about 52 years old at best. One morning, a shop owner in Midtown Sacramento found him unresponsive at her business’s main entrance. She called the paramedics, and Frank was taken to the hospital. While there, he received a terminal diagnosis. Hospital staff did not want to release him back onto the street, so they called YoloCares.
The next day, Frank was admitted to Joshua’s House, the West Coast’s first residential community for terminally ill individuals experiencing homelessness. Owned and operated by YoloCares, Joshua’s House provides a home along with medical and psychosocial support for people like Frank. At first, having structure and support was a challenge for him. Afterall, he had been living on the streets for nearly two decades. By this time, his sense of normal did not include a comfortable bedroom of his own or living in a three-bedroom cottage behind a tall fence and gates. Adapting to a culture that holds boundaries can be a challenge initially.
YoloCares staff who are specially trained in trauma-informed care (TIC) courageously and patiently walked him through a settling period. Unlike other approaches or care models, TIC shifts the focus from, “What’s wrong with you?” to “What happened to you?” It is a relationship-based approach to healthcare. It gives the clinical team (physician, nurse, hospice aide, social worker, spiritual care coordinator, and caregiver) a complete picture of a patient’s situation. Building trust and creating a safe environment are key components of TIC.
When Frank’s interdisciplinary team members learned that he loved playing the guitar and that he once was in a band, they explored this aspect of his life during their weekly interdisciplinary team meeting. One of the nurses said, “We have spare guitars at YoloCares. In fact, we have more than we need.” Musical instruments are frequently used for music therapy with children in the YoloCares for Kids program.
The next day, Frank’s nurse brought him a guitar. When she walked into his room, his eyes lit up. She said, “This is for you. We know you love to play.” She handed him the instrument, and his eyes began to well-up with tears. He immediately began to play. For the first time in a long time, Frank was smiling with an expression of pure satisfaction and joy.
Another recent patient-resident landed at Joshua’s House after being referred to YoloCares by a local hospital. By the time she arrived, she was just days away from death. She had not seen, or talked to, her family for more than two decades. But after seeing the facility’s warm homelike environment, three of her family members decided to come visit. In fact, they became comfortable enough to make their visits an everyday occurrence. The patient’s condition had severely compromised her vocal cords, leaving her unable to speak. The evening before her death, she and her family had reconciled their previously broken relationship. That same night, the patient miraculously mustered strength to whisper, “I love you.” Everyone in the room was reduced to tears.
The stories connected to Joshua’s House have become a case study in how to facilitate a more meaningful life and death for previously unhoused individuals. The program already has a track record of shattering otherwise impenetrable barriers, and fostering reconciliation, dignity and hope when it matters most.
Joshua’s House has been open for just nine months, yet it has already provided more than 1,000 days of patient care. Every 36 hours a Sacramentan dies on the streets. The problem of homelessness is not getting any better. The homeless crisis is visible every day while driving to work or running to the grocery store. A primary goal for YoloCares is to inspire five other similar movements/programs across the West Coast within five years. To that end, the organization has already partnered with an agency in Sonoma County to replicate a Joshua’s House-like program there. This small experiment of five cottages with three bedrooms will hopefully become a model for many other communities.
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Special Note: There are no walk-in services at Joshua’s House. Patients need to be referred by healthcare systems and partners who are well-versed in moving individuals through the care navigation process. Besides Sacramento, patients have come from Nevada, Santa Rosa, Butte County, and Stockton.
Joshua’s House relies on philanthropic support for its day-to-day operations. About $1 million annually is required to keep its doors open. For information on ways to give or get involved, visit us at www.yolocares.org
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