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?
Debra Collins, RN, RAC-CT says
The New York Times did an excellent article last Sunday on prison inmates with dementia.
There is a large population or elderly prisoners who have dementia because drug and alcohol use, neglect of health, and head injuries are more common in that population.
The article described how other inmates have been trained to care for the cognitively impaired prisoners. The caregiver inmates state that caring for other people has given them empathy they did not have previously.
Lorry Schoenly says
Thanks for bringing up that NYT article, Debra. I agree that it is very informative. I hope to post about dementia in the future and will use that resource. Thanks for sharing and being a part of our community of readers.