By Vanguard Staff
SACRAMENTO — Sacramento marked a historic milestone in its response to homelessness and end-of-life care on Tuesday with the ribbon-cutting ceremony for Joshua’s House, a first-of-its-kind hospice designed specifically for terminally ill unhoused individuals. The facility, set to open in July, will be the first hospice of its kind on the West Coast and one of only a few in the nation.
Located at 3630 Larchwood Drive, Joshua’s House will provide hospice care to up to 15 unhoused people at a time, offering shelter, dignity, and compassionate support in their final days. The facility is the culmination of more than a decade of work by founder and CEO Marlene von Friederichs-Fitzwater, who raised more than $3.5 million through individual donations, public grants, and foundation support.
“Joshua’s House began with simple but profound conversations with people living on the streets,” said von Friederichs-Fitzwater at the ceremony. “They weren’t afraid of dying—they were afraid of dying alone.”
The inspiration for the project was deeply personal. Joshua’s House is named in memory of von Friederichs-Fitzwater’s grandson, who died alone while unhoused. Her vision was to create a place where others in similar circumstances would not face the same fate.
An estimated 20 to 25 percent of unhoused people die from terminal illnesses like COPD, cancer, and heart disease. Without stable housing, supportive care, or access to consistent medical treatment, their prognosis is often bleak. In 2021, more than 190 unhoused individuals died on the streets or along the rivers of Sacramento alone.
Joshua’s House seeks to offer a humane alternative. Its care model includes medical support provided by YoloCares, a nonprofit hospice provider with extensive experience. The facility will also offer residents access to certified end-of-life doulas, trained volunteers, meals, music and art therapy, and writing workshops. Educational partnerships will allow medical and nursing students to gain hands-on experience through coursework and internships on-site.
Unlike traditional hospices, which typically assume a patient has housing and a support system, Joshua’s House was designed from the ground up to serve those who lack both. The facility has partnered with every major hospital in the Sacramento region, creating a network of referrals and support for patients who would otherwise die without care.
At Tuesday’s ribbon-cutting ceremony, local leaders and healthcare advocates gathered to celebrate the opening. Sacramento County Supervisor Phil Serna, District 1, addressed the crowd alongside Craig Dresang, CEO of YoloCares, and representatives from the offices of Assemblymember Maggy Krell and Senator Angelique Ashby. The ceremony was emceed by Misha Safran, founder of the Center for Empathy and Emotional Intelligence, and concluded with a symbolic release of white doves to honor those lost and those who will soon be served at Joshua’s House.
“This community really came together in a way I have rarely seen in my 15 years on the Board of Supervisors,” Serna said. “It really is a sacred site. People will come here and people will die here, and for that reason, we need to treat it as the sacred site that it is.”
Joshua’s House is expected to open its doors in July, marking a new chapter in how Sacramento—and potentially communities across the country—care for those living and dying on the margins.
