A group of Wisconsin-based organizations, including hospices, are working to improve end-of-life care among homeless populations.

A recent grant from local government agencies is helping to fuel these efforts. Solace Friends Inc. is among the organizations to receive $100,000 in grant funding that helped launch an adult family center. Dubbed Solace Home, the four-bed residential facility opened today and will provide end-of-life housing and caregiving for terminally ill individuals living in unstable or insecure situations.

Individuals who elect to receive hospice at the facility will receive care from local providers. A main goal of establishing the facility is to provide a safe and comfortable environment for those approaching the end of life, according to Kendra Deja, executive director at Solace Home.

“We offer an alternative to dying alone on the street,” Deja said in a statement shared with Hospice News. “People will have access to dying in a safe home environment with the support of people committed to honoring their humanity. Regardless of their past life experiences, residents of Solace Home will know they are loved and they mattered to others in this world.”

Homelessness and hospice challenges

Solace Friends supports individuals in a variety of situations, including those with transitional housing needs. The facility was funded by various grants and donations, which pay for housing, food, supplies and caregiving for residents.

Residents at the new facility will receive access to 24/7 interdisciplinary hospice services, including assistance with meals, laundry, medication and personal care needs, as well as emotional and spiritual support.

The funding boost for Solace Home was included in the Wisconsin Dane County Board of Supervisors’ 2024 budget increase. The board increased this year’s budget to include $12.7 million in support for the Housing Access and Affordability Division, which manages contracts with various community shelters, housing organizations and health care providers. The budget increase included an additional total of $1.35 million for housing and homeless services in the area.

“We are grateful to be able to offer this new resource to people who are facing housing insecurity,” said Katherine Kamp, board president of Solace Friends. “Volunteers and community members worked tirelessly to make this vision a reality.”

The Dane County region spans several urban, rural and tribal communities across southeast Wisconsin. The region is home to one of the largest metropolitan areas in the state and its capitol, Madison.

Solace Home is located in Monona, Wisconsin near the state’s capitol, which is an important part of access for people in need from various regions, according to Dane County Supervisor Sarah Smith.

The area has a broad range of underserved homeless populations from diverse cultural, spiritual and ethnic backgrounds, as well as individuals in the LGBTQ+ community, Smith stated.

People of color represented about 16% of the area’s homeless population in 2023, reported the Homeless Services Consortium of Dane County.

“The main goal is that the most vulnerable people in our community are able to be served as they prepare for the end of their lives,” Smith told Hospice News. “Typically unhoused terminally ill individuals can’t be accommodated fully in shelters or in assisted living facilities that require financial support. [It’s] identifying the different populations and care gaps that exist. It is really important that all people are supported, celebrated and included, and that inclusive approach that Solace Friends takes means a lot.”

The residential facility is across from San Damiano, a natural conservation area near Lake Monona. The landscape near Solace Home is intended to bring an environment of peace and comfort to those receiving hospice care at the facility, Smith said.

Establishing a facility for homeless hospice populations has been a project two years in the making, a process of building up structural, operational and financial support, she added.

Impacts of hospice among homeless populations

Four hospice organizations provide end-of-life care at Solace Home. These include Agrace, Heartland Hospice, Interim HealthCare of Madison and SSM Health at Home-Wisconsin. The hospice providers develop and manage individualized care plans for people with six months or less to live staying at the residential facility.

People experiencing homelessness often have higher mortality rates, and are more likely to have comorbid medical conditions and receive inadequate health care services, according to Rachel Nalwa, hospice manager at SSM Health at Home-Wisconsin.

Housing and health issues can complicate these individuals’ end-of-life trajectories and pose challenges for providers trying to improve access and quality, Nalwa stated. Providing hospice to these underserved populations in a safe and stable housing environment will help bring greater access to “the most basic necessities for comfort” at the end of life, she said.

“People with housing insecurity have very limited access to health care,” Nalwa told Hospice News in an email. “This includes access to end-of-life medications, or even an area to store the medications. They don’t have a space to be with loved ones in their final days, or access to clean water and food. A support network to help provide basic care needs, spiritual and psych-social needs are often unmet as well.”

The opening of Solace Home comes at a time of significant need as the availability of affordable housing lags nationwide, according to Dane County Supervisor Rick Rose. Access to safe and sustainable housing at the end of life is “especially critical” among growing aging populations and can help “set a precedent” for similar programs to take shape, he indicated.

The program will help connect individuals approaching the end of life with much needed resources, Rose indicated. Navigating health care and community systems can be an often difficult feat for homeless populations, he stated.

“Solace makes this so much less taxing for the individuals it serves,” Rose said in an email to Hospice News. “It connects the communities of those in need with those helping others. I anticipate this model sparking others’ interest to meet an even greater need with the housing crisis we are currently facing nationwide. This care can change lives, even in the last moments of a life.”