the impact of prison hospice

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The Impact of Prison HospiceLaura R. Bronstein PhD, ACSW, LCSW-R a & Kevin Wright PhD ba Department of Social Work, College of Community and PublicAffairs , Binghamton University , Box 6000, Binghamton, NY, 13902,USAb Department of Human Development, College of Community andPublic Affairs , Binghamton University , Box 6000, Binghamton, NY,13902, USAPublished online: 17 Oct 2008.

To cite this article: Laura R. Bronstein PhD, ACSW, LCSW-R & Kevin Wright PhD (2007) The Impact ofPrison Hospice, Journal of Social Work in End-Of-Life & Palliative Care, 2:4, 85-102, DOI: 10.1300/J457v02n04_05

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The Impact of Prison Hospice:Collaboration Among Social Workers

and Other Professionalsin a Criminal Justice Setting

that Promotes Care for the Dying

Laura R. Bronstein, PhD, ACSW, LCSW-RKevin Wright, PhD

ABSTRACT. This study reports on a qualitative national telephonesurvey with coordinators of 14 prison hospice programs in 11 states.The rationale behind the survey was to learn about interdisciplinary col-laboration between social work and criminal justice, using prison hos-pice as an exemplar of this collaboration. In addition to learning that allprison hospices in the study operate using an interdisciplinary teammodel and that most report high quality collaboration on the hospiceteam, the following additional five themes emerged: administrators andwardens are very supportive while correctional staff provides mixedsupport to team and program; greater collaboration with those outsideprison hospice is critical; collaboration through prison hospice has apositive impact on dying prisoners; collaboration through prison hos-pice has a positive impact on prisoner volunteers; and, collaboration

Laura R. Bronstein is Director and Associate Professor, Department of SocialWork, College of Community and Public Affairs, Box 6000, Binghamton University,Binghamton, NY 13902 (E-mail: [email protected]).

Kevin Wright is Professor, Department of Human Development, College of Com-munity and Public Affairs, Binghamton University, Box 6000, Binghamton, NY 13902(E-mail: [email protected]).

Journal of Social Work in End-of-Life & Palliative Care, Vol. 2(4) 2006Available online at http://jswel.haworthpress.com

© 2006 by The Haworth Press, Inc. All rights reserved.doi:10.1300/J457v02n04_05 85

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through prison hospice has a positive impact on the entire culture of theprison. doi:10.1300/J457v02n04_05 [Article copies available for a fee fromThe Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address:<[email protected]> Website: <http://www.HaworthPress.com> © 2006 by The Haworth Press, Inc. All rights reserved.]

KEYWORDS. Prison hospice, prison, hospice, interdisciplinary col-laboration, criminal justice

While interdisciplinary collaboration is heralded in many fields ashaving a positive influence on professional practice (Bronstein, 2002,2003; Claiborne & Lawson, 2005), we still have much to learn aboutits impact on client, community and organizational outcomes. What wedo know is often tied to collaborative relationships between particu-lar professional groups and in particular settings, for example socialworkers’ and teachers’ collaboration in the schools (e.g., Bronstein &Abramson, 2003) and social workers’ and physicians’ collaboration inmedical settings (e.g., Abramson & Mizrahi, 1996). A setting in whichcollaboration among social workers and other professionals has re-ceived little attention and even less research is criminal justice. Whilesocial work began as a profession committed to collaboration with thecriminal justice system, that relationship began to change in the earlyto mid-1960s (Reamer, 2004). Indeed, Reamer argues that “regrettably,the social work profession has largely abandoned the criminal justicefield” in all areas of practice, education and scholarship (p. 213). Healso stated that that those social workers, who do work in the crimi-nal justice field, often describe the environment as “hostile” to socialwork values (p. 218).

