The hospice at the California Medical Facility between San Francisco and Sacramento is one of the nation’s first, the New York Times reports. Built in 1993 in response to the AIDS crisis and inmate-led demands for more humane care, the hospice was first populated with men dying of complications of the disease. Today, the 17-bed unit is filled with a different demographic. Graying men with everything from end-stage cancer to Alzheimer’s disease shuffle around with walkers, sit in wheelchairs watching television or lie curled up under heavy blankets. Inmates older than 55 make up the fastest-growing age group behind bars, increasing more than 500 percent since the 1990s, from 26,300 inmates in 1993 to 164,800 at the end of 2016.
A mix of policies are responsible, including long sentences from get-tough-on-crime laws, a steady increase of older adults entering prison and challenges with the timely issuing of compassionate release and medical parole. One result is a different kind of death penalty for violent and nonviolent offenders alike. Most prisons were never built to be nursing homes. Correctional officers often aren’t equipped with the necessary training, and medical staff can be spread thin. At the California Medical Facility, two dozen men called the Pastoral Care Service Workers, mostly convicted murderers serving life sentences, have been granted an unusual role: providing dignified deaths to fellow inmates. Of 250 workers who have been released from prison since the program began, none has returned for a felony. Seven days a week, the workers pull 10- to 15-hour shifts, often longer. It’s one of the lowest paid jobs, just 15 to 32 cents an hour. They brush patients’ teeth, massage sore limbs, read books out loud, strip soiled mattresses and assist the medical staff. They pride themselves on their policy: No prisoner dies alone.