Posted on 02/28/2009 4:15:55 PM PST by Diana in Wisconsin
WAUPUN, WI — At 51, he looks two decades older.
His thin body is swallowed up by the afghan that covers his bed. The blanket's vibrant colors, and the powder-blue paint on the walls, make his gaunt face look even paler.
His chest is sunken, his limbs are fragile and doctors just found two new fractures in his spine. He is in some pain but says he's at peace in this place.
"I'm very comfortable here," he said in a voice one must strain to hear. "I wouldn't wish this on anybody or anything, but I would never get treated like this anywhere else."
Kaos Metz, who has end-stage liver disease, won't live to finish his 10-year sentence for causing injury while driving drunk and other alcohol-related crimes. But he's considered a success story, along with the 26 other prisoners who came here to die before him.
"They died well, and not alone," said Margie Barnes, coordinator for the hospice program that operates in one part of the prison hospital at Dodge Correctional Institution.
The program, a first for Wisconsin prisons, was 2 years old last month. Funded by inmate fees and donations, it draws terminally ill inmates with less than a year to live from all 19 of the state's adult-male prisons. Specially trained inmate volunteers provide most of the "comfort care" for which hospice programs, inside of prison or out, are best known.
That care includes sitting with patients, talking with them, writing letters for them, serving them meals, playing games and standing vigil around the clock — literally standing at their bedside — when death is imminent. On June 8, four inmate volunteers sang "Amazing Grace" as the hospice's youngest patient to date, Sellwyn Covington, a registered sex offender, died of cancer at age 28.
"You try to comfort them, as much as a person can," said inmate volunteer Triru Dillie, 36, who is serving a life sentence for murder. "We don't try to force anything on them. We find it is a privilege to be with them when they die."
'Right thing to do'
To those who would oppose granting anything special or more comfortable to prisoners — even on their death beds — Dodge staffers say hospice care isn't an extra and any debate over it isn't their fight.
"We don't consider ourselves the judge and jury," said Dodge prison guard Dawn Heeringa, who helps monitor the 62-bed infirmary, where two rooms have been dedicated for hospice patients, and a few more can be converted if needed.
What's more, as hospice care becomes more common in prisons around the country — 39 states offer it — and in the community, where the hospice movement began in the mid-1970s, it would be wrong to withhold it, officials said.
"This is the right thing to do," Warden Tim Lundquist said.
Hospice care in any setting is aimed at giving dying people support and more say over their final days. It reflects a gradual societal shift from the desire to prolong life at any cost to achieving the best quality of life in what time is left.
Doctors and nurses focus on the relief of pain and other symptoms, rather than on finding a cure, with a team of professionals and volunteers to address any emotional, spiritual and psychological needs.
At Dodge, prisoners entering hospice must understand they can't be cured and sign a form rejecting extraordinary methods to keep them alive. Officials believe that saves money, because it eliminates pointless tests and treatments, including visits to outside specialists and the security costs of transport.
Dodge's infirmary psychologist, Lynn Stock, said hospice even made the prison safer.
"When (other inmates) see staff demonstrate compassion toward dying patients, it creates more trust," Stock said. "It increases respect for staff."
Andy Land, who runs a community-based hospice in Fond du Lac as part of Agnesian Health Care, helped prison staff start the Dodge hospice and continues to provide training for its staff and volunteers. He is paid through a surcharge on prisoner phone calls.
"This is appropriate medical care," Land said. "This is not coddling."
Security, skepticism
Even so, the success of Dodge's program hasn't come easy, staff members said. Planners faced unique security challenges and some skepticism from within.
"We have to remember where we are," said Jim Hebel, a nursing supervisor who helped develop the hospice. "We are a medical facility, but we are in a maximum-security prison."
Some on the medical staff were concerned about giving narcotics to inmates with a criminal history of drug abuse, even for end-of-life pain relief. And the inmates themselves have been a tough sell, because many believe the system will always try to shortchange them.
"It's a constant education process," Heeringa said. "We have to sell hospice as a better way to die, and the rigidity of (prison) culture is a challenge we overcome daily."
Security chiefs balked at the idea of open doors on dying patients' rooms and at letting inmate volunteers be in the rooms at all without a constant guard, even though two officers and a sergeant continually monitor the infirmary floor on foot patrol and by camera.