Recent publications addressing social work practice in criminal jus-tice settings are largely conceptual or based in a case study approach.They include: educators advocating for collaboration in the class-room and internships in an effort to train social workers and criminaljustice professionals in each others’ worlds (Carawan & Reed, 1999;Madden, 2000; Madden & Wayne, 2003; Severson, 1999; Slaght,2002); authors arguing for increased collaboration between social workand criminal justice in the field (Brownell & Roberts, 2002; Riffe,2001); and, scholars citing the challenges involved in such collaborativework (Mason, 1991; Sheldon, 1994). One article provides a descriptionof social workers working with criminal justice professionals in cases of

86 JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE

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domestic violence (Allen et al., 2001). Others call for a strengths-basedrestorative justice approach to criminal justice that would be based insocial work values (Boes & Wormer, 1999; Van Ness, 2004). One argu-ment exists against collaboration, saying that the unique offerings ofsocial workers and police officers should be acknowledged, but that thetwo should work independently as opposed to collaboratively (Bar-on,1995).

Given that most social work practice occurs in host settings wherecollaboration among a range of professionals is required (Dane & Simon,1991) and that social workers often function as formal or informal facil-itators/coordinators of interdisciplinary teams (Abramson & Bronstein,2004), we were interested in what happens when social workers andother interdisciplinary team members do collaborate in a criminal jus-tice setting. In examining arenas where this collaboration frequently oc-curs, we were particularly interested in the rising phenomena of prisonhospices as an exemplar of this collaboration, especially given the factthat social workers often take a leadership role in developing prisonhospice programs (Craig & Craig, 1999). Despite the fact that hospicewas founded on the interdisciplinary team model (Saunders, 1978), andthat social workers have researched and written about collaborationon the community hospice team (Kovacs & Bronstein, 1999; Oliver,Bronstein, & Kurzejeski, 2005; Reese & Sontag, 2001), and that thereare some excellent case descriptions of prison hospice programs in theliterature (e.g., Boyle, 2002; Radcliff & Craig, 2004; Tillman, 2000),we found no research studies in any professional discipline examiningthe impact of collaboration in prison hospice on prisoners and the prisoncommunity. Given the dearth of research about professional collabora-tion in that setting and the centrality of social work to the developmentand coordination of this work (Craig & Craig, 1999), we set out toexplore the process and impact of interdisciplinary collaboration inprison hospice by conducting a telephone survey of prison hospicesacross the country to collect qualitative information that is presented be-low. A detailed report of our methodology and findings follows an in-troduction to the prison hospice phenomena and its rising importance inthe twenty-first century.

PRISON HOSPICE

Like the general United States population, the U.S. prisoner popula-tion is “graying.” Despite decreased arrests among the elderly, their

Peer-Reviewed Articles 87

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numbers in prison rose from around 9,000 in 1986 to four times that in1997, primarily as a result of longer sentences (Radcliff & Cohn, 2000).In 2002, there were 120,933 prisoners over age 50 in the nation’sprisons. They comprised 8.6 percent of the total prison population in2002 compared with 5.7 percent in 1992 (McMahon, 2003). McMahon(2003, p. A3) cites a picture of tomorrow’s “dangerous” prisoner as old,frail, and debilitated “hobbling down a prison corridor with a cane orwalker.” Not surprisingly, the “graying” of prisoners is leading to an in-creased number of deaths within prison walls. In 1999 alone, 3000 U.S.prisoners died in custody–50 percent more than the year before (Kolker,2000). In the Louisiana State Penitentiary at Angola, the largest prisonin the country, an estimated 85 percent of their 5,200 prisoners are ex-pected to grow old and die inside the prison’s walls (Schindler, 1999).

Until very recently, most prisoners who died of natural causes suf-fered a lonely, isolated, and painful death (Craig & Craig, 1999). A Texasprisoner describes what it was like when a prisoner died prior to the late1980s: “I remember sitting with a friend till he could no longer drink hiscoffee or put on his clothes. Till the pain was so bad he wanted to killhimself or wanted you to do it. We had no mercy program whatsoever.They’d put you in another unit, put you in a room and then you died. Atrusty would come in with rubber gloves and rubber boots and hose youdown to wash you” (Kolker, 2000, p. 1). Foley (1998) reports on an-other dying prisoner, not so long ago in 1984, that “. . . died in shackles,chained to his bed in the Charity Hospital in New Orleans with the coldsteel biting into him, as other prisoners have died before him.”

