Hospices Begin to Serve US Prison Population in Greater Numbers

As the aging population in prisons increases, the need for hospice services also rises. Advocates are pushing for ways to help the incarcerated “die with dignity,” and hospice providers are beginning to serve this patient population in greater numbers.

Prison populations are decreasing overall. There were fewer people held in state and federal prisons at the end of 2016 than in any other year going back to 2004, according to a study by The Pew Research Center.

Despite these reductions, the population of older individuals in prisons is surging. From 1999 to 2016, the number of people over 55 increased by 280%.


“Everyone knows in our department that our offenders are getting sicker,” Joan Wolff, the health services administrator at Oak Park Heights Correctional in Oak Park Heights, Minnesota, told Next Avenue.

Many prison facilities across the country have created hospice programs, but advocates are working to have even more programs developed and for even more compassionate releases, a special provision that allows for early release due to compelling circumstance.

In Minnesota, the state’s department of corrections utilizes a third-party, HealthEast Hospice, for its hospice needs.


St. Paul, Minnesota-based HealthEast is a nonprofit health care provider that employs 7,500 employees and 850 physicians across four hospitals, 14 clinics, and home care, hospice, palliative care and other outpatient services branches. The system joined forces with Fairview Health Services in 2017.

Primary care physicians within the prison refer inmates to the HealthEast team. The team then informs the inmates of the options available to them under the hospice program, such as pain or comfort management. Families are allowed to visit inmate patients as well.

Inmates have the choice to decline to participate in the program.

A recent trend in the space is the use of other inmates as volunteers in the care of the dying. At The Louisiana State Penitentiary prison, also known as Angola, inmates can sign up for 40 hours of training. Once they complete it, they can be a part of an inmate’s four-person team that performs hospice duties.

There are about 80 hospice programs modeled after Angola’s nationwide, according to Next Avenue.

While Minnesota does not use inmate volunteers, the state may be heading that way.

“Hopefully that’s our next step,” Nanette Larson, director of health services for the Minnesota Department of Corrections, told Next Avenue. She did note security challenges the program could present.

Like any aging senior, older individuals are more likely to experience chronic issues like dementia and impaired mobility. The Bureau of Justice Statistics found that inmates had an even larger likelihood of having a chronic condition over the general population.

In prisons, these ailments present a challenge as they may require facilities to make accessibility adaptions like wheelchair ramps. The price of medical services is having an impact on budgets. In 2016, state expenditures on corrections totaled $57.7 billion, according to the Sentencing Project. 

Along with programs, advocates are pushing for more compassionate releases, which could help with decreasing medical costs for prisons. But while all states and the District of Columbia grant compassionate releases, few actually occur, according to NextAvenue.

“Very few people are getting out,” Mary Price, the general counsel for Families on Mandatory Minimums told NextAvenue. “The problem is that nobody uses [compassionate release] to the extent that it ought to be used.”

Written by Kaitlyn Mattson