Oscar nod goes to film on Iowa prison hospice

Jan. 17, 2014

Written by

Mike Kilen

A prison inmate known as 'Herky' sits with Jack Hall in the Iowa State Penitentiary hospice in 2006. Hall's final days are documented in a film that is nominated for an Academy Award in the documentary short subject category.

 

Edgar Barens spent six months in the Iowa State Penitentiary in Fort Madison. On Thursday, he was nominated for an Academy Award.

He called his mom after the morning announcement and told her to get a dress ready. His extra ticket for the star-studded awards ceremony on March 2 goes to her.

She knows what it took for him to get there, and so do Iowa inmates. Barens’ next call was to an inmate featured in his film, “Prison Terminal: The Last Days of Private Jack Hall,” among five nominated in the documentary short subject category.

The film, to air on HBO at 8 p.m. March 31, captures inmates at the penitentiary who volunteer to care for dying inmates in the last days of their lives in the prison’s hospice, one of only 20 like it in the nation. It centers on the story of Jack Hall, a World War II veteran who fought in the war’s most harrowing battles and was also a prisoner of war. Decades after the war, he was convicted of murder and spent 21 years in the Fort Madison prison, right up to the point when he took his last breath, which Barens filmed in 2006.

Barens, 53, had cashed out his retirement fund to buy a camera to shoot the documentary and, in the years that followed, had struggled to finance its completion, working as a used car salesman, file clerk and phlebotomist before living in his grandmother’s home in the Chicago suburb of Aurora.

“I had to finish this film because of the people inside that prison,” Barens said Thursday from Irvine, Calif., where he was debuting the film at a festival. “I owed it to those guys, but also to society. We are so hell-bent on punishment. Granted, there are a lot of bad people in prison. But their punishment is being in prison. I don’t think additional punishment is needed.

“The point of this film is that even though these people did horrible things, we have to be better than them. We have to show them some dignity in death, even though they didn’t show their victims dignity.”

It was a kind of an odd fate that brought Barens to Iowa, whose maximum security prison with some of the most hardened criminals is notoriously tight in granting access to media.

It just so happened that nurse administrator Marilyn Sales knew of his work when Barens approached her in 2006 with his idea. She had seen his prior film he made while working for the Open Society Project, a how-to on prison hospices featuring Angola’s prison in Louisiana.

Sales, now retired and living in West Branch, had the idea of starting a hospice in Fort Madison’s prison, and showed the Angola film to five inmates in 2004.

“When the film was done, there were tears rolling down their faces,” said Sales, who soon after launched the program that used no state funds, other than her time to organize it.

When inmates were terminal, they were stuck back in their cells or in the infirmary to die. “No one should die alone,” Sales said. “No one.”

Inmates provided labor for furnishings for the two rooms in the infirmary devoted to hospice care. They were trained to care for the dying. Sales said the only thing many of them knew about dying was witnessing the people they had killed. But they soon learned to bathe their fellow inmates and tend to their needs and sit with them as they died.

She let Barens in because his film helped start the hospice, but she still wasn’t immediately sold. There’s a lot of trust issues in a prison and some days “I wanted to stuff that camera,” she said. But Sales soon learned of Barens’ own story and saw his passion.

“Edgar does care and it’s very evident in the way he filmed that documentary,” she said.

Barens had been making films since his days in college at Southern Illinois University. It was a tough life, so he took any job he could for money. After his Angola film, he knew there was a bigger story to tell.

“I cashed out my 401(k) and put all my money into a camera and for one year of not working to imbed myself in a prison,” Barens said. “I work alone without a crew. It’s too hard to build trust, so I’m a one-man band.”

He spent a month in the infirmary without a camera, getting to know the inmates and building trust. He said he was protected by one man in the prison who told other inmates this film was important and to leave him alone as he wandered the grounds for up to 15 hours a day. Many of them were going to die there one day, and without a hospice might be shackled to a hospital bed with a guard outside or left alone to die in a cell.

“After a while I felt like they totally accepted me. I could be in their face with a camera and they would look right through me,” Barens said.

He didn’t wait to cherry-pick a good subject. By sheer chance, Jack Hall, 82, was the next man to enter hospice. He served in the U.S. Army in the war from 1942-45, and when he returned couldn’t leave it behind.