In the late 1980s, the first two prison hospice programs were pilotedin Springfield, Missouri and Vacaville, California (Maull, 1998a). Theseprograms were initially started to address the high incidence of AIDSrelated deaths occurring in prisons. The Springfield and Vacavillehospice programs paved the way for other U.S. prison systems to adopta more compassionate, humane way of providing care to dying prison-ers (Maull, 1998a). In 1991, the National Prison Hospice Association(NPHA) was formed to serve as an educational resource for federal andstate prison systems that were interested in developing prison hos-pices (Maull, 1998a). The American Correctional Association insti-tuted a mandate in 1996 stating that prisoners should receive health careproportionate with community standards, including services for termi-nally ill prisoners and compassionate release when deemed appropriate(Craig & Craig, 1999; Maull, 1998a).

The development of prison hospice programs is often initiated bysocial workers (Craig & Craig, 1999). Hospice is a humane model of


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treatment for prisoners who will not or cannot be freed from the prisonenvironment by means of compassionate release. The goal of prisonhospice programs is to provide the terminally ill prisoner with effectivepain management during the dying process while also meeting the indi-vidual’s physical, emotional, social, and spiritual needs (Maull, 1998a).Successful prison hospice programs include collaboration among cor-rectional staff, social workers who often act as coordinators, medicalpersonnel (including nurses and physicians) and (at times) communityhospice workers (Craig & Craig, 1999). In addition, as with “free world”hospices, the critical partner in a prison hospice program is the volun-teer. In prison hospice, the volunteer is a fellow prisoner, who is fre-quently cited as the lynchpin to a successful program (Foley, 1998;Kolker, 2000; Lampman, 2000; Maull, 1991a,b, 1998a,b; Schindler,1999).

METHODOLOGY

In the fall of 2004, an initial list of 11 prison hospices and their contactpersons was drawn from within the Department of Justice (1998). Afterdeveloping a protocol, an interview guide, and securing approval fromthe university Human Subjects Review Board, the researchers attemptedto contact each hospice to secure updated names and contact informationfor prison hospice program coordinators. Letters went out to the hospicestelling them about the study and requesting their participation. A week af-ter the letters were sent out, one of the researchers began to make tele-phone calls to find out if subjects were interested in participating in thestudy of collaboration in prison hospice; if so, a telephone interview wasscheduled. Participants were given the option to have the researcher sendthem a copy of the interview questions before the actual scheduled dis-cussion as a way to familiarize them with what would be asked during theinterview. The original list of 11 sites changed with some prison hospicerepresentatives being unavailable and others added as we utilized snow-ball sampling from our final interview question asking the participants toshare if they knew another coordinator in a prison hospice program thatcould be contacted for this study. Ultimately we talked with coordinatorsfrom 14 prison hospice facilities in 11 states. Facilities with prison hos-pice programs with whom we spoke, and the professional affiliations ofthe person with whom we spoke, are listed in Table 1.

In the first half of 2005, one of the researchers conducted telephonesurveys with representatives from the 14 facilities through pre-arranged


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appointments, each of which consisted of 17 questions (see Table 2) andlasted an average of 45 minutes. Detailed notes amounting to an averageof five pages per interview were made. After all interviews were com-pleted, the interview notes were analyzed independently by two otherresearchers for themes. Responses were analyzed through the use ofgrounded theory techniques as developed by Glaser and Strauss (1967).The two researchers coded responses, unitized the data, agreed upon cat-egories or themes and the placement of units into these categories.These measures helped to ensure trustworthiness of the research process(Padgett, 1998). Saturation of the data led to the following six themes re-flective of comments across professional disciplines:

• Quality of interdisciplinary collaboration;• Collaboration between health care and prison staff;• Greater collaboration with those outside prison hospice is critical;• Collaboration through prison hospice has a positive impact on dy-

ing prisoners;• Collaboration through prison hospice has a positive impact on

prisoner volunteers; and• Collaboration through prison hospice has a positive impact on the

culture of the prison.


