A story is told of a young man who was sentenced to life imprisonment at 34 yrs of age and developed cancer of the stomach while in prison.
He was referred to a hospice for palliative care due to advanced illness with disseminated metastases.
This young man was admitted in a major referral hospital where he needed review by the hospice team.
A visit to the hospital reveals a frail patient, chained in bed & guarded with 2 armed prison warders.
In such a situation, one is left with more questions than answers;
· What are the rights of a patient?
· Isn’t having cancer in itself a lifetime imprisonment?
· What is the role of a carer?
Presenting this case scenario at the 3rd Kenya National Palliative Care Conference, senior nursing officer at Nairobi Hospice Catherine Atieno said that palliative care for prisoners has met several challenges with late referral of patients having advanced stages of illness.
Atieno said that patients of this category usually have their privacy greatly infringed into and their autonomy is greatly compromised.
She said that there is need to strike a critical balance between the roles of a law enforcer and those of a carer.
“There is a distant involvement in humane care approach to these group of patients.” She added.
The nursing officer said there is need to enhance freedom for such patients to be with their family.
The patient’s family needs to be re-define in the prison context in an effort to embrace a realistic and holistic approach to care in end of life care.
In her concluding remarks, Atieno said that there is need to train all those involved in the care of these patients on the palliative care goals & approaches.
She said that in such settings, there is need to have standard protocol in dealing with such patients focusing on their immediate/nuclear family as well.
Dr Zipporah Ali, the Executive Director of Kenya Hospices and Palliative Care Association (KEHPCA), informed participants at the conference that KEHPCA is currently working closely with Catholic Relief Services (CRS) to educate health care professionals working in prisons around Kenya.
Dr Ali said that wardens are also on palliative care program where they are learning how they can support their terminally ill patients to live a better quality of life by relieving their pain and other symptoms, as well as providing emotional and spiritual care.