Prison Hospice: From the Inmate Hospice Volunteers’ Perspective – A “Snapshot” by Barry R. Ashpole

A QUOTE FROM AN EARLIER ARTICLE I authored, “I’m somebody that nobody thought I could be,” attributed to a prison inmate at Iowa State Penitentiary, continues to resonate.(1)  The quote captures the very spirit and intent of prison hospice. They are the words of Bertrum ‘Herky’ Burkett, who died in January 2024.

Herky left an indelible impression on all those that came into contact with him. His unwavering commitment to the prison’s hospice program, coupled with his exceptional powers of observation, boundless compassion, and profound empathy, positioned him as the quintessential individual for the role of an end-of-life caregiver. His dedication was unparalleled, and those privileged to work alongside him can attest to this wholeheartedly. (2)

While the terminally ill are clearly the intended beneficiaries of hospice, the impact on those who volunteer in providing end-of-life care to fellow prison inmates is profound. In Herky’s words:

And we always wondered who was gonna be the last one living to take care of the rest of ‘em. Well, when they brought in a hospice, it gave us an avenue to take care of each other. In order to get in here, they’re pretty sick. They’re dyin’. So you’re dealin’ with them knowin’ that it doesn’t matter what you do. You’re not helpin’ them to live. All you’re doin’ is makin’ their passing easier.

We hold their hands. We pray. And we bathe ‘em. We feed ‘em, make sure they eat. We take ‘em to the yard. We take care of all the things that they need. And when that patient has a family, his family is allowed to come back in here to the hospice. When I started hospice, I thought it would be about what I can give to the patient, what I could do for that patient to make ‘em feel better.

But when you do what you do, the feeling that you get back from them, you can’t even describe it.1

A concept unique to the U.S., prison hospice, which is based on peer-caregiving, is gaining traction in the literature. For example, the evidence from the California-based Humane Prison Hospice Project underscores the profound impact of inmate caregiving, showcasing instances of empathy from hardened gang members and stories of redemption among people in prison serving lengthy sentences. The person- centred care facilitates a humanising experience for all involved.(3)

Findings of another U.S. study suggest that “inmate-caregivers” believe they provide a unique and necessary adaptation to prison-based end-of-life care resulting in multilevel benefits. These additional perceived benefits go beyond a marginalized group gaining access to patient-centered end-of-life care and include potential inmate-caregiver rehabilitation, correctional medical staff feeling supported, and correctional facilities meeting end-of-life care mandates. Additional research is imperative, however, to work toward greater standardization of, and access to, end-of-life care for the incarcerated. (4)

One study explored the motivations of inmate hospice volunteers. Participants expressed complex motivations; inter-related themes on personal growth, social responsibility, and ethical service to vulnerable peers suggested that inmate caregivers experience an underlying process of personal and social transformation, from hospice as a source of positive self-identity to peer-caregiving as a foundation for community. (5)

Few studies, however, have examined how hospice inmate volunteers cope with the death of those in their care. Understanding the bereavement needs of hospice volunteers and how prison hospice volunteers navigate grief and remain committed to providing excellent hospice care can help inform the grief processes and practices of hospice care professionals. (6)

The concept of prison hospice has a profound effect on the givers and recipients of compassionate end- of-life care.

References:

1. “I’m somebody that nobody thought I could be,” eHospice, June 2024. https://bit.ly/4kUgLcs
2. ‘Spirit of prison hospice: One man’s legacy,’ End-of-Life Care Behind Bars.com.  https://bit.ly/3IKd0cf
3. ‘How do people in prison access palliative care? A scoping review of models of palliative care delivery for people in prison in high-income countries,’ Palliative Medicine, 2024;38(5):517-534. https://bit.ly/46ulRZc
4. ‘“People don’t understand what goes on in here”: A consensual qualitative research analysis of inmate-caregiver perspectives on prison-based end-of-life care,’ Palliative Medicine, 2018;32(5):969-979. https://bit.ly/3Gqlbts
5. ‘To be truly alive: Motivation among prison inmate hospice volunteers and the transformative process of end-of-life peer care service,’ American Journal of Hospice & Palliative Medicine, 2014;31(7):735-748. Abstract: https://bit.ly/4nHXX2M
6. ‘The grief experience of prison inmate hospice volunteer caregivers,’ Journal of Social Work in End-of-Life & Palliative Care, 2014;10(1):80-94. https://bit.ly/3TuFpVN

BARRY R. ASHPOLE is an educator and communications consultant living in Ontario, Canada. Now semi-retired, he has been involved in palliative and end-of-life care since 1985. He established the End of-Life Care Behind Bars website (https://bit.ly/4dU4qmi), an advocacy, teaching and research “tool” to inform and, hopefully, affect a seismic shift in society’s attitudes towards the health and well-being of the incarcerated. Regular postings include annotated listings of current articles, reports, and so on, culled from the professional literature, the news media and other sources.

Republish This Article

The author believes in the free flow of information. Republish this article for free, online or in print, under Creative Commons licence, with due credit to the author and source. https://bit.ly/3B9EK6n