TABLE 1. Participating Prison Hospice Programs and the Profession of theCoordinator with Whom We Spoke

Participating prison hospice programs Profession

California Medical Facility, Vacaville ChaplainColorado Dept. of Corrections Social work/PsychologyFederal Medical Center–Fort Worth, TX Social workFederal Medical Center–Lexington, KY Social workFederal Medical Center–Rochester, MN Chaplain (co-coordinator with nursing

and social work)Federal Medical Center–Springfield, MO Social workIllinois Dept. of Corrections Social workKentucky Dept. of Corrections PsychologyLouisiana State Penitentiary–Angola NursingMissouri Dept. of Corrections Law enforcementNorth Carolina Dept. of Corrections BusinessOregon State Dept. of Corrections NursingState of Ohio ChaplainUniversity of Texas Medical Branch Nursing

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RESULTS

Study Participants

As noted above, we interviewed 14 prison coordinators from 11 differ-ent states. Prison hospice coordinators with whom we spoke had a widerange of professional affiliations including social worker, nurse, psychol-ogist, business, law enforcement and chaplain, with social worker beingthe most frequently cited professional affiliation of the coordinator (n =5). In addition to the five social workers with whom we spoke, one prison


TABLE 2. Interview Questions

1. What is your job title?

2. Who is your employer?

3. What is your educational background? What is your highest degree?What is your field of specialty?

4. How long have you been working in your current hospice position?

5. Prior to working with the hospice program at your facility, had you workedin another community based hospice program? If so, for how long?

6. Did you have prior experience working in a prison? If so, for how long?

7. I have a few questions about the staff working with your prison hospice program.

8. What professional staff is involved with your prison hospice program?; How manyfull-time professional staff are there?; How many part-time professional staff arethere?; How many other staff?; How many volunteers?; What roles do theseprofessionals play?; What is the nature of the collaboration amongthese staff members?

9. What kind of reaction and/or support do you get from the correctionalstaff not involved in the hospice program?

10. What kind of reaction and/or support do you get from other prisontreatment staff not involved in the hospice program?

11. What role do volunteers play in your program? How are they treatedby prison staff?

12. Is there administrative support for the program? Please describe.

13. Does the existence of the hospice program impact other aspects of the prison?If so, how?

14. What are the strengths of your prison hospice program?

15. How do you think your prison hospice can be improved?

16. Is there anything else we should know in attempting to learn aboutthe impact of collaboration on prison hospice work?

17. Thank you for your feedback and input. Can you share any names of individualswe can contact for this survey at another prison facility in the United States thathas a hospice program?

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hospice had three co-coordinators, one of whom was a social worker, al-though the coordinator with whom we spoke was a chaplain. Time at thecurrent prison hospice ranged from 2 months to 12 years. Most coordina-tors had master’s degrees, but educational preparation ranged from asso-ciates degree to doctorates.

Quality of Interdisciplinary Collaboration

In addition to the person identified as coordinator that we interviewed,the prison hospice teams also include psychiatrists, pharmacists, dieti-cians, physical therapists, respiratory therapists, physician assistants andan array of other professionals. All coordinators with whom we spokesaid that their hospices operated as part of an interdisciplinary team. Allteams reported including a nurse, physician and chaplain, and all but oneincluded a social worker.

The majority of coordinators reported their teams meeting at leastmonthly with many meeting on a weekly basis. Team meetings focus onsome similar areas to community hospice programs including patientcare, training, improving services and collaborating better. Additionalemphasis on the prison hospice team is on security, the role of the pris-oner volunteer and collaboration with community hospice.

Most respondents reported high quality collaboration within the team,with the following specific quotes:

• The diversity and collaboration on the team is great;• Our team works to gain an understanding of a prisoner as a person;• Disagreement among team members occurs in attempting to pro-

vide the best for the patients;• The social worker is the coordinator which is productive in en-

hancing the social work role; and• Collaboration is the key to a successful prison hospice program.

While the overwhelming response concerning teamwork was posi-tive, representatives from two programs had some negative things tosay about their team’s collaboration including:

• Better communication (is) needed regarding prisoner care; and• The focus of collaboration needs to be on the patient and not on the

egos of the staff members.


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Collaboration Between Health Care and Prison Staff

Most of the respondents discussed the support that their team andprogram received from their prison administration. Specifically identi-fied was the support of their warden, demonstrated by the followingquotes:

• The warden is supportive and visits the hospice every couple ofweeks;

• Headquarters gives a lot of support;• At every warden level, they have been supportive. At the adminis-

trative level there is pride in their hospice program which serves asa model for other facilities;

• The warden and deputy warden are negotiating to solve financialchallenges so that they don’t hurt hospice;

• The warden helps make the program stronger. If there is a needexpressed by hospice staff, there is support given.

