Column: Homeless and in hospice. His recovery is a lesson

He was homeless, behind bars, in hospitals and hospice near death. Social workers who had known him for years visited his bedside to say goodbye.

Then Sean Sauceda, 52, came back from the abyss.

I met Sauceda at his new apartment in Inglewood, where he grows tomatoes and basil in the garden, looks after a friend’s two children off and on, and is considering getting a cat.

“I want to live,” he told me in the living room of his house. “I want to stay alive”

This is a story about a man’s recovery, but also about how much work it takes to change the life of someone with a long history of troubles. It’s not uncommon for someone to get help and even a place to live, but end up homeless again.

I was visiting my buddy Nathaniel not long ago with one of his former case managers, a social worker, who said the system does a good job of getting people through the front door, but throws too many out the back door. It took me and others a year to bring Nathaniel into the house, and it took 15 years of vigilance to house and care for him.

As I eyed the Los Angeles local elections, with key issues such as homelessness and housing and promises about who will bring the most people through the front door, I didn’t feel like the candidates fully understood the importance of this continuum of caring is is.

Sauceda is now a client with Housing for Health, a 10-year-old LA County outreach, housing organization and long-term case management program. Due to budget constraints, it doesn’t reach everyone who needs help and it’s an expensive endeavor, but it’s also much more humane to take people through courts and prisons.

“The journey of caring for people affected by homelessness doesn’t end when they step into a motel room or a house or whatever,” said Dr. Heidi Behforouz, Medical Director of Housing for Health.

Not every homeless person in LA County needs Intensive Case Management Services. But about a third of the estimated 66,000 or so homeless people are “medically vulnerable” and can benefit from having someone “walk them through the arc of their lives,” Behforouz said. Physical and psychological problems are common, as is addiction.

Currently, Housing for Health has approximately 17,000 clients, and their care and management is provided by dozens of agencies, including non-profit organizations under county oversight. For the many who have serious and even terminal health problems, a medical team led by Behforouz is making home visits, and I’ll tell you more about that in the next column.

Like so many people who end up on the streets, Sauceda had a rough start in life. He doesn’t know his parents and described his childhood as follows: “Any institution that had a place for me, that’s basically where I went.”

Sauceda was diagnosed with bipolar disorder. As an adult living on the streets, mostly in small dens he built in secret locations around Pasadena, he got into several fights with fellow homeless people and police officers.

Sauceda became addicted to drugs. His heart failed. He was diagnosed as HIV positive. He is almost blind in one eye. In his lowest moments, he says, he tried to “jump off [things] and throw me in front of vehicles,” but all he achieved was to beat himself up.

“Sean has 25 lives,” said Sieglinde von Deffner, Housing for Health’s skid row coordinator.

She was staying at Sauceda’s Inglewood apartment along with two colleagues who have visited him over the years – Patricia Nwaekeke and Beatrice Tan.

It’s not uncommon for social workers to have longstanding relationships with the homeless. The aim is to stay connected, oversee client well-being and earn their trust to work towards a time when housing is available and the client is ready.

Von Deffner — who and her husband have lunch with Sauceda a few weekends a month — met him about 15 years ago while volunteering for a nonprofit called Housing Works. She and then-colleague Shawn Morrissey, another of Sauceda’s angels, ended up working for Union Station’s homeless service in Pasadena, the city where Sauceda spent most of his life as a homeless person.

He was placed more than once but did not stay. Rules can be confusing and confrontations all too common for troubled souls spun around the system, and Sauceda – with little confidence that the right situation existed – retreated to houses he had created himself.

When his organs failed, he spent a long time in intensive care. In a county where an average of five homeless people die every day, Sauceda was on her way to the morgue and was in hospice care for a while.

From Deffner, Tan called hoping to get him to Housing for Health.

“I met him in the Union Station bunker. He was in a sleeping bag and he was really cold and frail and he didn’t want to interfere at first,” Tan said. “I promised him. I said, ‘You know what? I’m very busy, but I’ll be there for you.’”

“She’s my lifesaver,” Sauceda told Tan at his apartment, but the feelings seemed to be aimed at all three women who had remained faithful to him.

Tan and Nwaekeke, who also participate in the Enriched Residential Care program, provided housing and intensive rehabilitation services to Sauceda. His health gradually improved over the next few years, and last year the team thought he had made enough progress to move to supportive housing that still provides services but offers more independence.

Sauceda told me that as his health improved, his mental attitude went hand in hand. He wanted it to work this time and he hopes he can make it happen. We will see. Sauceda said moving into the apartment in February was scary and he’s still trying to adjust.

“The place is big,” he said of the one bedroom. “The closet is habitable for one person, and that’s ridiculous. … I’m perfectly happy in a box.”

He does not sleep on the bed, which he considers unnecessarily large and comfortable. He usually sleeps on the sofa during the day and watches crime thrillers on TV at night. He checks in with a good friend who he once shared streets with. She’s also indoors in the Midwest now, and he’s hoping to visit her again for Thanksgiving when he travels by train.

Von Deffner said Sauceda checks on the people who helped him as often as they check on him, and he still stops by Union Station to say hello to friends.

“From the moment I met him, he was always taking care of other people or volunteering to clean up at the shelter,” she said.

Many years ago, Sauceda told me, he was mentored by the late Mollie Lowery—a mentor and inspiration to countless young social workers.

For a while, Lowery was my buddy Nathaniel’s case manager. One day the three of us were in the middle of a skid row when Nathaniel was about to lose his apartment and Lowery promised him she would find him another apartment.

She lived by a motto that to this day is the only way for Los Angeles to weather this humanitarian crisis:

Whatever it takes, while it lasts. Column: Homeless and in hospice. His recovery is a lesson

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