ABSTRACT
Why should anyone care how convicts die? ... Prison hospices represent a constructive development. ... However, as America ages, so too does its prison population. ... Dying in prison is what a lot of inmates fear. They fear spending their last hours in agony, alone, separated from family outside and from friends within the prison walls. Throughout Americas prisons, there are many aging inmates facing the bitter truth that while they may not have gotten life in prison, they will almost certainly get death in prison. ... Although there is a foundation in the Eighth Amendment entitling inmates to humane prison conditions, free of cruelty, it is difficult politically to implement programs that are rational and compassionate. ... Little published literature exists defining and describing public attitudes toward prison inmates and the health care provided to them. ... The project includes the comparative study of community and prison hospice, development of prison hospice guidelines, and the implementation of improved care strategies. ... As elsewhere, prison hospices need to address spirituality, advance care planning, family services, and pain and symptom management. Of particular concern in a prison environment, however, are the physical plant, the correctional organization and structure, development and needs assessment, resources, training, costs, women’s programs, security, interdisciplinary teams, and inmate volunteers. ... ”
The most challenging issues encountered with implementing such programs within the prison setting include pain and symptom management, family visitation and involvement, and training. ... Prison formularies severely limit available medications. ... Within any prison there is the possibility of theft and trafficking of the narcotics.
In the rare cases when family is located in the same community as the prison, family involvement in decision-making, especially in the event that the inmate is unable to express his own wishes, is limited. ... This issue is particularly acute for women, who compose a small segment of the prison population. ... Children are often not permitted in prison hospitals and the inmates are often too ill to be transported to the visiting area that permits children. For those inmates for whom prison has become "home" through long periods of incarceration, especially those with close knit inmate families, leaving general population for special care isolates them. ... Even if the inmate is relocated to a special housing unit or infirmary at the prison, they may be leaving "home. ... Thus, prison officials and others interested in improving end-of-life care for inmates must address societal or professional inattention, indifference, or even negativity toward providing inmates with basic end-of-life care. ... The idea of an inmate having control over decisions about his or her life stretches the imagination of most prison staff. ... In prison hospices, inmates are trained to become caregivers.
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