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Okay friends, welcome back. I am here with my friend Jillian Olmsted from the Inn Between which is an organization that provides medical respite and end of life care for those experiencing homelessness. Hospice is something you guys know my mom was a hospice nurse, I really grew up in this community, I think the work that these folks do is so incredibly important, but it’s not often talked about. So today we’re going to learn all about what Jillian is up to, and how you could maybe even gain some inspiration from the work she’s doing and make sure that folks in your part of the world are taken care of. So Jillian, welcome to the show. Thank you so much for being with me.
Jillian Olmsted 18:03
Thank you for having me, V.
V Spehar 18:05
So in your own words, tell us what the in between does.
Jillian Olmsted 18:09
Yes. So it’s a play on words. So if you’ll notice, it’s the Inn, our founder was a hospice nurse up at a cancer hospital here. And she was having a very difficult time discharging patients that were too well to be in the hospital, but too sick to go back on the streets. So she helped develop the Inn Between, which is the bed for people to receive end of life care. Or if they’re not end of life, they can receive medical treatment such as dialysis, cancer treatment, wound care, all of the things that will not get better if you’re on the street without shelter. Three Meals a Day, and people looking after you.
V Spehar 18:56
And about how many beds does the facility have?
Jillian Olmsted 18:59
We have 50 beds and there’s two sides to our program. We are an assisted living type two facility with 25 beds and then we have the independent or recuperative care side. That side operates like the Ronald McDonald House, which is zoned as eleemosynary. Those are the individuals that are able to take care of themselves on a daily basis, and just need a place to stay to receive their medical treatment. On the assisted living side, people are needing assistance with what is called ADLs, assistance of daily living or assistance with activities of daily living. That’s medication management, toileting, getting dressed. So we have two sides of our program and we can move people as needed depending on if they’re improving or declining.
V Spehar 19:44
So in traditional hospice care, and I really only know from what my mom would tell us, right, I mean, it wasn’t something that lasted a terribly long time. A lot of my mom’s patients were there maybe like two months was considered a really long time. It was usually like 7 to 14 days that she would be with somebody about how long is someone in your care?
Jillian Olmsted 20:05
It definitely varies. The average stay for our recuperative care patients is 90 days. For hospice patients, they’re not your typical hospice patients, most of them are extremely young and have been out in the elements. So sometimes they may be hospice eligible when they’re coming in here, but we technically see a great improvement. Some people go off of hospice on to palliative care for a period of time and then back on hospice. It really varies. We’ve had individuals who come in and they have passed away hours later. And then we have someone with us right now who has been back and forth between hospice and palliative for the past year.
V Spehar 20:45
Wow. And for folks who maybe don’t know what a hospice diagnosis is, can you just kind of give us the updated version of like, what that means for somebody?
Jillian Olmsted 20:55
Yeah, so typically, that means they’ve estimated that you have six months or less to live, and you’re stopping any treatments that would cure the disease, or possibly cure the disease. So more of comfort care, management of pain, yeah, with the expectation that you have less than six months to live.
V Spehar 21:15
And a lot of folks associate hospice with, you know, a terminal illness, like they got a cancer diagnosis, and it’s gone too far, or AIDS or something like that. What type of hardships are the residents coming to you with is it those same kinds of diseases or a little different?
Jillian Olmsted 21:31
it’s the same kind of diseases, it’s a lot of heart disease, a lot of uncontrolled diabetes, that can lead to someone losing a limb, which on the streets, right can easily turn into a major infection that can lead to death. So it’s a variety, there’s obviously a lot of cancer, which we see all over. But those are the three main things.
