More than 3,000 prisoners a year die of natural causes in US correctional facilities, many from terminal illness. While a few terminally ill prisoners receive compassionate release, some types of prisoners—such as death row inmates—do not qualify, and many others who do are still denied release. In California, there were 57 applications for compassionate release in 2009 but only three were granted. Those sick men and women who were not released face the demoralizing prospect of dying behind bars.
To help make this transition easier on both inmates and the prison system, some states have established dedicated hospices. According to a 2010 report by the Vera Institute of Justice, eight state prison systems in 2008 had hospice facilities, and the National Hospice and Palliative Care Organization indicates there are programs in over 75 prisons across the country. California’s hospice program is located at California Medical Facility (CMF), a prison in northern California designed for prisoners with healthcare needs. CMF was the subject of an extended controversy in the 1980s as a result of its reportedly inadequate response to the AIDS epidemic, which inundated the facility with terminally ill patients. To partly address the problem, the prison established a 17-bed hospice facility in 1996, the first of its kind in the world.
Hospice patients at CMF receive much of their help from inmate care-givers, whose assistance saves the state money while providing a valuable comfort for inmates. The care-giver position is in high demand, with as many as 40 applications per position. The program is rigorous: care-givers train by watching 50 videos and then proceed to one-on-one care-giving, cleaning bed pans, washing patients, and holding their hands. A care-giver’s role extends to the end of a patient’s life; final duties include washing the deceased inmate’s body, washing off the ink used for the postmortem fingerprinting, and placing the corpse in a body bag.
One of the most successful and active hospice programs is at Louisiana State Penitentiary, also known as Angola (or “The Farm”). Founded in 1997, the hospice has assisted 134 terminally ill inmates. Regarded as one of the harshest prisons in the country, the facility may seem an unlikely place for such a program. But Angola houses 3,712 prisoners with life sentences—more than any other US prison—and with so many lifers, far more of its prisoners die in prison (32) than are paroled (four).
Most prisoners in the United States face their final days separated from loved ones. Prison hospice programs cannot change this fact, but they can help ensure that some prisoners, no matter their crimes, can die with a measure of dignity and humanity.