Many of the elderly inmates in the Maine State Prison have done evil things, crimes that earned them a lifetime behind bars, but that doesn’t mean they should die without comfort or companionship, says Anne Haskell.

“They’re still human beings,” said Haskell, a Democratic state representative from Portland who became familiar with hospice care 20 years ago, when her first husband died of lung cancer.

“I know there are people who say, ‘Who cares? Look what they did in society.’ And they did some horrible, heinous things,” said Haskell, a member of the Legislature’s Criminal Justice and Public Safety Committee. “They are still our responsibility. I don’t want to be part of the society that says you have to have a painful, awful death because of what you did.”

The state prison is in its third year of a program that allows prisoners who are trained in hospice care to tend to terminally ill prisoners near the end of their lives.

The program — and the benefits of hospice in the prison setting — will be the focus of a conference Sept. 19, at the prison in Warren. The conference will explore the ethics and the expense of end-of-life care in prisons.

The nation’s prison population is aging. There are 14 times as many prisoners older than 55 as there were in 1980, according to a report in June by the American Civil Liberties Union. The total prison population is four times what it was then, the report said.

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A report this year by Human Rights Watch said that from 1995 to 2010, the segment of prisoners older than 55 grew at six times the rate of the overall prison population. The Department of Justice says there were 119,000 state and federal prisoners in 2010.

Harsher sentencing laws have contributed to the increase in elderly inmates, as have medical advances that help people live longer.

Maine has 169 prisoners who are older than 55, which is 8 percent of the total of 2,022 state prisoners. Ninety-six inmates are older than 60.

The Department of Corrections doesn’t track changes in the average age of prisoners, but Warden Patricia Barnhart estimates it is equivalent to the national rate of growth.

An aging prison population means more inmates face dying in prison.

“It’s almost a demographic imperative for us to get our arms around this — providing care and comfort and ensuring it’s done in the most cost-effective way,” said Kandyce Powell, executive director of the Maine Hospice Council and Center for End of Life Care.

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The council has been involved at the Maine State Prison for 12 years as part of its mission to reach out to underserved populations. It started with classes about end-of-life issues and then trained staff members.

In the past three years, the council has been training volunteers drawn from the prison population and has graduated two classes with 14 volunteers. They supplement the infirmary staff and sit with men who are dying, providing round-the-clock attention, sometimes just sitting and listening, Powell said.

There is little enthusiasm in the public for programs that appear to coddle people who have done terrible things, but Haskell said that misses the point of prison’s role.

“Being locked up is the punishment,” she said. “They go there not to have a hard life but to have their freedom taken away from them.

“When they have to spend their whole life in that prison, they’re going to die there within those four walls,” she said. “As human beings, the way somebody dies is one of the important hallmarks of us as a society.”

Fellow prisoners are ideal companions for prisoners who are dying, because they have a shared experience, Haskell said.

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“There’s a certain level of empathy, not just sympathy. They understand emotionally what it’s like to be part of a prison system for a long time,” Haskell said.

“I’m not saying it’s a fraternity house, but they care about how somebody is going to die alone. For many, their family is those people inside.”

The dying prisoner is only one of the beneficiaries of the prison’s hospice program.

Prisoners who have volunteered as hospice workers have studied how to offer not only physical care in easing pain and suffering, but also spiritual, psychological and emotional support.

“I would say the hospice program is a huge asset in a correctional setting, especially for guys who have made peace with themselves and are willing to reach outside of themselves and help others,” said Barnhart, the prison warden.

“Giving back is what we should all be doing,” she said, “and they’re able to be giving back in a humanitarian way and offer the opportunity for someone to not be alone when they depart this world.”

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Jim Bergin, spokesman for the Maine Prisoner Advocacy Coalition, praised the restorative value of giving prisoners the chance to become hospice volunteers.

“Any time you have prisoners who are actively engaged in some form of activity, it gives them meaning. They do their time, but they do good time where there is some meaning to their lives during that period,” he said.

Bergin said he would like to see sentencing reform that recognizes that keeping very old people in prison isn’t necessarily sensible.

“You have long-timer inmates, some of whom have done 40- or 50-year sentences, so they grow into being old men and geriatric problems the prison has to deal with,” Bergin said. “They’re no longer a threat to society, but the Department of Corrections has to care for them into old age and beyond.”

Bergin said, “Even though you’re on your deathbed, you’re still an inmate. There’s an absurdity associated with that.”

Despite the aging prison population, only two or three prisoners a year opt for hospice care, Powell said.

Some, like a man who died this year, was accompanied by hospice volunteers and the medical staff until his family arrived.

The hospital has converted a closet-size room in the infirmary into a hospice area, where the walls have been painted with murals aimed at transforming the institutional decor of the facility to something more soothing.

“There’s a lot of learning and healing that takes place at the end of life,” Powell said, “not only for the men who are dying but the men who are providing the care and comfort. There’s growth and maturity and healing.”


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