V Spehar 21:57
And in a traditional hospice experience, you know, somebody’s been under medical care, and they’ve gone through the hospital system, and then they’ve sort of exceeded the resources that the hospital the primary care can put into them. So they get put in assisted living, or they get put in a nursing home, or they get put into hospice bed, folks aren’t necessarily taking that same trajectory, if they were on the street previously, how are you finding these people,
Jillian Olmsted 22:18
So we are not a shelter. Shelters allow walkups. So we require a medical referral. So it’s typically coming from a hospital. That doesn’t mean that the hospital is the one that found us a lot of times it’s street outreach through Volunteers of America. And we also have a community clinic called for street. So they are seeing a lot of the unsheltered population and they can refer people to us, but it must come through a medical professional, so that we can really verify their medical needs and ensure that they’re, they don’t need a higher level of care. As an assisted living type two, there is a higher level of facility called a skilled nursing facility. So we can not take people that are too high of a level of care either. So we really have to look at their records and see if we’re able to help them.
V Spehar 23:06
Right. So tell me what the facility looks like. There’s so many folks listening at home who have luckily, in some ways never been to a place like yours. What does it look like in there.
Jillian Olmsted 23:17
So we like to be very homey. But we are also a facility. This was previously a skilled nursing facility that we were able to buy about four years ago. So we definitely upgraded because we were in a convent before this and an elementary school. So we’re now in a official facility that has an elevator and definitely much more ADA accessible. But when you walk in, we have a kind of a traditional lobby. And we have a large dining room. We have an activities room, a community room where we provide musical therapy. We have grief groups, AAA and NA groups. We also do our memorials in there if a resident wishes to have a memorial after they pass away, and also something that you probably wouldn’t think of we’ve had two weddings here. For people who have found love within the facility, there’s been to weddings. And then we have the building is essentially a square with a square in the middle. So there’s the outside set of rooms and an interior set of rooms with interior atriums and outdoor patios. So that’s, it’s definitely I think, much bigger than most people assume. And it is extremely nice. But all of the rooms here are different. They look a lot more like small apartments. The paint is different in each room. The finishes are different, the light fixtures are different, and they’re able to make it their own. So even though some people are only here for a few weeks, you know they’re able to hang up some of their pictures and decorate it as you know, as if it was their own place.
V Spehar 24:55
What made you want to specifically serve the unhoused population?
Jillian Olmsted 25:01
So about seven or eight years ago, when the Inn Between was trying to open in its original facility, it was dealing with the NIMBY, not in my backyard group, it was in a residential neighborhood. And there was a lot of uproar that homeless individuals should not be in a residential area, which is interesting right there people. They don’t belong in an industrial area. I didn’t live too far from the original facility. And I had saw on the papers, the consternation, and around the same time, both my mother and stepfather we were diagnosed with cancer about six weeks apart from each other. And they ended up passing away a year later, about a month apart from each other. And I got to have a crash course in hospice with two of my parents, and I was just going, how are they? How are they able to say these people don’t deserve a place to receive hospice care, because you can not receive hospice care on the streets, if you do not have a physical address and a support system. You can’t receive hospice care, and everyone deserves this not just middle class who have insurance in a nice house and family to take care of them. So I started volunteering, cooking meals, helping them with their fundraising events. And the executive director at the time offered me a very part time position, because I was a stay at home homeschooling mom of two boys and my husband was in the Air Force. So I had to say, very small commitment. So at the beginning, my kids were coming to work with me, because we had a separate area for admin from where our residents stayed. So I was I was doing dual duty for a little bit and then moved to part time pretty quickly. And I’ve been here for close to six years, and I’ve done a little bit of every position from volunteer coordination to HR and operations, and then was moved to the executive director in March.
V Spehar 26:55
It must be hard to get these folks to trust you, right? I mean, this is not a population that the world has been especially kind to, how do you forge that initial bond.