In contrast to the administrative support, mixed responses were givenwith regard to collaboration between correctional staff and prison hos-pice team members. While some respondents offered positive commentsabout collaboration with correctional staff, many voiced negative com-ments pertaining to the correctional staff’s concern with security andtheir prevailing view that all aspects of the prison experience should be“punishing” for prisoners. Despite the reporting of these experiences,respondents suggested that when corrections officers (COs) are exposedto hospice and participate in the hospice program themselves, they be-come more supportive and team players. Examples of specific quotesinclude the following:

• The correctional staff are mostly supportive although some be-lieve that prisoners don’t deserve hospice;

• Mostly they are supportive but less so when the prisoner has com-mitted a more heinous crime;

• The problems that arise with correctional staff are usually aroundprisoner volunteer privileges;

• New COs are usually skeptical but then come around;• The COs who are involved in the hospice see the benefit; some that

aren’t involved think its garbage.


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Collaboration with Those Outside Prison Hospice Is Critical

Respondents were clear that support from outside of prison is impor-tant to the program’s success. In addition to the support of prison ad-ministrators, noted above, a number of respondents talked about theimportance of inter-organizational collaboration between their prisonhospice team with community hospice, other prisons and other organi-zations outside the prison. This is reported as occurring in some prisonhospices, but not in others. Specific quotes regarding this include asfollows:

• We could use more support from the National Prison Hospice As-sociation. We need a clearinghouse that updates programs on cur-rent hospice curriculum;

• We need to collaborate with community hospice programs;• We need to get the word out and educate everyone in the prison

system about the benefits of the program;• We need earlier identification and referrals of prisoners requiring

hospice; services, especially from other prisons in the state thatdon’t have a hospice;

• We need more input from the outside.

Collaboration Through Prison HospiceHas a Positive Impact on Dying Prisoners

While there were comments about the effectiveness of individualprofessional team members, the most passionate statements regardingthe contribution of a single team member to patient care were in refer-ence to the role of the prisoner volunteer. The following comments re-veal general attitudes about the team’s impact on the patient as well asspecific quotes regarding the prisoner volunteer’s impact on the dyingperson:

• The patients’ last days are spent with dignity and respect;• Patients receive the same treatment from the hospice team that a

community hospice patient would receive;• The prisoner volunteer program helps patients share on a deeper

level;• Prisoners provide quality care to dying prisoners;• There is a common bond between the patient and the prisoner

volunteer;


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• The prisoner volunteers are like surrogate family for the hospicepatients;

• The prisoner volunteers know their role on the team, they know therules and regulations, they know how to provide in their role, andare very aware of boundaries. They are totally committed to thepatients.

Collaboration Through Prison HospiceHas a Positive Impact on Prisoner Volunteers

Respondents talked about the transformational role that being a vol-unteer has on the prisoner volunteer. This seems to be twofold and relatedto the respect and role prisoners have as part of the interdisciplinaryteam, as well as in their hands-on work with the dying patients. Specificquotes from respondents include the following:

• The program affords COs the opportunity to see that some prison-ers can be trusted and do good things;

• The prisoner volunteers have a transformative experience in a pos-itive way that is helpful to them when they are released;

• Offenders that care for prisoners as part of the hospice team un-dergo a personal transformation. They have a rise in self-esteemand self-worth. The staff notices a change in the offender volunteeras he gives of himself to another person.

Collaboration Through Prison HospiceHas a Positive Impact on the Culture of the Prison

While it is always a hope that productive collaboration in one aspectof an organization might have a ripple effect throughout the organiza-tion, this did seem to be the case at many of the prison hospice programsin the study. Indeed, this finding of the impact of the productive collabo-rative and caring environment characterizing the hospice program wasloudly touted as having a dual directional impact on relationships andbehaviors throughout the prison community. Professionals and staff, aswell as prisoners are seen as “more humane” as they get to know eachother and work together towards the profound goal of helping others diewith dignity. The following quotes from prison hospice coordinatorsexemplify this finding.


