Building Effective Prison Hospice Programs: Best Practices and Processes for Developing, Managing, Evaluating, and Sustaining End-of-Life Care in Prisons (SA526)

Abstract

1.Describe how prison hospice patients compare with community-based hospice patients on demographics, medical history, admitting diagnoses, and symptom prevalence and identify issues salient to developing, implementing, and evaluating prison hospice services.2.Identify key resources necessary to sustaining effective programs, including the interdisciplinary team, models of peer-care provision, and cooperative management among corrections and medical staff and inmate volunteers.3.Describe a best processes approach to integrating key resources with institution-specific resources to create community-based, community-owned, and therefore sustainable programs in other high security incarceration settings. The aging U.S. prison population is a widely recognized public health problem and has drawn increasing attention to how many prisoners experience acute, chronic, and life-limiting illness while incarcerated. In some prisons, including the Louisiana State Penitentiary at Angola, more prisoners will die while incarcerated than will be released. This situation has led to the development of prison hospice programs in a number of U.S. states that attempt to model the sustained success of the Angola Prison Hospice Program, now in its fourteenth year of operation. This concurrent session provides a description of the program and a broader view of how systematic analysis of the best processes developed there in conjunction with scientific study of program practices and outcomes could inform and facilitate an evidence-based approach to developing prison hospice programs in other institutions. Together, members of the interdisciplinary team from the Angola Prison Hospice Program, the executive director of the Louisiana-Mississippi Hospice and Palliative Care Organization, prison hospice researchers from the University of Utah, and, if possible, an inmate volunteer via phone or video will present and discuss ongoing implementation, management, and evaluation of the Angola Prison Hospice Program with consideration of practices and processes that are both context-sensitive and generalizable. Emphasis will be placed on growing community ownership and investment in the program and developing prison-specific processes and practices for training and evaluation. Specifically, the panel will present and discuss: the intrinsic value of the interdisciplinary approach in prison hospice, the development of education and training to accommodate both the specific needs of the corrections setting and the integral role of inmate volunteers in peer-to-peer care and mentorship, a comparison of symptom prevalence and patient outcomes for the program's patients compared with community-based hospice programs, and the role of the peer-care volunteer model in supporting these outcomes.