“His tour reads like a Hollywood script,” Barens said. “He probably killed hundreds of Germans and was a POW. When he got out they gave him 25 bucks and pack of Lucky Strikes and told him to forget everything. He couldn’t do that. He became an alcoholic.”

Hall’s son committed suicide while on drugs, so he confronted the drug dealer who sold to his son in the mid-1980s and killed him, Hall described in the film.

Hall was a cantankerous man in prison but people liked him. He kept his military photographs near his bed. The men who cared for him in the film were all black, and they carefully bathed him and lifted him to his bed and fluffed his pillows. They prayed over him. “I’m somebody no one thought I could be,” said a hospice volunteer in the film.

With the help of a job to pay his bills and work on his film at the University of Illinois-Chicago’s Jane Addams College of Social Work, Barens eventually convinced HBO in 2012 that it was a project worth editing and airing.

There are 200,000 elderly inmates in the fast-aging 1,800 U.S. prisons. The Iowa State Penitentiary is only one of 20 that has a prison volunteer hospice, which still operates today. There needs to be more, Barens said.

He didn’t sleep all night awaiting the nominee announcement, while reminding himself it was all about the prisoners.

“You hear about this stuff, finding out you are nominated for an Academy Award, and it’s really happening,” he said. “But, in the long run, it was a program for them.”

Prison Terminal: Kidnappers Care for Murderers at End of Life

Short-Listed for Oscar, Film Follows Gentle Death of Ex-POW

By SUSAN DONALDSON JAMES

Dec. 18, 2013

Hospice workers gently adjust Jack Hall's oxygen tube and lovingly massage his withered hands, making sure he is not alone as death approaches. 

Hall, an 82-year-old former World War II prisoner of war who is serving a life sentence for murder, has spent nearly a decade in the infirmary at Iowa State Penitentiary with a terminal heart ailment. But now, struggling to breathe, he is in his final weeks. 

His unlikely comforters -- kidnappers and murderers -- are paid nothing for their hours of care-giving to a growing population of aging inmates. These volunteers do it willingly, knowing one day they, too, will be old and can look forward to a gentle end. 

"Prison is cold, but death is colder," says one hospice volunteer. Another says he benefits as much from the all-volunteer hospice program as those who are dying. "For me, I'm somebody no one thought I could be." 

This unique program is the subject of a compelling HBO documentary, "Prison Terminal: The Last Days of Private Jack Hall," which was shortlisted this fall in the short-subject category for an Academy Award. It is scheduled to air in March. 

Chicago-based director Edgar Barens lived and worked as both sound man and camera man for six months at Iowa State, one of the nation's oldest maximum-security prisons, gaining the trust of Hall and his fellow inmates. With Hall's permission, he captured the profoundly intimate moment of his death.

"The problem of prisoners dying is getting worse and worse because we are sentencing people for so long," Barens, 53, told ABCNews.com. "I wanted to show the urgency of the situation. It's a huge problem and the states are grappling with it now." 

The prison population is aging as more than 200,000 elderly inmates are incarcerated nationwide. Of the 1,800 prisons, 75 have unique hospice programs and only 20 use prison volunteers, according to the film. 

Without in-prison hospice, these men would be sent off to state hospitals where they would die shackled to their beds without being allowed even a family visit. 

"Apart from showing compassion, even with murderers and kidnappers, I also wanted to show that compassionate commutation or medical parole is rarely used," he said. "Many die and not as peacefully as Jack Hall." 

Hospice not only benefits the dying, but their prisoner caretakers as well.

"Although these guys did some horrible things, they all, in some way want not to absolve themselves, but to seek some sort of redemption," said Barens. 

Barens was given unprecedented access to the penitentiary, largely because of a film he had done on a model program in Louisiana: "Angola Prison Hospice: Opening the Door," while working as media projects coordinator for the Center on Crime, Communities and Culture at the Open Society Institute. 

When he approached Iowa State, they had been using his short film as a training video to jump start their own hospice program. "I was flabbergasted," he said. "They gave me carte blanche in a maximum-security prison. … It was a dream come true." 

