As the number of prison inmates facing end-stage chronic illness grows, more prisons across the U.S. must address the need for end-of-life care. Many will likely need to develop a plan with potentially limited resources and external support. This case study presents one long-running model of care, the Louisiana State Penitentiary Prison Hospice Program. Based on field observations and in-depth interviews with hospice staff, inmate volunteers and corrections officers, we identify five essential elements that have contributed to the long-term operation of this program: patient-centered care, an inmate volunteer model, safety and security, shared values, and teamwork. We describe key characteristics of each of these elements, discuss how they align with earlier recommendations and research, and show how their integration supports a sustained model of prison end-of-life care.
Future studies should consider culturally tailoring interventions for Hispanic/Latino caregivers from differing subcultures, utilizing relevant technology in studies, and evaluating the functional level of the care receiver and assess where he/she is in the disease process continuum. A better understanding of within-group differences among Hispanic/Latino caregivers, especially with respect to acculturation, could lead to better tailoring of interventions. Future research should consider the possibility of discovery-based participatory approaches. Few studies have addressed these areas of concern in this population.
AIM
The aim of this article was to analyze the concept of caregiver stress in the context of caring for a person with Alzheimer’s disease and related dementias.
BACKGROUND
Currently, there are more than 15 million unpaid care-givers for persons suffering from Alzheimer’s disease and related dementias. This unpaid care can be stressful for caregivers due to the chronic nature of the disease process, as well as other factors.
METHOD
The paper incorporates the modified method of Wilson’s concept analysis procedure to analyze the concept of caregiver stress.
DATA SOURCES
A review of the literature was undertaken using the Cumulative Index to Nursing and Allied Health Literature, Google Scholar, and PubMed.
RESULTS
A theoretical definition of caregiver stress is provided, and the defining attributes, related concepts, antecedents, and consequences of caregiver stress are proposed, and case studies are presented.
CONCLUSIONS
The analysis demonstrates that caregiver stress is the unequal exchange of assistance among people who stand in close relationship to one another, which results in emotional and physical stress on the caregiver. Implications for future nursing research and practice conclude the paper.
The use of MSSE, as a non-pharmacological intervention, demonstrates the ability to decrease the number of incidences of disruptive or problematic behavior. The use of these interventions, where feasible, should be considered prior to the use of pharmacological methods.
The increasing numbers of aging and chronically ill prisoners
incarcerated in Western nations is well documented, as is the growing need for
prison-based palliative and end-of-life care. Less often discussed is
specifically how end-of-life care can and should be provided, by whom, and with
what resources. One strategy incorporates prisoner volunteers into end-of-life
services within a peer care program. This article reports on one such program
based on focused ethnographic study including in-depth interviews with inmate
hospice volunteers, nursing staff, and corrections officers working in the
hospice program. We describe how inmate volunteers learn hospice care through
formal education and training, supervised practice, guidance from more
experienced inmates, and support from correctional staff. We discuss how
emergent values of mentorship and stewardship are seen by volunteers and staff
as integral to prison hospice sustainability and discuss implications of this
volunteer-centric model for response-ability for the end-of-life care of
prisoners.
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