WARREN, Maine — Prison might be the worst place you can think of to die. Isolated from the outside world, perishing behind concrete walls and metal locking doors because death caught up with you while you were serving a sentence.
That is the reality for inmates housed in Maine State Prison’s infirmary because they are suffering from a terminal illness and are not expected to live longer than six months.
But a group of inmates has made it their mission to make sure no prisoner dies alone.
“We’re able to be there and be present and be quiet and gently tease some of those [existential] things out to help [the incarcerated patients] deal with some of the disappointments as they struggle with the choices they have made,” said Maine State Prison inmate Leo Hylton, who’s serving a 50-year sentence for attempted murder. “We’re there to say, ‘I am here for you. I am here with you, and I will carry your story after you’re gone.’”
The prison began offering hospice services when its new facility opened in 2001 through a partnership with the Maine Hospice Council. In 2008, the council began training inmates to provide end-of-life care to their fellow inmates.
Over the past decade, this group of incarcerated hospice volunteers has worked hand in hand with prison medical staff to provide comfort care to terminal inmates.
Watch: Prison hospice provides comfort and an opportunity to change
“Some of these patients literally just want someone to talk to. The [volunteers] will just check in and say ‘hi.’ Sometimes that’s the biggest thing that some of the prisoners here need is to know that someone else is checking in on them,” said Vanessa Reed-Chapman, a nurse at the prison.
Maine State Prison is the only facility in the Maine Department of Corrections system with an infirmary where inmates can be held and treated for extended periods of time, so it serves patients from other state prisons, too.
While the infirmary feels like a sterile, hospital setting, thick metal locking doors and guards remind you of where you are. Some of the cell walls here have been painted with elaborate murals to make the prison wing feel more conducive to healing.
In addition to providing end-of-life care, the infirmary provides palliative care to inmates who are recovering from surgeries or recovering from strokes and other medical incidents. Hospice volunteers bring meals to all of the infirmary’s patients — whether they’re on hospice or not — three times a day.
Hylton, who has been involved with the group for five years, is one of 11 inmates currently running the hospice program.
While there are no patients requiring hospice care at the moment, the volunteers had a busy end to 2019, when several passed away.
Medical staff handles any type of care that requires medical licensure, such as medication management, taking vitals and conducting assessments.
The hospice volunteers provide a number of services for the dying inmates. They feed them and brush their teeth if the patient is unable. They turn them in bed if they are too weak to move themselves.
But the most important service the volunteers provide is their presence.
“It’s very patient centered. These are people that we’re here to care for, whether it’s to be there to speak or to listen or to play music, or to sing or to hum. Or to sit there and listen when they sing or hum. That’s what we’re there for,” Hylton said.
When a patient requires hospice care, the volunteers go on “vigil,” with two volunteers with caring for the patient for four six-hour shifts — providing 24 hours of daily care.
The volunteers complete 150 hours of training — a large part focuses on how to improve active listening skills to better support someone who is grappling with the reality of death.
“[The dying inmates] are scared just like anyone else. We’re all scared. We’re all afraid and to know that you’re going to die within these walls, the men become very vulnerable,” Reed-Chapman said.
Death in a correctional setting takes the existential crisis of dying one step further. Hylton and Reed-Chapman said these patients are not only having to come to terms with death, but also the choices they made that are forcing them to die in prison.
Hylton said being able to connect through the shared experience of incarceration allows them to better understand what a dying inmate is going through.
“It doesn’t matter what you did. It doesn’t matter why you’re here or how much time [you’re serving]. It becomes one human being taking care of another, who both have this shared experience of incarceration, of being completely and totally isolated from the family and the world,” Hylton said.
But prior to his incarceration, he saw the importance of hospice care firsthand as his own father was dying.
Hylton said the prison’s hospice program has helped him grow as a person. He even calls the infirmary “home” because it’s the one place where he can “take off every piece of armor” and just be himself.
“I’ve learned that it’s OK to love people. It’s OK to receive,” Hylton said. “That is a very radical statement in prison.”