The prison gave Barens housing where their doctors live and even provided a full basement for his production equipment. Barens said he stumbled across Jack Hall, a curmudgeonly but sympathetic character, who was serving time for murdering a drug dealer by cutting his throat.

"Jack had another son who committed suicide because he was strung out on drugs," said Barens. "He was out drinking with buddies and overheard one guy brag how he made money selling drugs to kids. With his mental frame of mind as a soldier, he thought of the guy as scum and had to kill him." 

Hall says in the film that he had been "trained" to kill in hand-to-hand combat as an Army Ranger. "And when he came back from the war, they gave him a carton of Lucky Strikes and fifty bucks," said Barens. "Jack tumbled into alcohol and was destroyed by the Army. He was damaged goods."

 

Iowa State's 30-year nurse administrator Marilyn Sales told ABCNews.com that the film "brought tears to my eyes." 

She launched the hospice program in 2006 with a handful of inmate volunteers. At first, they were resistant to the idea, but soon they "put their heart and souls into it." 

"I called the cell house and asked them to send over five lifers who were trustworthy," said Sales, 69, who is now retired. "I knew it wouldn't work without the inmates. They came over grumbling, then we popped the ["Angola Prison Hospice"] tape in and there were just tears."

When she asked if they could handle it, three said yes. "For two of them it struck too close to home," she said.  "I knew that without them, we couldn't have a viable hospice program," said Sales. "I didn't want it to come from outside the institution." 

Hospice volunteers get a 14-week training course, learning "assistance in daily living." They work as orderlies in the 12-bed infirmary, change bedding, providing companionship, delivering food, and feed the ill and injured. Two of the rooms are reserved for the dying who receive 24/7 personal care and unlimited access to family.  "I think it's their way of giving back," she said of the volunteers. 

 

The program is financially self-sufficient with furniture made in the prison workshop. Local hospitals donated beds and quilts and other bedding provided by a local church. Lap blankets were knitted by a women's group. The inmates themselves buy videos for the hospice program.

Dying men like Jack Hall deserve the dignity of hospice, Sales said. 

"Jack was a cantankerous old coot for years," she said. "Jack was Jack and couldn't help [but] like him. His reason for a life sentence was very compelling. He righted what he saw as a wrong." 

Hall spent about six weeks in hospice, the only patient during most of the filming. Then a second prisoner, a 45-year-old dying from ALS, or Lou Gehrig's disease, was admitted, but he was not part of the documentary because he was unable to speak.

Sales answers critics who say those who have committed violent crimes don't deserve compassion: "We have to be better at caring and compassion for people," she said. "They are paying the price by being in prison. They can't choose what they eat, what they wear, when they go to bed and when they wake up. When the gavel drops, it's a life sentence. It's over." Sales said hospice should be mandatory in all prisons.

"I am not the judge and jury," she said. "There but for the grace of God go I. One bad decision, one stupid mistake and you are there for life. No one should die alone." 

"Prison Terminal" will have its world premiere at the Irvine International Film Festival in California. Oscar nominations come out Jan. 16. 

Edgar Barens is currently a media specialist at the Jane Addams College of Social Work at the University of Illinois at Chicago

 

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What people are saying...

Prison Terminal: The Last Days of Private Jack Hall challenges preconceptions about inmates and prison life in surprising and hopeful ways. Barens reveals the heart of humanity beating loud and strong within the harshest environments.

Faced with living and dying inside, the inmates we meet have chosen to live in community with one another. The commitment of the inmate hospice volunteers – and the competence and reverence with which they provide care – shows that dying people’s comfort and dignity can be preserved even in the least desirable situations. Our society could learn a lot from the example they set. A triumph of documentary filmmaking!

Ira Byock, MD, palliative care physician and a Professor of Medicine, Geisel School of Medicine at Dartmouth; author of Dying Well and The Best Care Possible.

Prison Terminal: The Last Days of Private Jack Hall transcends classification; it is more than a film about prison, and suffering or death.  It is a deeply layered story of how the human spirit overcomes the greatest fear of all prisoners - the degradation and isolation of dying alone in prison. This stunning film helps us to gain compassion for those that we both fear and ostracize. 

