Hospice care is a type of health care given to terminally ill patients. It focuses on quality rather than the length of days the patients are going to live. This means that hospice care is whereby terminally ill patients are given palliative care focus without necessary considering the curative intent. Therefore hospice care is usually given to people who have no other options for curing their diseases or attempts to cure their diseases are not successful. Hospice programs have been widely developed in order to give palliative care to patients who need it. Through this, patients whose length of life is medically confirmed and found to have less than six months to live to receive palliative care either at home or in the hospital facility (Cloyes et al., 2016). The process is vital to patients, and their families as the end of life wishes of the patients are respected and given to them.
Prisons have also adopted and incorporated the hospice care program in the prison facility. Many people who are incarcerated for various crimes are suffering from a terminal illness, and this has become a great concern (Cloyes et al., 2016). Most of the imprisoned men and women die from such illness on a daily basis, and their experiences from this terminal illness have not been great. Therefore, prison wardens have seen a need to introduce hospice care programs in prisons to cater and give palliative care to the terminally ill prisoners. Such a story has been shared in the documentary of “Angola Prison Hospice: Opening the door” where the experience and journey of offering palliative care to inmates are captured and featured.
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Louisiana Angola prison is a maximum-security prison with over five thousand inmates. It is popularly known to have a reputation for violence; therefore, a decision for incorporating a hospice program in the facility was unlikely. Eighty per cent of the inmates in Louisiana Angola maximum prison are expected to grow old and die behind bars (Cloyes et al., 2017). This expectation is very high since the harsh conditions and the imprisonment laws in the facility give them no hope to have a life beyond the bars. Similarly, for those terminally ill, they have no hope to be released and have their last days beyond bars with the presence of their family. In this case, the prison warden came up with the idea of introducing the hospice program within the facility.
The movie, "Angola Prison Hospice: Opening the door" is a documentary that features the experiences of the hospice program in Angola's maximum prison. The prison's administration, hospice care professionals and the inmates' volunteers are featured in the documentary as they give their experiences and lessons they have gone through and learned during the program (Open Society Foundations, 2011). The documentary has shown the success stories, and the positive change in the inmates brought about by the hospice program. Most of the inmates in Angola maximum prison are growing old, and ageing problems have become popular in the maximum prison. Most of these incarcerated people that are in Angola's maximum prison life with the expectation that they will spend their last days behind bars and even die while in there (Cloyes et al., 2017). Several inmates are featured in the film where they volunteer and dedicate their lives to giving palliative care to fellow inmates. The volunteering inmates give their stories behind their decision to volunteer as well as their experiences throughout the hospice program (Open Society Foundations, 2011). Most of these inmates are said to be hardcore criminals, and their decision to volunteer was a surprise to most of the prison staff and administration.
The positive change and the transformation seen in the volunteering inmates who are active in the hospice program give an impression that behind those hardened prisoners, there is the element of compassion, passion and care despite the crimes they committed. For instance, two of the inmates' volunteers featured are known to be second-degree murderers and rapists. However, despite the crimes they committed, they applied for the hospice program, attended the training and were now giving out hospice care and end of life care with so much compassion and dedication to their fellow inmates. On the other hand, the hospice care program members share the challenges they face while giving out and training palliative care to the inmates. One of the members' shares that the nature of the environment was one of the toughest challenges they had to face as the prison environment is a whole different from the community hospice programs (Open Society Foundations, 2011). They had to first learn about the Angola maximum prison, what is expected to be done, and what is not and the rules and regulations of the prison facility. The prison staff and administration also had to know more about the hospice programs and their way of doing things and giving out care. It was essential to both sides as it was discovered that their interests and expectations crushed and were not in line with each other. In this case, conducting a successful hospice care program comes along with its challenge especially in a prison facility setting.
Aging Issue
The ageing aspect in Louisiana Angola maximum prison is increasing as years pass by, and this is one of the main reasons as to why hospice care is essential in prisons in our world today. It has been discovered that individuals older than fifty-five are the fastest-growing age group in the United States in America, according to the Bureau of Justice Statistics (Cloyes et al., 2017). Similarly, in general, it is said that there will be more people who are over the age of sixty to seventy than children and young people who are under the age of eighteen. In this case, the numbers of the ageing population are increasing at a faster rate than the young. Therefore as the ageing population continues to grow, the challenge for the need to care for these elders and dying inmates is becoming a considerable challenge to prisons (Cloyes et al., 2017). A high number of imprisoned men in Angola prison are going through the end of life as some percentage are suffering from chronic illness. Therefore hospice care in the facility has improved the condition of the patients as some end their lives with dignity.
Sociological Issues
Family
The inmates behind bars in the Angola maximum prison are separated from the rest of the world. Looking at the geographical location of Angola, it is clearly evident that the inmates are on their own without regular support from their family. The geographical location of Angola's maximum prison makes it difficult for the family members and friends of the men imprisoned there to come to visit them regularly. Besides, some family members get no chance to travel to Angola maximum prison to visit their jailed family members. Therefore, once incarcerated in Angola prison, one is expected to forget about his family, and due to the life sentence given to them, they are forced to have their fellow inmates as their family. It sometimes becomes painful to them, especially to those who are serving a life sentence and those who suffer from chronic illness, and they need maximum support (Cloyes et al., 2017). Therefore several inmates volunteer into the hospice care program to take care of their fellow mates whom they consider to be their family for life.
