Welcome to our first blog about the homeless community in Sacramento, CA, their health issues and Joshua’s House, a hospice house for the terminally ill homeless.

The first story in this web of intertwined stories begins in January 2016 when Marlene von Friederichs-Fitzwater,Ph.D., MPH, professor emeritus at California State University and associate professor, University of California at Davis, School of Medicine, retired to embark on a mission  in loving memory of her grandson, Joshua Lee, who died at the age of 34 on the streets of Omaha, NE.

Joshua had struggled with drug and alcohol addiction most of his adult life and often found himself homeless, either living on the streets in a variety of cities or staying with friends. Over time, Marlene learned of his concern for others on the streets in various cities and his desire to do something with his life to make a difference. Following his death in 2014, the concept of Joshua’s House, a hospice house so that those among us who are homeless  and terminally ill can spend their final days in comfort and dignity, began to evolve.

This blog is a way to share the many stories of people who are homeless and living with illnesses – and whose stories may have never been told if it weren’t for this project.  It is also a means of increasing public awareness about their plight — a path for our community to understand, heal and transform. We will all die with little choice, but we hope to influence where those who are most vulnerable spend their final weeks, days, hours.

[Stories] touch something that is human in us, and is probably unchanging … It’s what holds a culture together.

Rachel Naomi Remen


Our goal is for Joshua’s House to embody Joshua’s grace and the impact he made on others. “Everyone left a conversation with Joshua feeling uplifted.”

The journey toward creating Joshua’s House began when, early on, Marlene met with Sister Libby Fernandez, RSM, CEO, Loaves & Fishes, who immediately connected her with key people throughout Sacramento with an interest in the homeless. One of the first of those critical contacts was Moe Mohanna and his daughter, Nikky, the owner of a large vacant warehouse on the Loaves & Fishes campus. Moe ad Nikky graciously shared their commitment to the homeless and embraced the idea of using about 6,000 square feet of their warehouse for Joshua’s House.

Joshua’s House is a project of a community-based nonprofit that works closely with the homeless, whose needs and experiences are designing the form, function and breadth of this remarkable hospice, which will be one of just five such facilities in the nation.

Currently, four people who are homeless serve on the Advisory Board for Joshua’s House and the design for the facility is based on focus groups and interviews with homeless men and women. Some recurring themes that resulted were “I don’t want to be reminded that I am poor!” “Please bring nature inside.” “It can’t be drab and institutional.” “We need to be able to keep our pets with us.”

To that end, the hospice house will be bathed in natural light, have abundant open space, including fountains, greenery walls and an atrium. Initially, there will be 10  beds, with room for 10 more.

Residents of Joshua’s House will also have opportunities for art, music and writing therapy and spiritual guidance. If desired, there will be reunification services so patients can reconnect with family members.

Currently in Sacramento, the terminally ill homeless have no hospice options and are likely to be discharged from the hospitals to the streets, to night-time shelters or river encampments that are often teeming with communicable diseases. The homeless often have no place to store medication, tend to wounds or care for themselves hygienically. Most will die on the streets or on the river banks.

The need for Joshua’s House is urgent. We hope you will join us to ensure that the terminally ill homeless don’t die alone, forgotten and in pain.


Hold fast to dreams, For if dreams die Life is a broken-winged bird, That cannot fly.

Langston Hughes