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• The prison hospice program sets a precedent for compassion andprofessionalism.

• The prisoners know that there are staff and volunteers that willcare for them when they are ill and this makes the facility a calmerenvironment.

• The entire prison is impacted. The facility has gained a greaterlevel of compassion after the implementation of hospice includingstronger, more trustworthy-connections between prisoners andstaff. There is increased interaction between all departments fora good cause. Correctional staff has become more flexible whenworking with infirmary staff.

• The hospice program has promoted the idea that caring can occurwithin a prison setting.

• Prisoners’ participation as part of the hospice team allows them tosee that staff can be compassionate and treat them with dignity.

• The prisoner volunteer involvement has a ripple effect resulting inempowerment and positive actions.

• The program has a positive impact on medical and correctional/se-curity relationships. Prisoners can see that the system can behavehumanely. Humane treatment lowers stress, which helps security.Prisoners can see that the system is working on their behalf.

DISCUSSION AND IMPLICATIONS

As we examine the words of those currently coordinating prison hos-pice programs, it is difficult to miss the major impact these programs arereported as having on all they touch; yet as with all research, as manyquestions emerge as answers. The following three areas are ones requir-ing further thought and exploration.

First, while the participants were told that we were studying collabo-ration in prison hospice, we did not ask them to tease out benefits thatthey felt came from the collaboration among professionals, staff andvolunteers, as opposed to those benefits that came from these profes-sionals, staff and volunteers’ involvement in a caring act of service. In-deed even if we had asked participants to separate out these areas, theymay not have been able to do so. So while it does seem clear that thehigh quality interdisciplinary collaboration, typical of community hos-pice programs (Oliver, Bronstein, & Kurzejeski, 2005), contributed tothe positive impact of the prison hospice program, we are unable to say


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if these benefits would occur in a prison hospice program if it were notcharacterized by collaboration.

Second, while members of interdisciplinary teams always come tothe table with differing viewpoints, educational preparation and social-ization, the members of the prison hospice interdisciplinary team in-clude an exceptionally diverse group including those whose primarymission is service and others whose primary mission is security. It isquite heartening that participants with whom we spoke volunteered thatteam attributes including “diversity” and “disagreement” were seen aspart of what made the collaboration so effective. Much remains to belearned from teams that embrace difference when a natural tendencyof many is to homogenize (Abramson & Mizrahi, 1996). How can wemaximize this quality to enhance all interdisciplinary teamwork?

Lastly, we were especially interested in the comments about correc-tional officers collaborating better and becoming more ardent support-ers of hospice as they gain familiarity with it. It tells us the importanceof sharing with our colleagues and clients and involving them in whatwe do as a means to greater understanding, better collaboration and ulti-mately, more effective outcomes for programs and clients. Again, howmight we utilize this understanding to precipitate stronger and earlierinterdisciplinary relationships in prison hospice and other settings?

Implications for Practice

Given what we learned from our respondents, there is certainly a lotthat prison hospice programs can do to inform practice in an array ofsettings. For one, it tells us that if collaboration can work successfullywith such diverse partners, then diversity is not something that needs tostand in the way of teamwork. It also teaches us that if prisoners con-victed of murder and rape can find compassion within themselves, andgive to a team of colleagues and most importantly, to dying prisoners, itgives hope that people can indeed change when they are in environ-ments that promote respect, care and responsibility. The belief that di-versity, teamwork and opportunity can be transformative is critical insupporting social workers’ beliefs in the strengths and resources of allpeople.

One way to promote this collaborative practice is through a strongorientation program, supported by ongoing training. Kinlock, Schwartz,and Gordon (2005) claim that their early orientation program has beencritical to the collaboration among correctional, health care and socialwork staff in their prison work. Models for such orientations already


