Sherry Campbell began to see the situation, the hospice patient with no outside visitors, more and more frequently.
"It would wake me up at night," the former social worker with Hospice of Chattanooga said. "I tried to ignore it, [believing] somebody else will come along."
But those somebody elses never came, so Campbell and fellow social worker Rachel Smith formulated the idea for an actual home where homeless clients could receive hospice care in their final days and weeks.
Two years in the planning, that nonprofit agency, Welcome Home of Chattanooga (www.welcomehomeofchattanooga.org), is expected to open by the end of the month in the former home of Bethany Christian Services on Germantown Road.
Homeless individuals, according to the National Health Care for the Homeless Council, are at risk of dying at three times the rate of the general population at every age. And since the number of single Americans has reached 50 percent and is increasing, their chances of dying alone are statistically on the rise.
Campbell emphasized that while local hospices have provided care for people without an ability to pay, whether it be in a tent, camper or extended-stay hotel, no homelike setting has been available for such people.
Welcome Home of Chattanooga, working in partnership with whichever hospice is chosen by the resident, will provide "the home, shelter, love and care" needed at the end of life, she said.
Residents already must be approved for hospice care and will be referred by hospitals, hospice agencies or the Homeless Health Care Center.
Priority will be given to those who have nowhere to go, those who have no family and those who would not fit into a traditional nursing home environment, Campbell said.
Residents will be charged on a sliding fee scale, based on their ability to pay, but she said "we wouldn't turn anybody away."
Although the average "pre-active phase of dying" is two weeks and the average "active phase of dying" is three days, according to the Hospice Patients Alliance, Campbell hopes the residents would arrive "sooner rather than later."
"Coming in at death's door," she said, "you have strangers taking care of you." With a longer stay, "you get much more benefit. You get to know the team, the nurses. We can help with comfort - physically, emotionally and spiritually. The home wants to add that [component]."
Campbell, 47, said she's had the dream for such a place for several years but always figured she could never make it a reality with $50 in her bank account. With a grown daughter and the realization she wasn't going to win the lottery or a sweepstakes, she told herself she had to "start making progress."
In time, BlueCross BlueShield of Tennessee stepped in with a three-year, $360,000 grant, Memorial Health Care System Foundation and St. Alexius Outreach Ministries offered financial assistance, and Joseph's House of Washington, D.C., a similar agency with 17 beds, has provided telephone mentor- ing. Others have provided money or in-kind gifts.
Volunteers, according to Campbell, have come out of the woodwork, including 83 locally from BlueCross BlueShield who adopted, furnished and decorated the home's four bedrooms. The University of Tennessee at Chattanooga, Chattanooga State Community College and Southern Adventist University have discussed internships at the agency.
"We want to have this place be a home of opportunity for everyone to come," she said. In America, "we've become more turned away from being present at the deathbed. We say, 'Oh, that's so depressing.' But that's holy and sacred ground. We're blessed to be with people at that time. It's the way we've been doing it for 10,000 years. We want it to be a learning experience - for volunteers to see that, to know about end-of-life care and to share it with their families, their friends and their churches."
Campbell, like so many in the American experience, did not wait for government to take care of a problem she observed but moved on her own. What has resulted is a home for those who haven't experienced much of a home to have in their final days.
"If people encourage you, you can move mountains," she said. "I've met so many beautiful people. I wouldn't be here without them. There are no words for how awesome these last couple of months have been."