Composing a Life

level of care that can be given to an individual—and how can thin resources be stretched farthest? Even more complex, when is it justifiable to give substandard care because this is preferable to no care at all—and when does this court the risk that substandard care may be institutionalized, that a group of professionals may acquire a vested interest in maintaining it? Beyond these questions lies the issue of when and how standards can be made to converge and how individuals in need can be strengthened to the point of being able to care for others—and indeed, as Alcoholics Anonymous has demonstrated, how caring for others becomes a source of strength.
    In 1987,1 went with Ellen and a group of her colleagues on a committee sponsored by the Institute of Medicine to visit several Boston-area shelters for the homeless. The program at these shelters ranged from almost one-on-one care-taking, designed to provide whatever support was needed to get individuals established in long-term independent living, to intensive utilization of resources designed to get as many individuals as possible off the streets and minimally cared for during the winter nights when they might otherwise freeze.
    At one extreme, there was Project Hope in Roxbury, run by the Little Sisters of the Assumption, a teaching order. The sisters have adjusted to reduced numbers of vocations and changing neighborhood needs by retraining themselves and turning their energies and dedication to new activities. The old convent now functions as a shelter for homeless women and their children. We sat in the convent parlor and chatted with some of the guests: teenage mothers with children who had never had a home of their own, and divorced or never-married women with long histories of seeking affordable housing and struggling to make ends meet, camping with relatives or sleeping with their children in parked cars. “You can trace it back,” Ellen said. “Before a family or individual enters the category, ‘homeless,’ there has been a long history of difficult circumstances and uprooting, sometimes violence, often going back more than a generation, so that simply providing housing isn’t enough. And you can see the depression and developmental deficits appearing in the children.” It struck me that because having a home of some kind is a precondition for the other ways in which one generation cares for another, making growth possible, that homelessness almost has the look of a genetically transmitted disease.
    The sisters at Project Hope attempt to address the full spectrum of problems—including problems with the bureaucracy and its intricate rules surrounding housing subsidies, welfare payments, the placing of children in schools with appropriate special programs, and so on. They try to maintain support as long as it is needed, working together in the handsome old convent with its bright kitchen and wonderful big playroom, and sharing childcare. The children seemed spunky and lively, grabbing the visitors’ hands, asking our names and then showing us around, but the very friendliness made me uneasy, as if these children were urgently seeking adult response and warmth, even in this small facility with its very high ratio of caretakers. The sisters can accommodate no more than six or eight families at a time, a total of about twenty guests with some dozen adults devoted to caring for them and solving their problems, giving each family group at least a private room and a home address to which to return. But the program seems to work; within a year or so, a good percentage of long-term solutions are achieved, with families settled in apartments and even self-supporting, children achieving up to grade level in school, mothers able to care for themselves and their children. The most striking difference between homeless families and welfare families, both of them usually headed by females, is that substantially more of the homeless female heads of household came from
unbroken
homes, homes where men were present, although often abusive. Women who know how to survive in the welfare jungle often grew up in female-headed households—poor but not homeless—where women looked after women. *
    Family shelters like Project Hope are a recent phenomenon. When Ellen was doing her research at the Bunting Institute in 1983, homeless families were just beginning to turn up. She would come upon parents in the shelters, perhaps with a baby sleeping beside them in a