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What Happens To The Homeless When They Die

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"What Happens To The Homeless When They Die"

On a hot June morning in Washington, DC, roughly 30 people gathered in St. Stephen’s Episcopal Church to remember Michael Leslie. It was an open casket viewing, with the body encased in white satin and a small red light illuminating his face. Several women broke down in sobs. Friends shared stories about Mike the comedian, the magician, the beloved younger brother and the center of attention.

They also remembered the Mike who was homeless. He spent many nights with his brother Jeffrey sleeping near a construction site, just a few miles from the nation’s capitol. Leslie had been coming to the basement of St. Stephen’s almost every weekday for the last several years for a free breakfast and other services from homeless outreach organization Thrive DC. Many of those mourning his death were fellow Thrive clients or DC social workers. Seated in the pews was a woman who knew him from the “hypothermia shelter” he stayed in during DC’s bitter winters.

“Many of you know Mike from coming to services like Thrive,” said Josh Neal of the Northwest Community Church, where Leslie was a regular at their monthly outreach program. “But Mike had a fuller life than that, and we’re here to celebrate it.”

DC’s homeless population has grown 18 percent since 2010. And as more people live in DC’s shelters and streets, more people die in them. But who cares for and buries the bodies of the elderly woman found dead at a bus stop, or the two men who froze to death underneath a highway?

Some, like Leslie, are buried and remembered by family members and friends. But many are left unclaimed at the city morgue. After 30 days, they are cremated by a private funeral home and often buried outside the city limits. There is no funeral, no head stone, just a name written in the ledger book of a Maryland or Virginia cemetery.

“A lot of places don’t take them. Whoever owns the cemeteries don’t want them,” said Gary Troxler of Bacon Funeral Homes, which has handled the city’s unclaimed remains for the last several years. About once a month, Troxler said, a homelessness organization will contact them about paying for a proper burial.

Beyond providing for DC’s growing homeless population in life, homeless advocates and religious leaders are trying to make sure they’re remembered in death.

“I think that’s what a civilized people does,” said Linda Kaufman, national field organizer for the 100,000 Homes Campaign and an episcopal priest. “Somebody rejoiced when this kid was born. I think it’s really important that their life and death be memorialized, whether it’s with 50 people or three people.”

Kaufman estimates she’s officiated 25 funerals for DC’s homeless. There was Carmen, the towering and kind-hearted woman who was just moving into her own apartment. Everyone from her judge to her high school military recruiter came to pay their respects. There was Steven, the “brilliant guitar player” who was mourned by his many friends from Narcotics Anonymous. There was Lawrence, for whom they found a donated casket when they found out he didn’t want to be cremated. Many of them are buried in a memorial garden outside St. Stephen’s, where their names are engraved on a plaque.

The memorial garden outside DC's St. Stephen's Church.

The memorial garden outside DC’s St. Stephen’s Church.

CREDIT: Christie Thompson

But the most troubling are those whose names Kaufman didn’t know, like the woman she found tucked between a cafe and an office building in downtown DC in the middle of winter. “She refused everything — medical help, services,” Kaufman said. The next day, cops told Kaufman she had died. “I have no idea what happened to her body.”

While national homelessness rates decline, the loss of affordable housing in the District has pushed homelessness higher. An estimated 7,748 were homeless in DC in 2014, though a larger proportion is now sleeping in shelters instead of on the street. Meanwhile, the homeless population is graying at pace with the rest of the country. The average age of a homeless person in the US has climbed from 35 years old in 1990 to 50 years old in 2010.

We don’t actually know how many of DC’s homeless die each year. The city does not track such statistics. The National Coalition for the Homeless counted at least 26 homeless DC residents that died in 2013, but the number, based on news stories and reports from local service providers, is an underestimate.

“We do the best we can, [but] there’s people we miss,” said Michael Stoops, director of community organizing for the National Coalition of the Homeless. In cities like San Francisco and Seattle, he says, the medical examiner produces a yearly report on homeless deaths.

DC and surrounding counties have seen an increase in unclaimed remains since 2010. Eighty-three bodies were left with DC’s Office of the Chief Medical Examiner in 2012, down from 97 in 2011 and up from 63 in 2010. But not all of those were homeless, or even alone. With the median funeral price costing over $7,000, many families can’t afford to bury their loved ones. Several counties have reported an increase in bodies left behind during a recession.

Similarly, not all of DC’s homeless remain unclaimed. The Office of the Chief Medical Examiner does what they can to contact any surviving relatives or next of kin, and homeless organizations are sometimes able to get in touch with family members. “The majority of our residents have had some type of insurance one way or another, and their families were able to take care of that,” said Donald Page, director of administration for the Community for Creative Nonviolence, which runs the largest homeless shelter in DC.

The Community for Creative Nonviolence shelter does have the remains of 35 or so former residents stored in a cabinet in the third floor lounge. Page said several of them had died of hypothermia. “They may not have had a place to stay in life, but they have a place to stay in death,” he said.

It’s often difficult for homeless service providers to know when people pass away. They may have nothing more than a missed soup kitchen meal to indicate something has happened. “Often times we find out too late,” said Thrive DC’s Director of Social Services Jessica Macleod, who found out about Leslie’s passing from another client.

Unlike cities like Seattle, where the medical examiner releases a list of names of indigent deaths each year, DC does not release the names of unclaimed, identified bodies. A spokesperson from the Office of the Chief Medical Examiner said they do try to coordinate with homeless organizations when identifying an individual. “Our office has a working relationship with homeless advocacy organizations and we interact with such organizations accordingly on a case by case basis,” said spokesperson Beverly Fields in an emailed statement.

