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