Dying for Change: An Examination of the affect of Prison Hospice Programs on Institutional Culture

The number of individuals living their natural lives within the U.S. penal system has increased substantially over the last 20 years. Convicted offenders are receiving longer sentences due to increasingly severe sentencing restrictions and being sent to correctional facilities at older ages. This has created a unique problem within the prison system: how to deal with the issues that come with aging offenders, specifically healthcare issues and healthcare costs. Various states have begun to examine different ways in which to deal with the natural disease states that accompany aging as well as the natural deaths of offenders. One such way has been to provide end-of-life programs or hospice and palliative care inside the prison facility. Deaths, both natural and unnatural, of offenders have a significant impact on the unique culture within the prison system. This study employed qualitative measures to examine how these types of end-of-life programs affect the culture in the prison system as well as to understand and document if such programs facilitate any type of culture shift within the facility. The researcher explored hospice programs in three correctional facilities, examining documents and interviewing subject matter experts. While the effects are more difficult to ascertain in the inmate populations, it was determined a culture shift has occurred within the administration in conjunction with the creation of a hospice program.