Program planners eased security concerns by putting the hospice rooms near the floor's central nursing station for increased supervision, while convincing many nurses that the inmate volunteers could ease their immediate workloads.
But one major limitation could not be helped, staff members said. To safeguard against abuse, inmate volunteers are only allowed to touch hospice patients on their hands, elbows and shoulders, Hebel said.
Medical staff face the same restrictions, except as needed for specific procedures.
"We don't allow hugging," Hebel said. "It's kind of difficult for us, but when it comes to hugging, which is typical in (community-based) hospice, we have to draw the line. We don't want to endanger our program by not having a very definite standard."
The program does come with some extras that prisoners might otherwise not see, but they are either made by inmates or purchased through inmate fundraisers or donations from staff and patients' families. Extras includes the paint on the walls, white-lace curtains for the windows, quilts or afghans for the beds, special food, books, movies, fans, clocks and TVs.
"I have not seen one instance of abuse of the program," consultant Andy Land said, "because the inmates own it."
'Looking for redemption'
Kaos Metz, who had lived in Jefferson and Madison, arrived at the hospice in late January from the state prison in Oshkosh. By mid-February, as he was failing, his main hope was that his daughter and her baby, whom he had never met, would visit soon.
Hospice staff try to arrange for visits from outside friends and family. But for about one third of patients, no one comes, Barnes said.
That makes the job of inmate volunteers even more important, as they are perhaps the dying patients' only real confidantes and confessors.
"They serve a role that no other person can serve," Land said. "All the masks come off. Every single one of us has to answer the question, 'What have I done with my life?'"
And as the end nears, prisoners in hospice often look to reconnect with family and "make amends," Heeringa said.
"No question they are looking for redemption," she said.
To be hospice volunteers, inmates must have good conduct records and pass personality tests, followed by 16 hours of training. They aren't paid and must commit to the work — typically in two-hour shifts — for at least two years, on top of their required prison jobs.
Inmate volunteer Dennis Gordanier, 37, who is serving a 20-year sentence for sexual assault, said volunteers get to be present for moments that range from sad to angry to harrowing to uplifting, sometimes all with the same person.
"(One patient) flat-out came to me and said, 'Do you think I'm going to meet the Lord?'" Gordanier said. "And it was the greatest feeling in the world to be able to tell him yes."
It can be difficult when patients die, he said, especially if the death isn't an easy one.
"But you know they won't suffer anymore," he added. "They're going away from all that. It's a bittersweet thing."
Metz died at 3:10 a.m. Wednesday. He never had a visit from his daughter, who lives in Michigan, or his nine-month-old grandson. Staff were trying to set it up, but bad weather and other circumstances got in the way.
"Time ran out," Barnes said.
Believe me, I have been there too. I don’t mean to sound “preachy”, but it is only by the grace of God that we can forgive our enemies. That’s what makes us Christians. And that’s why we have muslim terrorists, because they can’t forgive. I had to pray every day that I could forgive. It is not easy. But it is merciful.
Lord have mercy on us.
Christ have mercy on us.
As a hospice volunteer (not with a prison) I can understand why they want to help. No one wants to die alone and it’s up to the volunteers to comfort them.
I’m as tough as anyone on criminals but these are prisoners helping other prisoners on a voluntary basis. Maybe some of them will have a change of heart before it’s too late.
Forgiveness for sins ultimately is God’s decision. But that should not prevent us from showing some compassion for the sick and dying offender in his final days of life. Perhaps he will finally call on God for forgiveness, come to know Jesus as savior, and for all we might know die redeemed and saved.
We all are sinners, and in need of forgiveness.
Well, I said I would think about it, and I have. This still doesn’t erase the great wrongs those people have committed against others, but if it is prisoners helping each other out, and not my tax dollars going to support this, then I can live with it.
For I was hungry and you gave me food, I was thirsty and you gave me drink, a stranger and you welcomed me,
naked and you clothed me, ill and you cared for me, in prison and you visited me.’
I know, I know... :)
You know, there’s a vast difference between hatred and justice.
You are practically being accused here of being spiteful (hateful) and lacking mercy, and it bothers me to think that crimes and victims should be overlooked in the name of false forgiveness.
These people in the jail hospice are obviously paying in spades for their crimes, as they should. But neither you, nor any victims’ advocate, should be vilified or accused of lacking mercy for pointing out the truth.
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