Our Aging Prison Population: Should Criminals Die Free?

As the number of senior citizens locked behind bars skyrockets, cash-strapped states are unable to foot the growing health care bills.


Last month, Human Rights Watch released staggering figures on the human and financial costs of the growth of aging persons behind bars in America. According to their report, from 2007 to 2010 the number of prisoners over age 65 increased by 63 percent, even as the total number of inmates grew by less than one percent. Cash-strapped states are seeing health care costs for their aging, imprisoned population skyrocket.

My home state of Louisiana currently leads the nation in the highest rate of incarceration (PDF). According to the Pew Group, one in every 55 Louisianans is behind bars. The Baton Rouge Advocate newspaper documented that caring for aging inmates costs $80,000 annually, a cost borne fully by the state since inmates do not qualify for Medicaid or Medicare. Last summer, Governor Jindal signed House Bill 138 (PDF), making parole possible for non-violent prisoners who are age 60 and older, who have not been convicted of a sexual crime, and who have served a minimum of 10 years.

If in our freedom we choose to treat prisoners with care and dignity, we are not imprisoned by the memories of what they have done.

For years before its signing, the bill had been hotly debated. I witnessed the front lines of this debate as a leader at the non-profit Hospice of Baton Rouge, which played a part in shaping the ground-breaking hospice program at Louisiana State Penitentiary in Angola. That prison became one of the first to offer an end of life care program in which inmates, most of whom will never be eligible for parole, volunteer to train as caregivers for their fellow inmates who are dying. The documentary Serving Life, directed and narrated by Forrest Whitaker and broadcast on Oprah's television network, has brought national attention to the program.

Although many inmates die behind bars, some dying prisoners become eligible for the "compassionate release" program established by Congress in a federal statute, which makes release from prison possible for inmates who are terminally ill with a prognosis of less than a year. We partnered with Angola and other area prisons to transfer prisoners eligible for compassionate release in acute medical distress to our inpatient unit. Each of the inmates was completely bed bound, non-responsive, and died within a few days. To their families, several of whom were able to be at the bedside in those final days, it was deeply meaningful that their loved one died free.

But the debate continued. As hospice staff and professionals we provided these men with the same quality care that we provide any other patient. But among ourselves we agonized. Some asked, should the fact that you made a criminal choice earlier in life negate any choice you might want to make at the end of life? Does every person have the right to die free? If so, what does free really mean, especially when the care was not cost-free. Each released prisoner was considered a non-funded patient, which meant that our charity patient care fund covered the services related to their terminal diagnosis.

Presented by

Amy Ziettlow is an affiliate scholar with the Institute for American Values where she currently studies Gen X caregiving and grieving. She is ordained in the mainline Evangelical Lutheran Church of America and most recently served as Chief Operating Officer of Hospice of Baton Rouge.

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