The National Coalition of the Homeless wishes that they could find out every name. “They could very easily give us the names to notify service providers that they have an unclaimed body,” Stoops said. “They don’t do that.” He remembers including one man in their yearly count of DC’s homeless that have died, only to have him show up a year later. “They could have died, they could be in jail, they could be in the hospital,” he said. “We have to have a better system.”

For the homeless who served in the U.S. military, Quantico National Cemetery in Virginia is supposed to be their final resting place. Their funeral costs are supposed to be covered by Veterans Affairs. “We attempt as much as we can to find out who they are,” said Fields, who added in an email that they coordinate with Veterans Affairs to confirm whether there are veterans among their unclaimed remains. Of the 83 unclaimed bodies the medical examiner’s office dealt with in 2012, 6 were identified as veterans and sent to Quantico Cemetery.

But experts say former service members may be passed over. “We find 10 to 30 percent of the names we look at in a funeral home are veterans,” said Fred Salanti of Missing in America, an organization he founded in 2005 to locate and bury deceased veterans. A former major in the U.S. Army, Salanti has found thousands of unidentified, unclaimed veterans’ remains sitting on cemetery shelves waiting to be interred.

“The VA offers a free burial, but they have no way to know [veterans] are there until someone researches and turns them over,” Salanti said. “I just think it’s a skeleton in America’s closet that we don’t honor our dead, civilian or military.”

DC budgets a few hundred thousand dollars to be given as burial assistance grants for non-veterans. Those organizing Michael Leslie’s funeral this June received $800 from the fund. But it wasn’t enough for a proper wake and ceremony. Staff members from Thrive DC and Northwest Community Church rallied to help Leslie’s brother Jeffrey find the extra money. They raised $400 in online donations, received $1000 from another church, and used suits from the church’s supply of professional clothes meant for job interviews.

“You have to tap your resources,” Josh Neal of Northwest Community Church said. “You scramble around and do what you can to make things work.”

Several of Thrive’s regulars came upstairs to say their final goodbyes to Leslie, who always had a joke, story or blunt opinion to share over their daily sandwiches and coffee. One friend remembered how Leslie gave him the metro fare out of his pocket when the friend broke his leg.

“A lot of people knew Mike but they didn’t know his struggle,” said his friend Samuel. Leslie was bullied and dropped out of school by the 6th grade. From as early as 11, he battled alcoholism and was in and out of jail. “I admire how he kept his strength up. He was pure, he spoke right from the hip,” Samuel said.

Leslie was the eighth client of Thrive to die so far in 2014. He was just 40 years old. “We’ve lost a lot of our community,” Macleod said at his service. “Our table keeps growing with empty seats at Thrive.”

It’s not just Thrive’s clients: research shows the chronically homeless have a much higher mortality rate than those in steady housing. “In general, homeless people die at about four times the rate of someone in the same age in a house,” said Dr. Jim O’Connell, president of Boston’s Health Care for the Homeless program. “That’s the highest crude mortality of any subgroup we know in America.”

Researchers at Health Care for the Homeless have found drug overdoses, cancer and heart disease to be the leading causes of death for homeless individuals, accounting for 17 and 16 percent in a recent five-year study. Overall, most homeless die of “natural causes,” meaning age or disease.

But 100,000 Homes Campaign’s Linda Kaufman says that’s a misnomer.

“He didn’t die of natural causes. He died of our neglect,” she said. “Anytime we choose to leave people on the street, we are sentencing people to death.”

In 1990, as advocates watched more of the homeless community pass away, Stoops and the National Coalition for the Homeless claimed December 21st National Homeless Persons Memorial Day. Last year, a record 184 cities took part. “In the 70s and 80s, we used to have memorials on the soup kitchen floor,” Stoops remembered. “Then there got to be so many people dying we proclaimed an unofficial day.”

In DC, over 100 people convene each year at New York Avenue Presbyterian Church for prayer, song and to hear the names of those that died in DC without a proper home. “If I had it my way we would have an individual burial for every homeless person,” Stoops said. “But there’s so many of them it’s not doable.”

There’s a different approach just over the border in Maryland, where the state takes up the charge of burying and memorializing those that die on the street. Unclaimed bodies are automatically donated to the state’s anatomical board to be used by medical students learning everything from surgery to dentistry. Then the bodies are cremated and are buried in a tree-lined cemetery on the grounds of Springfield Hospital. The state hosts an annual memorial to honor their contribution.

Flowers adorn a grave for those whose bodies were used by the Maryland State Anatomical Board.

Flowers adorn a grave for those whose bodies were used by the Maryland State Anatomical Board.

CREDIT: Christie Thompson

“There were those that chose to donate their bodies. Others are donors by circumstance, for whom no loved ones came forward,” said Ruth Smith, chaplain of the University of Maryland Medical Center, addressing the audience at a this year’s memorial. “We honor them too, for their gift is no less important.”

Some mourners clutch photos of parents and spouses who recently passed away, as a bagpiper plays near the flower-covered grave stone. There are many familiar faces, those who come every year to remember their family members or Maryland’s homeless. Medical students fill out the back several rows, honoring those whose names they never knew but who taught them how the human body worked.

This year, the board buried around 800 remains, roughly half of which were bodies left unclaimed, said Ronald Wade, director of the Maryland State Anatomy Board. “We’re trying to bring humanity, decency, respect and honor,” he said of the ceremony, now in its 41st year. “We don’t throw people away.”

As for Michael Leslie, his cremated remains are now buried alongside his mother in a cemetery in his hometown of DC.

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