A new hospice facility in Sacramento will open its doors to terminally ill homeless people on June 18.
Joshua’s House Hospice, located at 3630 Larchwood Drive in North Sacramento, will provide end-of-life care for up to 15 residents. The project, a decade in the making, was funded by more than $3.5 million in contributions from individual donors, local foundations, the city of Sacramento and Sacramento County.
“This project began with simple but profound conversations I had with people living on the streets,” said Marlene Von Fredericks-Fitzwater, founder and CEO of Joshua’s House. “They weren’t afraid of dying, they were afraid of dying alone.”
The facility consists of six residential units, each approximately 670 square feet, and was built by Jackson Construction. The total cost of the project is $2.8 million, covering site development, home purchases, design work, repairs and accessibility features such as ramps. Over the last 10 years, the project explored multiple designs and locations, each requiring separate funding and contributing to the overall investment in bringing the vision to completion.
According to Von Fredericks-Fitzwater, traditional hospice care assumes that a patient has stable housing, a bed and a support network. Unhoused individuals typically lack all three. “Many of our residents have complex medical histories, emotional trauma and no family support,” she said. “Hospitals can only do so much, and when care becomes palliative, these patients are often discharged back to the streets.”
In addition to hospice-level medical care, the facility will offer therapy services, spiritual counseling, and what Von Fredericks-Fitzwater described as “community for people who have none.”
The project is named in honor of Von Fredericks-Fitzwater’s grandson, Joshua, who died alone while homeless. Von Fredericks-Fitzwater said her family’s loss inspired the long-term vision behind the facility, which she hopes will serve as a model for other cities.
“This was always meant to serve as a blueprint,” she said. “We’ve already had people fly in to learn about what we’re doing with the intent to take this model back to their communities.”
Joshua’s House says it’s one of only a few such hospices in the United States. According to the organization, between 20% and 25% of people experiencing homelessness die from terminal illnesses such as cancer, COPD and heart disease, often within months of diagnosis.
The need for services like Joshua’s House is underscored by data from the Sacramento County Coroner’s Office and the Sacramento Regional Coalition to End Homelessness, which reported that more than 190 unhoused individuals died in the city in 2021. Many passed away without medical support, family or a safe place to spend their final days.
Von Fredericks-Fitzwater said she envisions Joshua’s House as a model for how communities can restore dignity at the end of life.
“No one should die alone and forgotten. Every life matters. Everyone deserves compassion, especially in their final moments,” she said. “Humanity shouldn’t come with conditions.”