Seven months ago, Terry Davis lived out of a downtown San Diego mission and faced the double tragedy of being homeless while suffering from AIDS.
"I felt just like stepping in front of a car," says Davis, 26. "I had no medications, no energy at all. At night, I used to just try to find a place to curl up in just to avoid the cold and hope that nothing would happen to me."
But today, as he sits in the cozy, stuffed animal-filled bedroom he shares with another man with AIDS, Davis considers himself a lucky man.
"I feel much healthier now because I get medication, three meals a day, and I have a decent place to live," says Davis, who weighs about 100 pounds. "If I was still on the streets, I wouldn't be living right now."
Davis is a resident of Ariel House, a residential AIDS shelter on College Avenue that provides Davis and other men with housing, food and occasional donated clothes, as well as the round-the-clock attention their illnesses often require.
The home is one of five private houses in the county set up to provide hospice care for AIDS patients who can no longer care for themselves.
Ariel House and the other hospices opened about three years ago in response to the gradual increase in the number of people in San Diego County with AIDS who needed a place to stay where they could have round-the-clock care, said Binnie Callender, chief of the San Diego County Department of Health Services Office of AIDS Coordination said.
"People implemented these (homes) from the beginning because there was a shortage of places for people with AIDS who (didn't) have anywhere else to go or (didn't) need the acute care services that hospitals provide," Callender said. "No one was around to fill that need, so people started to try to deal with the problem on a grass-roots level."
The nonprofit houses were set up by private individuals determined to provide housing to AIDS patients.
In 1988, when the first shelters opened, there were 528 diagnosed cases of AIDS in the county, said Dr. Donald Ramras of the county Department of Health Services. In 1990, the number of people with AIDS had risen to 629. Although 1991 figures were still being tabulated, they are expected top previous years, Ramras said.
One of those who responded to the plight was Lois Sheldon, who opened a shelter to care for AIDS patients who could no longer care for themselves.
Sheldon, executive director of Christian Social Concerns Inc., an umbrella group of local churches concerned with the fight against AIDS, opened Ariel House in September of 1988.
Sheldon, who worked in hospice care after retiring from a medical technology job in 1985, says she had been thinking of opening a hospice for several years after the death of her father from cancer. She says she decided to join the AIDS fight because churches were "not doing enough for the AIDS situation, and it was frustrating."
The final push came after a woman, whose son died of the disease, rang Sheldon's doorbell and challenged her, as a Christian, to open the shelter. "I finally said to myself, 'Here we have a real crisis, let's get involved.' I wanted to help the community as well as do something for myself spiritually."
Sheldon began speaking at local churches on behalf of the cause and eventually received a $10,000 donation from a parishioner to help her get the project started.
With the money, she leased a house and recruited a staff. The shelter was moved twice (once because neighbors objected to the AIDS hospice) before settling in its current College Avenue location.
Today, Ariel House helps about 75 men a year approach death with dignity, or allows them to be taken care of until they are well enough and feel like leaving, Sheldon says.
The state-licensed house costs about $100,000 a year to run, and the county grants a stipend of $30,000 to help out with utility and food bills, but the rest of the money comes from donations from various sources, Sheldon says. Patients pay up to $500 a month to stay at the shelter, which can accommodate 13 men. Since the men cannot work because of illness, their entire rent is footed by Social Security with medical expenses and private nursing costs absorbed by Medicare.
Ariel House has been praised by county AIDS workers as the best of the five residential AIDS Shelters in San Diego County--a few of which they have labeled as "institutional."
It is seen by many of them as less of a final stop before death, and more of a place to feel welcomed and loved--mostly because of one person, Ariel House manager Joyce Simpson, who residents have dubbed the "Mother Teresa of San Diego" because of her patience and understanding. Simpson joined the staff of volunteers when the house opened, and became a manager in February, 1989.
"Ariel House is a comfortable atmosphere and a home (instead) of being like an institution," said Jeff Clellen, a social worker with the AIDS Waiver program, a county project that grants funds to AIDS patients based on need. "And, because of Joyce, it's not a place where there is military discipline and rigid rules. It's a more of a home."
"I am in it because I have a heart for people, and I really care about them," says Simpson, who is originally from England. "It's not easy to put yourself in their shoes because you are not going to die soon. I try to talk to these fellows and give them advice and something that may have been missing from their lives--love and respect."
Ariel House sits innocuously in a residential neighborhood, identified only by a wooden placard bearing its name that hangs above the front door.
Inside, residents lounge in the living room and watch daytime television while chatting with guests.
The smell of frying chicken wafts from the kitchen, blending in with the overlying odor of alcohol and iodine that permeates the house.
All the clients are men because residents are required to share a room, Simpson says.
Although some of the men wear robes or hospital gowns, many wear street clothes around the house. The sicker men, most of whom require a wheelchair or are bedridden, stay in four bedrooms downstairs, while the healthier ones, such as Terry Davis, live in one of the three upstairs bedrooms.
Simpson's minimum-wage salary, and the pay of the other seven staff members, is based on the number of hours of care the state determines each patient needs.
Though Simpson's duties are mostly administrative, (ranging from scheduling appointments to picking up prescriptions) she also occasionally cooks meals, cleans house and changes diapers. Simpson says she is not allowed to administer medicines because she is not a health care professional, but tries to make sure everyone takes their medicine.
But it is Simpson's no-nonsense mother-hen personality that seems to have earned her the Mother Teresa title.
As she grasps Davis' hand and asks how he is feeling, she worriedly glances across the room at Davis' roommate, who has slept through most of the rainy afternoon. Even with these concerns, there is always work to be done, she says. She heads downstairs to check on the chicken dinner and jot down details of how patients are feeling in a daily journal.
Davis, who calls Simpson "mom" behind her back, says that her concern is genuine and something he sees every day. "Joyce will really go out of your way to help you. I think she will make the time I have left to live beautiful."
Simpson, a former housewife, scoffs at all the praise and says she is just doing her job.
"It is a lot of responsibility to worry about," she says with a British accent. "Sometimes you wonder if you bought enough food for the house, whether you made a new appointment or whether someone got their medicine correctly. I take on a lot so that I can give the guys the greatest quality of life I can give them."
Simpson, who lives outside the home, says that she must manage Ariel House house with compassion as well as tenacity.
House rules include no sex on the premises, no smoking and no alcohol or drugs--a tough measure she says is necessary because many of the men attempt to escape their harsh realities through intoxication.
"It's easier to handle the house when there is no drinking or drugs," she says. "The drugs may mix with their medicine and make them sick."
At least one patient a month dies, says Simpson, who says she tries not to get too emotionally close to her boarders.
"I tend to handle death pretty well, but it is hard because some of them you know pretty well, and you do get attached," she says. "You've got to get on with life though, because if you get into a blue funk about it (death), nothing will ever get done."
Even though the job is challenging, Simpson says that she would never quit because of the emotional rewards she reaps.
"Some of the guys look at life sometimes, and they are so sick that they figure: 'What have I got to live for?' " she says. "It isn't easy to relate to what they are going through, but I try to give them all the love and understanding I can."