Susan Rosenberg - Human rights activist, adjunct professor, award-winning writer

Prison Terminal: The Last Days of Private Jack Hall shows us both the pain and the humanity of life behind prison walls. In doing so, it gets beyond the day-to-day politics of crime and punishment, and challenges us to think about how we can bring out the best in all of us, even those who may have committed terrible acts in their lives. 

Marc Mauer - Executive Director of The Sentencing Project and author of Race to Incarcerate

 

Prison Terminal: The Last Days of Private Jack Hall is an insightful and sensitive documentary. Barens, given a rare opportunity to film within the correctional institution, makes the most of this opportunity. Viewers will undoubtedly marvel at the profound working relationships between prison staff and inmate volunteers.

Russ Immarigeon - Editor of Offender Programs Report

UPDATE!

Oscars: Eight Documentary Short Subjects Make the List

Forty films were submitted, and three to five of them will earn nominations.

October 10, 2013 - The Academy of Motion Picture Arts and Sciences' documentary branch has selected a short list of eight documentary short films that will compete for the 86th Academy Awards.

The eight films were chosen from 40 eligible entries. Three to five films will be nominated in the documentary short subject category when nominations are announced Jan. 16

The eight films, listed in alphabetical order by title, with their production companies, are:

CaveDigger, Karoffilms. Jeffrey Karoff's film tells of Ra Paulette, an artist who digs cathedral-like caves in the sandstone cliffs of New Mexico.

Facing Fear, Jason Cohen Productions. Jason Cohen's directorial debut centers a gay man, who was attacked by a gang of neo-Nazis as a teen, and encounters one of his attackers 25 years later. 

Jujitsu-ing Reality, Sobini Films. Chetin Chabuk's documentary focuses on a screenwriter, Scott Lew, dealing with Lou Gehrig's disease.

Karama Has No Walls, Hot Spot Films. Yemeni-Scot filmmaker Sara Ishaq looks at one tragic day during the 2011 Yemeni revolution.

The Lady in Number 6: Music Saved My Life, Reed Entertainment. Malcolm Clarke's film is a portrait of 109 year-old holocaust survivor Alice Herz Sommer, who offers her views on how to live a long and happy life. Clarke, along with Bill Guttentag, won the Oscar in this category in 1989 for You Don't Have To Die.

Prison Terminal: The Last Days of Private Jack Hall, Prison Terminal LLC. Shot over a six-month period at Iowa State Penitentiary, Edgar Barens' doc looks at the final months in the life of a terminally ill prisoner.

Recollections, Notrac Productions. Nathanael Carton's film concerns survivors of the 2011 Tohoku earthquake and tsunami.

SLOMO, Big Young Films and Runaway Films. Joshua Izenberg's film follows Dr. John Kitchin, a neurologist who abandons his career to take up rollerblading along the Pacific Coast.

Prison Terminal - Short Trailer

Prison Terminal: The Last Days of Private Jack Hall is a moving cinema verité documentary that breaks through the walls of one of America’s oldest maximum security prisons to tell the story of the final months in the life of a terminally ill prisoner and the hospice volunteers—they themselves prisoners—who care for him.

Prison Terminal: The Last Days of Private Jack Hall provides a fascinating and often poignant account of how the hospice experience can profoundly touch even the forsaken lives of the incarcerated.

Prison Hospice - A Perfect Storm

The Aging Prison Population

The aging of the prison population in the United States can be attributed to what some have called a perfect storm in the world of corrections. With an increase in tough on crime legislation - including harsher sentencing, curtailing the powers of judges, and the elimination of parole throughout the Federal Bureau of Prisons, the U.S. correctional system is finding itself saddled with a booming elderly population of long timers and the chronically ill.

The rumblings of this storm are just beginning. From the early 1990s until now, the number of state and federal inmates age 50 and older has grown an astonishing 172 percent. Some estimates claim that within the next fifteen to twenty years, over 20 percent of the United States prison population will be classified as elderly.

How Old is Elderly?

