Table 1.

Essential elements of prison hospice: Patient-centered care

Patient-Centered Care
Concepts in Context	Definition and Dimensions	Exemplary Quote
Unconditional care	Every prison hospice patient deserves humane care and should be treated with respect regardless of a patient's history or circumstances; acknowledgement of the humanity and uniqueness of each hospice patient, and the need to support and maintain dignity at end-of-life.	“I'm not here to judge anybody. When you're dying, you need somebody to care about you. I'm a nurse. I'm not a judge.” (Nurse)
Responsiveness	Alleviating patients' symptoms in a timely way and taking other measures to prevent unnecessary suffering due to their illness process; willingness to respond not only to patient needs but to other team members' assessments and requests.	“A change with their pain medicine, [the nurse is] right there. And she's doing it. Or [a patient] wants to talk to family, something's going on. They're calling me.” (Nurse)
Forming real relationships	Being fully present whenever a volunteer is at the bedside and engaged in patient care, and being fully available and open, physically, cognitively, emotionally, and spiritually, to the experience of providing end-of-life care. Therapeutic relationships provide comfort and were supported by establishing trust with patients (and staff), as well as learning to establish and maintain appropriate boundaries.	“I let my patients know that...I'm here for you at all times. And whenever you need me to talk, man, I don't care what it is, if you just need me to come in there, you want to cry on my shoulder, I'm here for you. I want you to feel that you can trust with anything you tell me.” (Volunteer)
Know your patient	Specific in-depth knowledge of each patient, as an individual person, to optimize care; includes sharing knowledge about each patient, forming relationships early on, nurturing those relationships, and knowing how to “read” individual patients in order to accurately assess for changes in status, pain, and mood.	“You come in contact with so many different people with various personalities and you can never treat each individual the same. But as long as you have the ability to empathize and sensitivity to listen to what your patient is saying, it will be easier to adapt to those conditions.” (Volunteer)