Analysis
Hospice: Definition and Real-Life Image
Hospice care is a team-based approach that offers terminally ill patients medical, psychological, and spiritual support (Lally & Valentine-French, 2022). Established in 2005 at Iowa State Penitentiary, Jack Hall’s hospice care was manned by inmate volunteers to establish a supportive environment inside the maximum-security facility (Barens, 2013). After viewing the documentary Prison Terminal, I understood that regardless of one’s past behavior, everyone deserves dignity when the time comes.
Freudian Defense Mechanisms
Psychological techniques known as Freudian defense mechanisms are used by individuals to shield their ego from upsetting emotions (Defense mechanisms, n.d.). Redirecting feelings to a different target from their initial source is known as displacement (Defense Mechanisms, n.d.). An example can be seen in Jack’s remark, “You’re damn right I’m cold,” in response to a question—he concentrated on the feeling of being cold rather than his unease regarding his health (Barens, 2013, 29:18). Suppression is the deliberate decision to put off addressing emotions or circumstances (Defense mechanisms, n.d.). When Jack told Herky, “I’m sorry I had to wake you up this way,” he was trying to suppress the significance of his failing health by apologizing for the inconvenience (Barens, 2013, 30:01).
Jack’s Stage According to Erikson’s Model
Jack exhibited characteristics of Erikson’s “Ego Integrity vs. Despair” stage as he approached death (Lally & Valentine-French, 2022). He expressed a wish to be with his loved ones, exhibiting acceptance and thankfulness. When Jack said, “I don’t wanna leave my boy, Herky,” he demonstrated Pattern 1, the need for forgiveness, as there was an unresolved issue in his relationship with his son (O’Reilly, 2014; Barens, 2013, 31:53). Jack’s expressions also clearly showed a need for remembrance (pattern 2)—he wanted his loved ones to remember him, asking Herky to “tell my boys I said, ‘Thank you’” (O’Reilly, 2014; Barens, 2013, 32:47).
During his passing, Jack was surrounded by Herky, a volunteer from hospice and fellow prisoner; Don Skinner, Jack’s son; and Marilyn Sales, the director of hospice care. Jack’s culture was defined by his time spent in the military and his incarceration. In later years, he experienced the effects of his deeds on his relationships—particularly with his son. In Hays’ ADDRESSING model, incarcerated individuals may be regarded as a social group (Tagg, 2020). This group, defined by age, gender, and socioeconomic status, creates a distinct cultural identity shaped by the stigmas associated with incarceration (Tagg, 2020). Jack often talks about the challenges of adjusting to civilian life, like abusing alcohol (20:44).
Patterns in Jack’s Dying
Jack partially followed Kübler-Ross’ stages of death: moments of acceptance appeared in his interactions with Herky, though they did not necessarily follow a linear progression (Death and Dying, n.d.). Don Skinner and those who knew Jack may anticipate a problematic grieving process that includes acceptance, processing the emotional anguish, adjusting to life without Jack, and ultimately beginning a new life (Lally & Valentine-French, 2022). When Jack was passing away, certain ceremonies were followed: Herky prayed to recognize Jack’s quiet passing family (Barens, 2013, 37:03). Jack’s body was fingerprinted following his death, as mandated by state law (Barens, 2013, 36:33).
Reflection
The documentary “Prison Terminal: The Last Days of Private Jack Hall” profoundly affected me. The documentary contrasted the prison environment with the compassion shown by prisoners who volunteered for hospice care. What I discovered was a human connection that transcends incarceration. I find that the documentary’s effect was aided by the course materials, such as hospitals’ financial incentives to reduce inpatient care (Lally & Valentine-French, 2022). I began to think about the systemic changes that could lead to a compassionate approach to end-of-life care.
The data comparing death settings across countries made me consider how cultural norms influence end-of-life preferences. I found the differences between China and Japan fascinating (Lally & Valentine-French, 2022). I gained a new perspective on the variables that decide where people spend their last moments, realizing that societal attitudes often influence these preferences. A particularly striking data point was that more women than men typically pass away in residential care (Lally & Valentine-French, 2022). It let me consider the damning implications of gender disparities in healthcare access.
References
Barens, E. (Director). (2013). Prison terminal: The last days of private Jack Hall [Film]. The Cinema Guild.
Death and dying [PowerPoint slides]. (n.d.).
Defense mechanisms [PowerPoint slides]. (n.d.).
Lally, M., & Valentine-French, S. (2022). Lifespan development: A psychological perspective. LibreTexts.
O’Reilly, M. (2014). “Am I dying?” The honest answer. [Video]. TED. Web.
Tagg, R. (2020). ADDRESSING cultural complexities. In Conners, B. M. & S. T. Capell (Eds.), Multiculturalism and diversity in applied behavior analysis (pp. 5–18).Routledge. Web.