Jillian Olmsted 27:06
So it starts from, you know, the minute they walk in the door, we want to make sure they’re treated like a human not treated like a number or inconvenience, or someone that we have to deal with. So from the time they come in, we make sure that if they’re hungry, they can go get a meal first, if they need something to drink, they can get something to drink. And then we spend some time with them just one on one going through, you know, what do they want to get out of their stay here? If they’re not end of life? Do they want to try and get into housing? Do they need to get benefits? Have they lost their identification? Or if they are end of life, we start the conversation about, you know, do you have any sort of end of life wishes? And how can we help provide those for you. So a lot of times, it’s just really laying it out there all of what we can offer them, if they’re willing to accept it, I think that’s where it starts. When they go into their room, there’s a welcome basket for them, which has some, you know, games, puzzles, snacks, towels, everything they need for their first few days. And, and we really just give them the space, some people come in, and they’re so excited, and they’re social. But there’s others who really want to be left alone for you know, maybe even a week. And as soon as they’re ready to start talking to people, we have a volunteering activities coordinator, and she’ll go in and do an activities assessment, find out, you know, what are they interested in? Here’s what we offer at the facility, do you like bingo, it’s Fridays, come out for that. And if you want to go on an outing, the great festivals next week, so you can sign up for that or haircuts are coming up. So we try and you know, approach it in, in a way that really makes them comfortable. And in a trauma informed way. We definitely don’t want to re-traumatize them, we don’t want to make them continue to tell their story if they don’t want to continue to tell their story. So we it’s really we just put it in their hands, we’re here we can offer you a lot. If you’re willing to put in the work and accept it.
V Spehar 29:05
How do you attract talent to work at the in between that’s got to be the like there’s like the folks who are coming to you for services, but then the people who are providing services, it’s such a niche, special group of people who can handle this particular one amount of grief. But also, you know, the unique challenges of working with the unhoused population. What’s the staff like?
Jillian Olmsted 29:28
Yeah, it can be difficult to find individuals that are going to be able to deal with just the circle of grief that can happen here. There’s just, there can be a lot of loss, even if it’s someone moving out, you know, with a happy ending. It’s still someone we can get close to. The majority of our staff came to us as volunteers, which I think is the best way to do it. It’s like we get to have a test run with someone before we bring them on the staff. Similar to myself, I think once you get in here and see what it’s like and see the difference we’re making. It’s hard to not want to sign up for, you know, some a larger commitment than volunteering. So I would say that that is one of the easier parts is recruiting people. The mission really speaks for itself.
V Spehar 30:15
It is one of these things where somebody, I mean, experiences lost themselves, they understand the value that they felt by whoever would cared for them, when it was their turn to be the grieving person or the person who experienced loss, they want to give that back. You are dealing with death nearly every day in some form. How do you kind of steel yourself for that when you’re getting ready in the morning to go into work?
Jillian Olmsted 30:38
So mine is really succinct. And maybe it’s because I’ve just been around a lot of death in my family. But for me, it’s just knowing what the alternative was for these individuals. And it’s still difficult. So a couple of things we do in the facility to help the staff is when someone is actively passing, we put a blue butterfly on their door. And that’s just to signify, you know, have good energy around that room. You know, please be quiet, don’t start having water cooler talk outside of that door and disrupt you know, what’s going on inside. And we have a end of life doula. She’s actually a former resident that stayed with us for a little over a year. And then we hired her as a house manager. And then she wanted to go through schooling to become an end of life doula. So a few months ago, she got that certification. And so it’s really awesome that we have a live in end of life doula, and yeah, she can be talking with them and get to know them in a very non, you know, confrontational way about death, because she’s living with them. So she can learn things about them, and, you know, take notes so that we can, we can use that end of life. And then we have our Noda volunteers, which is the No one dies alone program. And that’s used in a lot of hospitals in the US, and we just adopted it here. And so we train our volunteers in a three hour course, to learn how to sit bedside with individuals when they’re actively passing, just holding space, and whether that’s just sitting even in the other side of the room, if they don’t want someone in there to listen, you know, if they are struggling or sound like they’re in any pain, you know, they can go and get the nurse to come in and help them. And then when someone passes, we asked all of the staff who’s willing, and residents have started joining in as well, to do an honor line. So we lined the hallway, out to the lobby. So when someone leaves the building for a final time, we come together as a community and say goodbye. And then we hold a memorial if that’s what the person wanted. Sometimes people don’t especially because as they’re staying here, they see a memorial happening. And they might say, I don’t want that for myself, I just want you guys to say goodbye. And I don’t want you to do that. So that helps with staff closure. And then we also have grief groups put on by one of the local hospitals. And then also one of our board members who’s a chaplain that can allow, we do it separate for residents and for staff because we have different experiences. But it gives everybody a time to just kind of decompress for the staff maybe debrief, what did we learn from this? What could we have done differently? And, yeah, we have a pretty good support system here. But there are people that it affects, you know, in different ways. And some people need to take a mental health day or maybe two after someone passes that they felt really close to. So we try to just give a lot of space because we know, you know, burnout is a real thing, especially in nonprofits and especially in the social service industry.
