ospice is something special to me because it allows me to gain peace as I start to prepare to pass into eternity.”
This was shared by a 62-year-old inmate serving 45 years for murder who knew he would never get out of prison unless a miracle occurred. This offender had numerous health issues, which had worsened over the last few years, and required increased medical care. He had recently been admitted to the hospice unit.
With an increasingly aging prison population, end-of-life care for inmates is becoming a more prominent issue. Terminal illness is an increasing reality. Ultimately, every correctional facility will have inmates who are diagnosed with a terminal condition. This can be a time of great sorrow, loneliness, confusion, and emotional pain for inmates.
According to the Missouri Department of Corrections, the population of inmates who are 50 and older has grown from 10.1 percent in 2004 to 17.5 percent in 2013, and those numbers will only continue to rise as prisons are faced with aging populations. Currently in the U.S., approximately 3,400 inmates die of natural causes each year, making prison hospice programs more of a necessity than ever.
The Chaplain's Role in the Hospice Journey
So, what is a chaplain’s role in the dying process of an inmate? First, we must understand what a chaplain does. A chaplain cares for souls and gives hope without discrimination. A chaplain should be able to communicate and demonstrate compassion regardless of a person's religious belief. A chaplain is called to be there during pain and struggle, seeking to reflect the light of God in a dark and intimidating place.
The role of a chaplain in the hospice program is crucial, since many people turn toward spirituality for comfort at the end of their lives. The spiritual care and counsel this person provides is paramount in helping patients come to terms with what is happening to them and helping them find peace.
The chaplain is dedicated to providing patients with spiritual care and counsel that meets their needs and is in accordance with what they wish. If a patient does not wish to engage with a hospice chaplain or receive any form of spiritual care, he or she is not forced to. Also, the patient can change his or her mind at any time. Chaplains do not seek to convert patients to a specific religion, but to meet them where they are on their spiritual journey. The goal is to help the patient discover renewed meaning and spiritual peace. Regardless of religion, creed, or culture, a chaplain’s purpose is to provide patients with compassionate spiritual support and counsel.
A cornerstone of the hospice philosophy of care is that no one should be alone at the end of life. No matter the time of day or night, the hospice team, including the hospice chaplain, is dedicated to ensuring that no patient dies alone. To aid in this, many prisons have introduced hospice programs, where fellow inmates are selected and trained to assist with dying inmates and become their daily living assistants. The chaplain plans the schedule to make sure that a daily living assistant (DLA) is always at the bedside of a dying inmate to provide comfort and support.
When it comes to hospice care, the chaplain is not there to “fix” anything. Instead, he or she is there to listen to the inmates as they talk about what is important to them. Hospice patients talk about a variety of topics ranging from their impending deaths to their thoughts about God. Mostly, they just talk about what people always talk about: unfinished business, unanswered questions, regrets over their past, family issues, and their feelings of not being ready to die yet. Listening to final inquiries like these has long been the domain of a family pastor, priest, or rabbi, but for a growing number of older Americans who are now incarcerated and do not know a member of the clergy, that bedside responsibility has now been given to the chaplain.
Some chaplains refer to what they do as fostering a more “caring and successful” experience by helping inmates gain peace in the final hours of their lives. End-of-life care for hospice inmates is not just about people getting more spiritual or religious. It is also about a shift in the way people are meeting the spiritual and emotional needs of the inmates before they take their last breath. Church members, whether or not they are members of the clergy, are often surprised at the needs of their local prisons in regard to having someone to simply be an encouraging presence to a dying inmate. There are simple procedures in order to be placed on a volunteer in corrections (VIC) list, and like most prison ministry, there is no glamour or glory involved in this work. There is, however, a reward that transcends any worldly measurement: It is about making sure that no hospice patient dies alone.