January 10, 2023 – Tashi Taliaferro doesn’t want anyone to die alone.
Taliaferro has worked as a nurse for greater than 30 years – 12 of which as a hospice nurse – and has all the time felt comfortable coping with the sick and dying.
What frightened her was the variety of her patients who died without the comfort of family and friends.
“We see people in their 80s and 90s who no longer have family. We see veterans, homeless people and people who are underserved and forgotten,” says Taliaferro, assistant director of nursing at Advanced Nursing + Home Support, a house health care company in Rockville, Md. “We met people who had no one, and that goes straight to my heart.”
Taliaferro is within the means of opening a residential home for the homeless and chronically underserved in her community in Montgomery County, MD, outside of Washington, DC. The community has considered one of the very best Percentage of the country's population living in povertyEvery night greater than 4,410 people in the country's capital are homeless.
“No one should die alone unless they choose to,” says Taliaferro. “I think every person, no matter how old or young or rich or poor or whatever their background, deserves the utmost integrity, grace, compassion and love.”
The growing need for end-of-life care
As the child boomer generation ages, the variety of family caregivers will not be sufficient to supply this care. The AARP Policy Institute estimates that by 2030 there shall be 4 potential family caregivers for every body over 80. This compares with a ratio of seven to 1 in 2010. By 2050, this figure will fall to three to 1.
Of course, the variety of homeless people can also be aging. A report from 2019 of the University of Pennsylvania predicts that the variety of homeless people age 65 and older within the United States will nearly triple over the following seven years, from 40,000 in 2017 to 106,000 in 2030.
Homeless Americans are aging prematurely attributable to the chronic stress that comes with living in shelters, on the streets and couch browsing. The phenomenon is generally known as “weathering,” an area of particular interest to Rebecca Brown, MD, MPH, a geriatrician and assistant professor of drugs on the University of Pennsylvania in Philadelphia.
Brown's work has found that homeless people aged 50 and over suffer from age-related conditions, cognitive impairment, urinary incontinence, frailty and difficulties with basic every day activities comparable to bathing and dressing at similar or higher rates than the overall population, which has a median age of 80.
“They develop these age-related conditions when they are younger and then, not surprisingly, they die earlier,” Brown says.
Many individuals with a terminal illness comparable to cancer look after themselves in homeless shelters for so long as possible, says Dr. Travis Baggett, research director of the Boston Health Care for the Homeless Program.
“But once they can no longer get out of bed or wash themselves or need oxygen, which is not possible in most shelters, they can no longer stay there,” says Baggett.
These people may find yourself between hospitals and nursing homes, where they receive medical care until they die.
Taliaferro has worked with Emily Cavey, an expert photographer and end-of-life counselor. Like a birth companion, Cavey provides psychological, emotional and physical support to dying people and their families. The two became close after Taliaferro coordinated look after Cavey's dying loved one as a part of her job and discovered they shared a typical desire to assist people in the ultimate stages of their lives.
Taliaferro told Cavey about her idea of a residential home that may provide underserved and formerly homeless individuals with a dignified death. To raise money for his or her project, they eventually founded the nonprofit organization Good Hearts Foundation.
They are still within the early stages of searching for a possible donor for an acceptable home to operate in, in addition to other sources of funding comparable to grants to establish and operate the house.
It's currently unclear how the house shall be licensed or permitted. Taliaferro and Cavey are also working on what form of license they'll must operate as a residential home; county officials in Maryland initially thought the couple would want a hospice license. But the house itself is not going to provide medical services. Residents can use outside health care providers for his or her services, but there shall be no financial ties between the residential facility and people entities.
They have already got a reputation for the primary house: Maddy's House, after Taliaferro's mother, who died in a automobile accident when Taliaferro was 2 years old. They hope to open it in 2023.
The Grace House: An exemplary care home for the homeless
Taliaferro was inspired to create Maddy's House after learning concerning the Omega Home Network, a membership of 40 residential homes and more homes under development that every one share the identical goal: to supply a loving environment for individuals who would otherwise need to spend their final days alone.
Grace House, a nursing home in Akron, Ohio, and a part of the network, opened in September 2022 for terminally in poor health people.
The facility is funded by grants and donations and has three requirements for residents: They have to be enrolled in a Medicare, Medicaid or private medical insurance hospice program; they should have limited financial resources; and they need to not have anyone else who can house and look after them. All services are free to residents.
Holly Klein, a registered nurse and founding father of Grace House, repeatedly cared for homeless patients during her 14 years as a hospice nurse in Akron.
“I use the term 'home' in the broadest sense, because it was actually the place where the patient lived,” she says. “I met people under a bridge, in motel rooms, in homeless shelters, and some in living conditions that were simply not dignified. Seeing people die alone in these conditions was a burden, and I began to ask myself the question, 'Isn't there more we should be doing?'”
Hospice providers – who will not be financially tied to Grace House – visit each resident repeatedly, as if the residents were living in their very own home, to supply clinical care. At the identical time, home staff assist residents across the clock with cooking, cleansing, personal care and medicine administration.
“We see ourselves as a surrogate family,” Klein adds. “And anything a hospice program can teach a family to do at home, they can also teach our staff, such as simple dressing changes and medication training.”
Since its opening, 16 residents with incurable diseases comparable to heart and kidney disease have come to Grace House to live and die there.
Five residents were already homeless before they arrived, and several other got here from homes “that were literally collapsing on them or had no running water, electricity or heat,” Klein says.
Residents at Grace House who've lived alone for years often arrive withdrawn and distrustful. But many form friendships with one another, with staff and volunteers—and even reconnect with estranged relatives in the ultimate days and weeks of their lives.
“We provide them with an environment where they feel safe and secure. This allows them to break down some of those walls and old habits and reconnect with people,” says Klein. “It was incredible to witness.”