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exist (e.g., Abramson, 1993) and can be built on. Perhaps having a so-cial worker, corrections officer and a former prisoner hospice volunteer(that has been released from prison) facilitate such an orientation inother prisons considering a hospice program, can lay the groundworkfor successful collaboration early on. Since social workers are often theones that initiate, and later, coordinate prison hospice programs, it is upto us to spread the word and do what we can to promote development ofthese programs. This includes using our skills in advocacy and programdevelopment both when we are working inside jails and prisons as wellas when we are working in community hospice programs. After prisonhospice programs are up and running it is up to social workers to pro-mote the high quality service and collaboration evidenced in the hos-pices surveyed. This involves acknowledging our skills in facilitationand the need to take on a leadership role in facilitating teamwork evenas an informal as opposed to formal role. In addition, given the fact thatcoordinators cited the need for more connection outside the prison, so-cial workers in community hospices can use their training in systemstheory (e.g., Bowen, 1976; Hartman, 1995) to open up previouslyclosed systems by partnering with a prison hospice in their commu-nitythrough joint orientation, training, and communication about bestpractices.

Implications for Research

As stated earlier, this research did not distinguish whether these prisonhospice programs are seen as successful by respondents because they oper-ate on an interdisciplinary team model or because they provide an impor-tant service to dying prisoners. It is likely that both of these contribute to thequality of the program, the impact on the dying, the volunteer and theprison as a whole. Further research should attempt to explore the individualcontributions of each. In addition, as our study was qualitative and thus didnot benefit from a representative sample, it would be useful to hear frommore programs and to learn the impact of intervening variables includingprogram and prison size, longevity, location, etc., to the collaborative effortand the impact on prisoners and prison culture. While our interviews gath-ered data from professional staff who identified as (one of) their prison hos-pice’s coordinator(s), it would be useful to survey correctional officers,prisoner volunteers and, if possible, patients to learn more about their per-spective of their role, of the collaboration, and the general contributionsand challenges that they see to be addressed.


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Implications for Education

Prison hospice settings can serve as models for educational trainingin interdisciplinary collaboration and strengths-based practice. Hospicehas been cited as an exemplar of productive interdisciplinary collabora-tion (Oliver, Bronstein, & Kurzejeski, 2005). Given what was learnedhere about the programs’ success given diversity and challenges, theprison hospice might be the ideal model for learning and teaching aboutwhat makes successful interdisciplinary teams. Examples from studieslike this can be brought into the classroom. In addition, those social workprograms that do operate in communities where prison hospices existare encouraged to develop field placements for students. Then, in addi-tion to faculty, students can share with their classmates examples fromtheir own experience of what it takes to work with those who many feelhave no redeeming qualities, and to be able to impact not only clients,but to be positively impacted by them as well.

Since social workers practice predominantly in host settings, muchneeds to be done to help prepare students for their work with colleaguestrained in other disciplines. One additional means towards this end is tocross-list courses so that students from different disciplines (e.g., socialwork and criminal justice) are in the same classroom and thus dialoguebetween them is enhanced. In addition, faculty from social work andcriminal justice programs are encouraged to co-teach entire coursestogether or at the least, to guest lecture in each others’ classes as waysto begin to build the bridges necessary for professional, collaborativepractice critical to serving clients today.

CONCLUSION

The purpose of this study was to learn about interdisciplinary collab-oration among social workers and other professionals in a criminal jus-tice setting by examining prison hospice programs as an example of thiscollaboration. What was learned was that despite the fact that socialworkers (like others in the health care field) come to their work with adifferent mission from those in the criminal justice field, there is prom-ise for collaboration. Coordinators of prison hospice programs indi-cated that those in the criminal justice field are likely to value a programlike hospice when they are exposed to it personally and have an oppor-tunity to see that it can actually help their primary mission–security


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measures in the prison by creating a calmer, more trusting environment,as opposed to detracting from security.

Results of this study revealed much more than were expected. It be-came clear that a critical member of the hospice team was the prisonervolunteer. The empathy and care that are inherent in all human beingscome to the fore when prison volunteers are valued members of the hos-pice interdisciplinary team where they have an opportunity to pro-vide empathy and concrete support to a dying prisoner. The tremendousamount that the prisoner volunteer appears to gain through participationon the interdisciplinary team and through providing service to a dyingprisoner is matched only by what the dying person receives and by theimpact of prison hospice on the culture of the prison as a whole.

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Date Received: 05/13/06Date Revised: 07/17/06

Date Accepted: 11/10/06

doi:10.1300/J457v02n04_05


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the impact of prison hospice

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