V Spehar 33:54
I wanted to ask you about the folks that you call the 11th hour volunteers because also for people listening who are like, I could never do this. There are lots of people who can’t do this, like there is a special job. Let’s find the people who can do it. And you know, let them take over for this time. But talk to me about your 11th hour volunteers.
Jillian Olmsted 34:11
So the 11th hour volunteers is what we now call the note of volunteers. So we use them interchangeably. So what we do want when someone’s actively passing is we have a program that sends out an alert that says you know, resident in room five because most of our volunteers you know the residents, resident in room five has entered the active dying phase. Please log in and sign up for a shift if you’re available. So our 100 note of volunteers can go and say I can take from 6am to 8am or I can take from two to 4am and they come to the facility they check in with our nurse or CNAs and they go and sit with the resident or there’s instructions for something that the resident wanted. Maybe it’s reading from the Bible or reading poem. was, or not sitting in the room with them, sitting in the adjoining room and just listening. So they’re an amazing group of volunteers, not for everyone, like you said, not everybody is able to do it. But most people surprise themselves and say I wasn’t sure how it was going to be. But you know, once you just settle in and realize the only thing you have to do is be there and be present. So it’s a great experience. And it’s an awesome way to volunteer at our organization. But if they’re not interested in that we have lots of other opportunities.
V Spehar 35:31
How do you approach writing an obituary, calling the funeral home making those final arrangements for a resident who maybe doesn’t have someone?
Jillian Olmsted 35:40
Yeah, so if someone is willing to talk about it beforehand, we get information from them that they would want in our in their obituary. If not, we just get permission to post an obituary from them and we write it ourselves. In our medical record system, we have a bio section. And as we’re caretaking these people or as volunteers or working with them, we start taking notes in there, you know, where are they in the military? Where did they grow up? What are some things that they liked, and then we can pull from that. If someone has a family member that writes an obituary, we ask them to post it, and we will then just post that obituary so that we’re not having, we don’t ever want to be the ones telling someone’s story, if there’s someone that was much closer to them, that can do it. When someone passes away, it’s relatively rare that there’s next of kin with our residents. As much as we try and reunite them with people, not everybody is ready to mend fences. So if there is someone, it’s our administrator and nurse supervisor who reaches out to them to let them know that their loved one has passed, and then we try and ship them any of their belongings, or they can come and pick them up. And they can also participate in the memorial. If they would like we have had several families that asked us if we will put the memorial on for them. And we’re happy to do that. And then they can bring their friends and family to the facility for that memorial.
V Spehar 37:03
Now you are fairly new as the executive director here, what are your dreams for the facility?
Jillian Olmsted 37:09
My biggest dream has just been to use this building to its capacity, which doesn’t sound very dreamy. But for me, this facility can hold more than 50 people. It’s a zoning restriction that’s prohibiting us from getting more people in here. So it’s very difficult for me to walk the halls, see where someone could be, here about their referral on our waiting list and that they need to be here, but we can’t put them in here. So my dream would be to revisit the zoning and try and get a zoning change, hopefully in the next year, and increase our beds to you know, somewhere in the 70s, I really feel that we would be able to operate without a waitlist and take everyone that qualifies to fit in our facility. That’s one of my dreams. Another dream would be for someplace here locally, where we could permanently housed the aging homeless individuals who fit more into the long term care. So say someone with dialysis, do they need to be here to get dialysis? Yes. Will they be more successful? Yes, but they could be on dialysis for 20 years. And we could fill our facility with dialysis presidents and then not be able to serve anyone else. So for us, the discharging someone without a place to go is heartbreaking. But we have to stick with our mission of short term medical respite stay or end of life care. So my dream would be making sure we use this place to its capacity and then have access to more safe discharges. In previous years, it’s been very difficult to find permanent housing for our residents. Last quarter, we exited 15 of our 63 residents into permanent housing. And that’s huge. I don’t know if we’re always going to be able to make it happen for our residents. But we’ve been working on increasing our case management within the facility, working with people right outside of the gate saying you may only have four weeks here, but what can we do while we’re here? Do you want permanent housing? Can you put in the work, get all your documentation and you know, you need to want it and we might be able to make it happen. And that’s a really big percentage of the people we’re serving, right? Because a handful of those 60 individuals passed away. But for 15 of them to go to permanent housing that they can call their own is awesome. A lot of other people are, you know, connected with family members. So not you know, not the remainder of those aren’t discharges to the street, but like I said, some of them are and so some of them that’s what they choose is to go back out to the street. But I would love to have you know, zero discharges out to the street.
