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Learn how a Sacramento hospice project got its start—and why it is named for Joshua

The site for Joshua’s House is a 1+ acre property bordered by Larchwood Drive, Patio Avenue and Northgate Boulevard. It will be completely fenced with wrought iron and flowering bushes and trees.

By: Matt Jocks April 7, 2023

A distinguished career in academics has put millions of words in front of the eyes of Marlene von Friederichs-Fitzwater, MA, Ph.D, MPH.

But the research that guides her life now didn’t come from houses of learning or science. It came from the hand of her late grandson.

“He would describe what he saw on the streets,” von Friederichs-Fitzwater says. “He would talk about seeing homeless people dying on the street.”

Von Friederichs-Fitzwater’s grandson Joshua saw it because the street is where he was living. And he would eventually become one of those who died there.

His death in 2014 would start the next chapter in von Friederichs-Fitzwater’s life. She embarked on what at times has been a one-woman mission to create a hospice center for terminally ill homeless persons.

“It has become my passion,” she says, “to hopefully accomplish this before I die.”

Joshua’s House, a community of homes to house 15 patients in Natomas, is due to open in early summer. It will be the first of its kind on the West Coast, a partnership in which von Friederichs-Fitzwater’s organization will provide comfort care (clothing, house furnishings, music and art therapy) while local health providers will provide hospice care.

To get from passion to open doors took years of hard work and money.


“It’s just horrible to think that, in this country, there are people who are dying with no place to go to be cared for.”


Marlene von Friederichs-Fitzwater
Founder of Joshua’s House

Von Friederichs-Fitzwater provided much of that herself. She estimated that she sank about $200,000 of her own retirement money and uncounted hours speaking to church and civic groups seeking financial support.

Her efforts produced about $2.3 million. Until a recent city grant of $450,000, almost all of it came from individual donors, swayed by an inescapable argument.

“It’s just horrible,” she says, “to think that, in this country, there are people who are dying unhoused with no place to go to be cared for.”

With the exception of a handful of facilities in other parts of the country, the homeless have been excluded from hospice care, which by definition, is home-based.

The passion von Friederichs-Fitzwater feels has driven her through the fund-raising process, as well as the detail work that followed—buying and storing the ADA-compliant manufactured homes, procuring property and now preparing the property for the homes to be delivered.

There was also dealing with reluctant neighbors, unhappy with the prospect of children on their way to school passing a house where people have died.

“My answer,” says von Friederichs-Fitzwater, “is that it’s better than stepping over them on the street.”

The issue of the terminally ill homeless dovetailed with the focus of von Friederichs-Fitzwater’s academic efforts at Sacramento State University and UC Davis. At UC Davis, she was an associate professor in the School of Medicine, focusing on disparities in health care based on age, ethnicity and income.

Von Friederichs-Fitzwater previously founded the Health Communication Research Institute, a nonprofit concerned with reducing healthcare disparities.

Those academic and societal goals take on a different power when it comes home to your own family.

Von Friederichs-Fitzwater was with Joshua from the beginning—in the labor room—through the babysitting years.

Drug and alcohol use led to a life and death, at age 34, on the streets.

“He was the most caring, giving, loving person ever,” von Friederichs-Fitzwater says. “He wrote songs and played the guitar. He was so talented. But so addicted. And he couldn’t get past that.”

His story is played out in one form or another across the country, but more so in California than anywhere else with the largest homeless population in the country.

When Joshua’s House welcomes its first residents, von Friederichs-Fitzwater says she will feel relief at what her hard work has achieved and happiness that Joshua’s legacy will go on.

But her goal is also for this to be the start, not the end, of the story.

“We’ve had people fly in,” she says, “to learn about what we’re doing and hopefully take it back to their communities to do something similar. I hope so.”

A short video about Joshua’s House by filmmaker William Foster shows von Friederichs-Fitzwater in her office. On the window next to her, a sign conveys a message at the heart of the effort to bring dignity to the terminally ill homeless:

“We’re all just walking each other home.”

For more information, visit https://joshuashousehospice.org/

TOPICS:hospice care

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    Joshua's House Hospice
    Joshua's House provides comfort care to terminally ill homeless men and women and access to quality hospice care.

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