Terminal illness is an increasing possibility as incarcerated persons age and remain in custody. This can be a time of great sorrow, loneliness, suspicion, pain, and suffering for incarcerated individuals. They may have great fear of dying alone, in pain and without support. Every correctional facility will inevitably have an incarcerated individual who is diagnosed with a terminal condition. Are you prepared to provide the care needed for a good death in your facility?
People with life-limiting or terminal illnesses suffer not only from the illness itself but from loss of function, diminished control of their body, and loneliness, as others around them go on with life. An incarcerated person suffers these losses but also experiences the loss of family, the freedom to determine their surroundings and schedule, as well as their individuality. The losses associated with incarceration magnify the suffering of a patient with life-limiting illness.
According to the National Hospice and Palliative Care Organization, 75 prisons and jails in 41 states have a form of hospice program available to dying patients. When the first programs started in prisons there were no standards for delivery of hospice services in correctional settings. Many programs now involve fellow inmates in peer-support roles that benefit both the dying incarcerated person and the care provider. Correctional nurses have an opportunity to profoundly affect the end-stages of terminal illness and assist patients to have a ‘good death’ even while incarcerated.
The Humane Prison Hospice Program is one project that created a curriculum for palliative care and hospice peer-training programs. With the goal of improving patient-centered palliative care for aging and dying incarcerated individuals, the curriculum developed focuses on preparing peers in the correctional facility to provide emotional support and hands-on care. Peer-support is an integral component of these palliative care programs, encouraging trust and community between those receiving the training and the individuals for whom they care, but also between incarcerated individuals and custodial and healthcare staff, resulting in a healthier environment for everyone.
HPHP SHORT CLIP
This is “HPHP SHORT CLIP” by Edgar Barens on Vimeo, the home for high quality videos and the people who love them.
Correctional nurses provide end-of-life care in this video documentary by Edgar Barens filmed in Iowa State Penitentiary.
Do you have a hospice program at your facility? How do you manage dying inmates?
Debbie J Burgess says
Here at Lowell CI in Ocala we don’t have a program at all and need one ASAP! We, the medical staff, have been told by security that even if an inmate has a DNR in place the prison doesn’t honor it. When we have had DNR inmates pass away the security officers will start CPR even though the inmate has a DNR and has been put on comfort measures only status. WHY??? THe DNR is a State of Florida document and they work for the state of FL. I have been trying like mad to get some answers. Trying to get this clarified so this will stop. The aging population here at Lowell is quite high. At present we have 3 imates that are DNR but if they code or pass away security will still come and do CPR? Help please
Lori Roscoe says
Hi Debbie,
Thanks for sharing your DNR program (or lack thereof) frustrations! Perhaps one of our colleagues who have been through a similar situation can help with strategies used at their facility. I think that the issue needs to be discussed/resolved at the administrative level. Perhaps a meeting with your site/regional administrators and the DOC representative? I am sure that no one wants to make patients suffer or place staff in a risky situation unnecessarily. Everyone deserves to die with dignity….don’t give up the fight!
Lori
Bohdan Hrynewych says
Cruelty in our “correctional” facilities continues to the moment of death! I hope that clergy are allowed to visit when requested by imprisoned persons and that this request is well known by the people behind bars. Do you have information about which states do allow prisons to provide palliative and hospice care? Is there any momentum to make this a national
Regulation?
Lori Roscoe says
Thank you for your comment. Yes, there are many many facilities across the US that provide compassionate end-of-life care/hopsice services behind the wall. There is no movement towards a national regulation that I know of….perhaps you should check with the Hospice Foundation of America or The National Hospice and Palliative Care Organization (NHPCO) or the Center to Advance Palliative Care.