Caregivers: The Parallels

 “We’re not the ones who got convicted.” (frequently overheard)

In a personal capacity, I have cared for an individual in government custody (detention, then federal imprisonment) since 1997. In my professional life, I have been a part of discussions about family caregiving in the context of aging and disability. The literature on family caregiving is distinct from the literature on criminal justice and prisons.  In my observation, the intersection with respect to families is very real. 

Policy Contexts:

Family caregivers have recognized roles in the system of health care and long-term support, as personnel who are critical to maintaining and improving the functioning of impaired relatives.  Policy discussions have to do with support for caregivers; compensation; respite; direct roles in consumer decision-making, etc.

Families of inmates have recognized roles in the criminal justice system as important “outside ties” over the course of incarceration; outside ties are associated with positive post-incarceration outcomes and reduced recidivism. Policy discussions have to do with inmate-family contact through visits, phone calls, and mail; furloughs; early or supervised release opportunities; parenting classes, etc. Policy discussions rarely focus on family impacts.

Burdens and Challenges of Inmate Caregivers:

Inmate caregivers experience financial burdens; demands on their time and attention that interfere, or threaten to interfere, with job responsibilities; emotional stress; and practical surrogacy responsibilities that may have ethical dimensions. The following examples come from first-hand experience.

Financial Contributions:

Legal expenses.

Monthly allowances to supplement low-paying prison job.  Extra money helps cover telephone calls to family members, postage, writing materials, over-the-counter medications, supplemental food, vitamins and proper footwear for physical activity.

Travel costs for visiting the prison 150 miles from home – gas, car upkeep, occasionally motels. Costs associated with visits of minor children traveling longer distances.

Food costs (average $15 for two people) on visiting days – vending machines – to replace meals otherwise supplied by prison.

Demands on Time – The Hassle Factor:

Financial contributions must be sent by money order to a national clearinghouse, requiring trip to Post Office plus transactions costs.

Due to restrictive visiting rules, 4-8 hours of working days are missed per month (compensated in my case through flexible arrangements of generous employer).

Challenges in coordinating visits with friends and other family members traveling longer distances.

Inherent in regular visiting, time away from domestic chores and other family obligations.

Emotional Stress:

On-site – Tedious lines and waiting times for entry to visiting room; drug-testing; metal detectors; unpredictable application of rules about attire which could delay or cancel visit; impact of monitoring and surveillance in the visiting room; impact of noisy environment and close proximity to other families; anticipation of having important conversations interrupted if visit is ended early due to overcrowding.

Off-site – Social isolation; awareness of telephone monitoring; concerns about inmate health and welfare, with limited access to inmate information, but with direct knowledge of arbitrary practices by prison authorities, and awareness of possibility of abuse.

Practical Surrogacy:

Primary liaison with lawyer.

Advocate within prison system.

Liaison with creditors.

Tax preparation.

Health decisionmaking in event of incapacitation, with limited access to information.

Liaison with friends and family. Note: In September 2005, I volunteered to serve as a contact point for an inmate in Virginia whose entire family were New Orleaneans and who were unaccounted for and out of reach for a period of time after the hurricane and flood. I was a surrogate for a surrogate as it were. The experience pointed up, among other things, the fragility of the informal inmate caregiver support network.

Implications for Policy:

Becoming a caregiver can happen to anyone overnight, without warning and opportunity for planning and preparation. Public policy confers a significant role on caregivers but fails to provide supports and, frequently, enacts barriers within the system. Caregiving practices represent uncompensated costs that are not visible in administrative budgets, budget strategies, or accounts of societal costs. The financial and practical burdens of caregiving fall hardest on those with limited financial resources, inflexible employment situations, additional family obligations, and limited skills in navigating public and private bureaucracies.  Enacted policy provides inadequate strategies to fill in practical gaps when no able family members are available to act as caregivers.

by Lisa Foley Stand -- October 2005