This week's blog is the final installment in a three-part series about Hosparus Health’s volunteer program at the Kentucky State Reformatory, sharing stories of both the inmates who offer companionship and vigil to dying inmates, and the volunteers and staff who support the program. Click here to read Part 1 and here for Part 2.

The photo accompanying this blog shows inmate DJ visiting with another inmate in hospice care on the medical unit. DJ is the longest serving volunteer in Hosparus Health’s prison hospice program, going through training in 2006, a dozen years into his life sentence. He’ll be eligible for parole in a few more years. Most of the volunteer inmates are serving life sentences, with several of them not eligible for parole. They will become the hospice inmates that they now serve. The youngest volunteer inmate in the program, Channing, is 33 years old. Channing was incarcerated when he was 19 and is serving a life sentence. He became a volunteer about two years ago, also a dozen years into his sentence.

Even though he is the youngest, Channing always has advice for the two newest volunteers who were trained last fall. His insight even helps the older inmates with some of the problems that are unique to incarcerated hospice volunteers.

We typically like to go into the group with a relevant topic to discuss with the inmates during our bimonthly sessions at the prison. The past couple of meetings, Dr. Webb has discussed diseases common to the prison or of hospice patients. At the end of the year, we will have a Service of Remembrance, modeled on the one that the Hosparus Health Grief Counseling Center offers to our communities, to remember the hospice and general population inmates who died in prison. The first meeting of the year is a review of their service hours and recognition of the thousands of hours that they’ve contributed as a group. Sometimes, we leave the topic up to them and discuss whatever arises.

The most common issues that they deal with are getting to their patients, belongings stolen from patients by other inmates, and maintaining their boundaries with the staff. Although the inmates all have a special badge attached to their prison ID that designates them as a hospice volunteer, they aren’t always easily able to get to another part of the prison. Sometimes the guards are dealing with serious issues with other inmates. Sometimes the newer guards aren’t familiar with the procedures of the program. Last year, KSR was the second largest institution in the State Department of Corrections with a 2,005-bed capacity.

When the hospice inmate patients need medical attention beyond what the prison infirmary can provide, the patients are sent to area hospitals and medical providers. This has included the Hosparus Health Inpatient Care Center. Our volunteers have had to help patients who leave the prison and return, or those who are on the medical unit and are not lucid, reclaim their belongings.

Their possessions are meager and things as ordinary as underwear gets stolen, or the very few personal items an inmate may have to pass along to their family comes up missing. The volunteers do an excellent job of problem solving as a group. While there are prison staff who facilitate the group, it is often the inmates themselves who develop solutions as they discuss whatever their most recent challenge is. It has helped them to have the assistant warden join our meetings, as he can help guide the prisoners to reasonable expectations or give context to their issues. For example, the solution to stolen underwear was a more durable lock purchased from the commissary.

Whenever new staff is in the infirmary, there is a lot of education about the procedures that takes place between the program coordinators, the inmate volunteers and the medical staff. Much like our volunteers “on the street” sometimes encounter facility staff who don’t understand the role of a hospice volunteer, and what a volunteer can and can’t do, the prison medical staff might expect the inmate volunteers to exceed their boundaries.

The inmate volunteers also get frustrated when care is not delivered to the patients in a timely or compassionate manner. They also deal with uncooperative roommates while sitting vigil with an actively dying patient. The inmate volunteers rely upon each other to make sure that their patients are cared for as best they can in the circumstances. There is little that they can control in prison, but when they are able to help a dying patient, they do everything possible to help him die as good a death as possible. The vigil shifts during which an individual inmate might sit with an actively dying inmate can last up to 8 hours, sometimes longer if there are many hospice patients.

Grief is a topic we cover regularly. With life sentences, the inmates are serving with men they will know for their entire sentence. Additionally, the inmates must reconcile the people they hurt and the crimes they committed. Most of the volunteer inmates are serving life sentences for murder. Serving as a hospice volunteer helps them to come to terms with their crimes and their punishment.

Many tell us that being a hospice volunteer also allows them to feel human. Being in prison, even incarcerated with over 1,000 men, can be lonely. Family members may give up on them and stop visiting. As a volunteer, they find camaraderie with the group and develop connection with the hospice inmates whom they serve. The hospice program gives them a strong sense of purpose and helps them feel like they are paying back their debt.

Almost 10 years ago, The Courier-Journal ran a front-page feature on the hospice prison program. One of the prisoners quoted in the article who is still serving said, “I didn’t get into this for the parole board. I didn’t get into this for the institution. I got into this for me, to save my soul. I know deep down in my heart I’m probably never going to get out of prison. But I don’t want to die alone here. I want one of these guys to be with me when I go.”

In a place not known for kindness or compassion, the small group of Hosparus Health volunteers are doing what they can to make sure that their fellow inmates don’t die alone while giving themselves a chance to do something good. All of us at Hosparus Health are grateful to be part of this program.