Hospice: The Prison’s Forgotten Corner

PRISON HOSPICE CARE IS NEEDED

Outside prison, hospice care patients often receive support from relatives, friends, and loved ones. Having support groups such as these help make patients more comfortable. They also allow for companionship and closure. However, terminally ill prisoners frequently do not have access to these same forms of support in their final days.

Several states do allow parole for certain prisoners in medical situations (see sidebar). And under the FIRST STEP Act, which Prison Fellowship^® advocated for in 2018, compassionate release—or early release based on extraordinary or compelling circumstances like a terminal medical condition—became more accessible to some federal prisoners. But most of the nation's elderly or terminally ill prisoners are cared for in the handful of correctional centers (about 3.5%) that have on-site prison hospice programs.

One such program is at the California Medical Facility in Vacaville, a medium-security facility northeast of San Francisco. Vacaville's program was established as the nation's first licensed prison hospice in the early 90s during the AIDS crisis. Today, the facility is often considered the gold standard for in-prison hospice care. The program has 17 beds for eligible prisoners. Staff help patients with everything from pain management to taking a shower.

In some facilities with hospice programs, such as Minnesota Correctional Facility-Oak Park Heights and Louisiana State Penitentiary, families are allowed to visit their incarcerated loved ones, which resembles the community hospice model.

Joe Avila, the national director of special programs and Angel Tree Sports Clinic ^TM for Prison Fellowship^®, worked in a prison hospice program while incarcerated. Avila explains that even if a prisoner gets into the prison hospice care program, they don't always have the traditional benefits of hospice, like family companionship. This is either because family members don’t have access, or because they have lost touch with loved ones.

"It's very lonely for [the hospice prisoner]," says Avila, remembering what he saw in the 1990s. "Family isn't let in until it's a day or hours before the person passes, and that's only if they have family. [Patients] get tended to as far as pain management and appropriate food, but it's very lonely."

Avila, who still remembers sitting at the bedsides of friends as they passed on, explains that the hospice ward is out of sight and out of mind even for most prisoners. "Nobody on the yard talks about it. Hospice is the prison's forgotten corner," he says.

THE BENEFITS OF CARE

Hospice benefits not just the prisoners who use the time to reflect on past mistakes and make amends but also the staff or other prisoners tending to them. "I listen to people's regrets, their stories, their happiness, their joy. I listen to their confessions," a former gang member named Fernando, who volunteers in Vacaville’s hospice while serving a 41-year sentence, told Reuters.

A 2011 report on palliative medicine suggests that incarcerated volunteers gain a new sense of purpose and psychological rehabilitation through end-of-life caregiving, which can lead to a more peaceful prison culture.