While 50 may seem too young to be called elderly in the free world, several important factors hasten the aging process for those behind the walls. The amount of stress experienced by inmates navigating the harsh realities of prison life; financial and familial stress due to incarceration; withdrawal from chronic substance abuse; and the lack of access to adequate medical care prior to and during incarceration, all contribute to accelerating the aging process. It is estimated that an inmate ages an average of 7 to 10 years faster than their counterparts in the free world.

The Costs of Healthcare

Since the mid 1990’s, prison healthcare spending in the United States has increased 27 percent, from $2.7 billion to $3.4 billion a year. The average cost of healthcare per inmate rose 31 percent during that same period, from $5.62 to $7.39 a day. The annual cost of incarcerating elderly, chronically or terminally ill inmates has therefore risen dramatically - to an average of $65,000, compared to about $27,000 for a healthy inmate in the general prison population.

What’s Killing the Inmates?

Correctional institutions house a growing number of inmates with terminal illnesses. Most systems define inmates as terminally ill if they are known to have a fatal disease and have fewer than 6 months to live. Each year more than 2,500 men and women die in United States prisons, and while it is widely assumed that the leading cause of death in prison is AIDS, most deaths can be attributed to other illnesses such as cancer, liver disease, hepatitis, chronic obstructive pulmonary disease, and congestive heart failure.

A Compassionate Alternative

As a nation, our consciousness about how we die has expanded over the past twenty years to include many alternatives and options. But these changes are only just beginning to enter the world inside our prisons and jails. Dying with dignity is particularly challenging in a prison setting, where individuals are often both physically and emotionally isolated from friends and family. In the past five years, two approaches have gained momentum for meeting the needs of terminally ill prisoners: the utilization of compassionate release, and the development of prison based hospice programs.

While laws vary from state to state, terminally ill prisoners who pose no threat to themselves or society and have family members willing to care for them may be granted compassionate release from prison. But sadly, compassionate release has become more of a political process than a medical one; with many prison administrators and legislators thinking twice about releasing terminally ill prisoners in the current tough-on-crime climate of this country.

Even when compassionate release is granted, often it comes too late, with the terminally ill prisoner passing away before the paperwork is completed. Thus a prisoner’s greatest fear of dying in prison becomes a reality. But there is an alternative for those faced with the prospects of dying in prison – which is prison-based hospice care.

What is Prison Hospice?

Over the past decade, hospice programs have become increasingly common in communities around the country, and the movement is also slowly gaining a foothold among state, federal, and municipal prison administrations. Currently there are 58 prison hospice programs throughout the United States, with exceptional programs operating in Oregon, New York, Minnesota, California, Kentucky and Iowa.

In the community hospice model an interdisciplinary team (IDT) consisting of the family members, physicians, nurses, social workers, counselors, clergy, and trained volunteers cares for the patient, offering support based on their particular areas of expertise. Together, they provide comprehensive care aimed at relieving symptoms and giving social, emotional, and spiritual support.

The prison hospice model, however, has additional elements that distinguish it from the community hospice model in the free world. Added to the IDT within the correctional setting is the crucial element of security. Maintaining safety within the walls and for the public at large is the primary function of a prison, and this must be maintained even in a hospice setting.

Once the security component is effectively added to the IDT, the decision of whether to incorporate inmate hospice volunteers vs. community hospice volunteers into the program must be made.

Inmates as Caregivers

In any hospice setting, whether it is in the free world or behind bars, volunteers play an important role in planning and giving hospice care to their patients. They are instrumental in providing companionship and may listen, reassure, share worries and concerns, hold a hand, help feed, or just sit quietly with the patient.

For some prison hospice programs, inmate hospice volunteers are not included in the program, for fear that they may find it difficult to follow the rules of hospice, steal from or abuse their patient in some way. In such cases the community hospice sends in community volunteers to administer care and compassion to the dying inmate.

While this practice is noble and well intentioned it must be recognized that the connection a dying inmate has with a community hospice representative is not as strong as the connection that patient would have with a fellow inmate who understands the plight of dying in prison – because he himself may be dying in prison one day.

On the whole, it has been seen that inmate volunteers are deeply invested in their hospice and offer exceptional care and companionship to their patients – often exceeding the expectations of prison administrators. The inmate volunteers are well aware that the success of the hospice rests upon their shoulders and in turn will guarantee there will be a hospice program for them when their time comes.