Volunteer services and teamwork
According to the Angola prison hospice, the most important people making the program easy and successful are the volunteers of hospice care. Therefore it is not only the staff, nurses, doctors, case managers and correctional officers that make the hospice services possible but also the volunteers. The principal volunteers in Angola Maximum prison are the inmates who are widely known to be violent and hardcore offenders. As such, the inmates are must undergo a training program under the supervision of nurses and doctors in conjunction with the prison staff and correctional officers. They then gain the skills and knowledge that they need to offer palliative care to those facing their end of life and also to those terminally ill. Volunteers are said to be critical in the program as they would sit down and spent their time with them through conversations. By doing this helps prisoners who are on their last days, as well as those who are in pain due to chronic illness, feel appreciated and their dignity restored once again (Chassagne et al., 2017). Moreover, they spent their last days as happy men and smiles are once again restored in their faces courtesy to the hospice care given to them by their fellow mates and friends considered as family. They, therefore, rest peacefully and happy and this brings meaning to them and the rest of the inmates.
Overarching Themes
Overarching themes are severally portrayed in the movie with deeper meanings in them. One of the themes portrayed is safety and security whereby the need and mission for security and end of life and hospice care should be balanced and integrated (Chassagne et al., 2017). Nurses and doctors should acknowledge that the hospice program is a prison hospice program; therefore, the priority should be security unlike the beyond bars hospice community programs. Secondly, the prison administration and correctional officers should understand that some boundaries have to be eliminated, such as protocol, procedures, and policies in order for them not to become a barrier to hospice care. For instance, any touch among the inmates is prohibited in most of the prisons. On the other hand, touch in the context of hospice care is crucial to patients and elders. It gives a sense of compassion and a feeling of care. In this case, the correctional officers and staff were willing to have changes in their rules in order to allow and support the hospice services within the facility.
Another theme portrayed in the movie of Angola prison hospice is the aspect of shared values. During the offering of the hospice services to the inmates, there are specific standard values that all participants should have for a successful program (Cloyes et al., 2016). These core values portrayed by the correctional officers, mates and volunteers are empathy and compassion, responsibility, respect and principled actions. All participants of the hospice services need to have the ability to identify with the patient's suffering and needs. Moreover, they need to have an ethical mandate to care for them as they would care for themselves. Through shared values, the program runs smoothly, and successes are achieved from the hospice services.
Teamwork is also one of the themes that are portrayed in the movie. The program participants, especially the volunteers, showed the essence of working together as a team in caring for the patients and elders. Volunteers in the Angola prison are mainly the inmates and the teamwork between them was amazing. The volunteers worked together to care for their close family members who are their fellow inmates. They teamed up and successfully began to build caskets for their mates who have passed away instead of giving their last respect in a carton box.
Moreover, through their teamwork, they organize for their no longer mates funeral services where they invite everyone to pay their last respect and have a place to mourn and grief them. The biological family members are also invited by the volunteers and other inmates to attend the funeral service of their imprisoned family member. The teamwork has made things easy for themselves as the volunteers and quality service for their fellow inmates making the hospice program successful in Angola's maximum prison.
In conclusion, the meaning of the movie, "Angola Prison Hospice: Opening Door" is to illustrate the life of the prisoners and their grief that they go through behind bars. Our general perspectives on how we perceive the people behind bars should be changes and looked at a different angle. Most of the people conclude that people behind bars are dangerous and should not be given any care and compassion while serving their sentences. However, this may not always be true as some inmates, whether dangerous or not, should be given some care as they are also humans. As we have seen in the movie, people are capable of changing and behind the criminal, there is a compassionate, kind and caring person that the world is not familiar with. For instance, one mate featured in the movie accepts that he has done many wrongs to the people out there and would like to change how these people perceive him after he was able to join the hospice program (Open Society Foundations, 2011). He further says that it is possible to do this only with actions as people will not believe him, but actions will speak put for him (Open Society Foundations, 2011). This communicates out loud that we should not judge any prisoner from the crimes they committed, but rather the changes they are experiencing as we treat them with care through programs such as hospice care programs. Concluding, future prisons will take a huge turn when such programs are incorporated and adopted in their facilities.
References
Cloyes, K. G., Rosenkranz, S. J., Berry, P. H. … & Shannon-Dorcy, K. (2016). Essential elements of an effective prison hospice program. American Journal of Hospice and Palliative Medicine , 33 (4), 390–402. doi: 10.1177/1049909115574491
Cloyes, K. G., Rosenkranz, S. J., Supiano, K. P., Berry, P. H., Routt, M., Llanque, S. M. & Shannon-Dorcy, K. (2017). Caring to learn and learning to care: Inmate hospice volunteers and the delivery of prison end-of-life care. Journal of Correctional Health Care , 23 (1), 43–55. doi: 10.1177/1078345816684833
Chassagne, A., Godard, A., Cretin, E., Pazart, L., & Aubry, R. (2017). The Collision of Inmate and Patient: End-of-Life Issues in French Prisons. Journal of Correctional Health Care , 23 (1), 66–75. doi: doi.org/10.1177/1078345816685084
Maschi T., Marmo S. & Han J. (2014). Palliative and end-of-life care in prisons: a content analysis of the literature. U.S National Library of Medicine, 10 (3), 172-97. doi: 10.1108/IJPH-05-2013-0024.
Open Society Foundations. (2011, September 11). Angola Prison Hospice: Opening the Door [Online Video File]. Retrieved from https://www.youtube.com/watch?v=mMLjANwBRDk