V Spehar 39:48
Are there organizations like yours operating and other states. Is this something that’s becoming more popular or is this something that is really difficult for people to get off the ground?
Jillian Olmsted 39:58
It’s difficult to get off the ground, and we’re extremely unique. We’re the only facility providing end of life and medical respite care. Recently, if anybody has seen the LA Times article, there is a facility trying to open called Joshua’s place, it’s just outside of Sacramento. And it would be a place for end of life individuals experiencing homelessness to go. But they’re dealing with the same thing we dealt with when we were opening, there’s, you know, it’s near a school. And so it’s what is it going to do to the children and it’s in, you know, in a neighborhood and what you know, what’s going to happen to the neighborhood. So I would love it, if more of us, more facilities like us would pop up in the US. But there’s just really not that many. There’s some for families and things like that. But it’s it fills a definite need, there really is a gap in the system, for people experiencing homelessness that, you know, hospitals can’t keep them. And they’re never going to get better on the street. So what is the alternative? And what can we do as a society to make the in between a norm and non this anomaly that everybody says, Oh, my, this is amazing. But we had no idea this was a need or that it even existed. So, you know, we don’t want to be the only ones. We want people to look at this model and hopefully duplicate it in other states.
V Spehar 41:18
So as the winter season approaches, we know that there could be an uptick in need, especially in Utah, how can we be helpful? How can folks help the work that you’re doing?
Jillian Olmsted 41:29
Reach out to us if someone isn’t able to make a financial donation, but perhaps they want to do a neighborhood donation, drive or drive in their school, we can give people a list of items that we need, whether it’s winter coats, gloves, that sort of thing. We’re able to help individuals, even if they’re not in the facility, we work closely with the street outreach team. And if there are individuals needing items that we have, we’re willing to help give them. So in kind donations is something we really need to thrive. Also just helping us spread the word is very helpful. Even locally, we need everyone here to know that we exist. We need people to be referring individuals to us so that we can get to them before it’s too late. Yeah, any kind of advocacy that people are interested in volunteering, financial donations, sharing our social media posts, as the winter comes, we will definitely fill up. So a little difference when a community pulls together can change hundreds of people’s lives, right? We’ve had 109 People here pass away with dignity. And we’re probably nearing 1000 individuals who have come through our program, whether they passed away here, or left recuperated from an illness. So I just want everybody to think what can we do in our community to make sure that these people aren’t suffering alone on the streets?
V Spehar 42:54
Absolutely. Jillian, it is such a pleasure to get to chat with you. Thank you so much for taking the time. And thank you so much for doing this work. It’s so important and you just give me hope that humanity is okay. And we’re gonna be okay, we could do more of this.
Jillian Olmsted 43:08
Thank you so much, V.
V Spehar 43:13
Thank you to Jillian, who you guys if you ever have a moment where you start to think that the world is just rotten and cold and hard. Just remember Jillian, and all the things we learned here today and treat people how they want to be treated and know that every single day there is good to do and there is good to be found. And speaking of good people. Why don’t you leave me a voicemail. Tell me how you’re doing? What are you up to? You can leave that voicemail at 612-293-8550.