Angola prison shows how TLC makes a difference
Inmates initiated rituals around death
In at least one way, the Louisiana State Penitentiary at Angola, LA, is an ideal setting for a hospice: It's an encapsulated village in which 90 percent of its residents will die within its walls and fences.
Its 5,108 inmates, who all are men, have been convicted of the most violent crimes, including murder, rape, armed robbery, and habitual offenders, says Burl Cain, warden of the prison.
Angola is unique in that it is a former plantation of 18,000 acres along the Mississippi River. Prisoners are paid pennies per hour to work on Angola's farms. Some prisoners have office jobs or other work, and those who volunteer and are accepted can become hospice volunteers in their spare time. The prison also has its own Bible College, chapel, radio station, and newspaper.
"These prisoners are selfish people; they take your money, your body, your life because they're selfish," Cain says. "So hospice is about giving back, and when these inmates become caregivers it works."
In the decade since Cain brought hospice into the prison, the violent acts between inmates have decreased from almost 400 acts in 1996 to about 90 acts in 2006, he says.
"We have 3,200 lifers, and the average sentence for others is 88 years, so this is a serious prison, and no prison in America has more maximum security inmates with more time than we do," Cain says.
Along with the hospice program, the prison also began a Bible college a decade ago, and that has also contributed to the reduction in violence, Cain notes.
"When the moral programs started having some effect, it started to have some success," Cain says. "The only true education is moral, and hospice is a part of that."
When Cain decided to start the program after reading about hospice care in a local newspaper, he encountered some resistance from his staff, which feared the inmates would take advantage of the program to smuggle drugs from the infirmary to the living quarters.
"I said to them, 'We'll keep them from doing that, but I believe we're going to do this anyway,'" Cain recalls. "Consequently, it didn't happen; the inmates didn't abuse it, and we never had a case where the drugs ended up back in the prison." In fact, the opposite transfer of good occurred.
Inmate hospice volunteers started using their own cash, earned at 4 cents to 20 cents per hour, to buy the supplies the hospice patients might like that are not provided by the prison, Cain notes.
"It's been an incredibly rehabilitative program, and it's also improved our morale," he adds.
Cain says he believes the key is that these predominantly selfish men suddenly find themselves on the giving end of life, often for the very first time.
He offers this example: "One of them said, 'I never believed I'd wash somebody's feet or wash their behind,'" Cain recalls. "He said it was the most humbling experience in the world and the most blessed experience to give that to someone else; the man said, 'I gave a fellow man a bath, and it didn't cost me anything.'"
This hospice volunteer was a man who had murdered someone without remorse, and now he was proud of the personal care he gave a dying man.
The hospice program also has removed the stigma the Angola infirmary had among inmates, says Jamey Boudreaux, MSW, MDiv, executive director of the Louisiana Mississippi Hospice & Palliative Care Organization in New Orleans, LA. Boudreaux visits Angola regularly to offer hospice support and assistance.
"Before the hospice program, inmates told stories about how you didn't want to go to the treatment center because you went into the treatment center and never came back," Boudreaux says. "With this new emphasis on hospice, the attitudes began changing in terms of the administration's commitment to patient care, and inmates began providing part of that care."
The hospice volunteers reported back to other inmates that the infirmary wasn't so bad, and people stopped fearing it, says Carol Evans, LCSW, a consultant to the Louisiana State Penitentiary Hospice Program.
"The inmates saw that the infirmary wasn't a horrible place, and the staff got to see a more human side of patients who were inmates and volunteers who were inmates," Evans says.
Another big change is that the hospice has reinforced a sense of community and family among inmates, she says.
"The hospice program lets inmates define their own family, and if they choose other inmates to be family, then those inmates have rights to visit them more liberally," Evans says. "They're treated as family members in the program, and they receive all the support that the program gives."
A lot of the men who have died in hospice care had families who had stopped visiting them years before, Boudreaux says.
"Now that they're dying, the families are coming back and trying to reignite family ties from years ago, and Angola is very accommodating to the families," Boudreaux says.
For example, the family members can stay with the dying man and attend the funeral service, Evans says.
The prison's inmates and staff became so transformed by the hospice experience of dying that they've added some additional traditions to the process.
"Prior to hospice, when an inmate died, he was wrapped in a sheet and dropped in a hole," Boudreaux says. "Now there are full-fledge funerals, and inmates built a horse-drawn carriage straight out of the 18th century, and there's a ritual around death."
Hospice volunteers transport the dead inmate's body to the morgue, where he is prepared for burial. Inmates build wooden coffins that the inmates are buried in, and there is a funeral service held in a hospice chapel on site, he says.
"There maybe singing, a funeral service, and everything is handled by the inmates," Boudreaux adds. "It's a very different prison than it was 10 years ago."
Before the hospice program began, none of the inmates wanted to die at Angola or be buried at Angola's Point Lookout cemetery, Cain says.
"Now they say, 'This is my family, this is where I live,'" and they are buried here," he says.
The dead man's coffin is carried to the cemetery in the carriage, which is pulled by two Clydesdale horses, and inmates, who also serve as pallbearers, sing songs along to the cemetery, where the man is buried in a grave dug by inmates' hands, Cain says.
In at least one way, the Louisiana State Penitentiary at Angola, LA, is an ideal setting for a hospice: It's an encapsulated village in which 90 percent of its residents will die within its walls and fences.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content