A look at hospice social work in the prison system

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American flag flying over a barbed-wire fence at a correctional facility

Prison hospice care is a growing need as an aging prisoner population puts pressure on the existing health care systems in correctional facilities. The U.S. prison system has been facing growing challenges related to the elderly in prison, and social workers can play a vital part in offering essential care that promotes justice.

The potential for rewarding work in prison hospice is significant, and a Master of Social Work degree can help prepare individuals for the unique challenges that emerge when working with inmates. To fully understand where the MSW can prove valuable, let’s first explore the situation surrounding hospice care in prisons.

Why prison hospice care matters

The report, “End of Life in Prison: Talking Across Disciplines and Across Countries,” published in the Journal of Correctional Health Care, outlined a few key reasons to be concerned about hospice care in prisons. They include:

  • The idea that neglecting ethical treatment of all people is a breach of the social contract.
  • The belief that there is not an inherently just way to determine the level of a treatment an inmate should receive as a form of punishment, and inmates should therefore be given equal care.
  • The concept that getting inmates involved as volunteers for end-of-life care can prove a positive part of the rehabilitation process.

In essence, the report’s conclusions, based on a variety of past industry studies, point to the core idea that treating prisoners justly is a critical part of a successful justice system. As such, end-of-life medical services are essential. The core problem is that prisons have traditionally been dominated by younger population groups. Matters pertaining to the elderly dying in prison have either been a relatively small issue or kept silent. However, the number of prisoners aging as inmates and bound for life sentences is increasing.

The scale of the problem is put into perspective in a Social Work Today report. Jamey Boudreaux, executive director of the Louisiana-Mississippi Hospice and Palliative Care Organization, told the publication that in the Louisiana State Penitentiary alone there are 4,500 men serving life sentences. Nationally, there are more than 206,000 inividuals who are facing either life sentences or virtual life sentences, which are prison terms exceeding one’s expected life span, The Sentencing Project found.

Boudreaux described the situation as the graying of prisons, telling Social Work Today that prisons have become a microcosm of society.

What do typical prison end-of-life processes look like?

In many cases, prisons don’t have dedicated hospice strategies or nuanced methods for offering any sort of end-of-life services. Marvin Mutch, associate director of the Humane Prison Hospice Project, told Social Work Today that when a prisoner is incarcerated for an extended period, he or she often ends up with the same cell mate for a long time, with both on similar sentences. When that prisoner passes away, the cell mate is moved to solitary until a pathology report is completed. Alternatively, a dying inmate may be left to die alone in a medical unit with only occasional visits from a nurse.

In some cases, an inmate may be moved to an external hospice facility, as prisons are ill equipped to handle end-of-life care.

Regardless of the specific circumstances, the trend is clear: Most prison systems lack a dedicated system for hospice care, and the demand for solutions is rising as more prisoners reach old age.

The growing need for social work care for older inmates

A separate Social Work Today report explained that the social work industry still has a great deal to learn about older individuals who are incarcerated. In many cases, these people have faced life sentences with no hope of parole and are very concerned about the latter stages of their lives. Whether its issues like receiving hospice care or dealing with family ties that have disappeared over the years, many inmates are concerned that the world doesn’t think their lives matter because of mistakes made in their distant past. Many have gone through major life changes during their time in prison, but with no hope of release, still face death while incarcerated.

The growing awareness of the need for end-of-life care has led to a shift in practices as initial efforts to resolve hospice care challenges have started to breed results and lay a foundation for future strategies.

Common prison hospice strategies and what they mean for social workers

Based on details from multiple Social Work Today reports, prison hospice efforts typically involve a blended team that incorporates groups made up of a physician, nurse, and case manager. There are also typically security and classification officers involved, but initial hospice projects have shown some challenges getting buy-in from security teams. Another common tactic is to build teams of inmate volunteers who get actively involved in end-of-life work as part of the rehabilitation process.

In these situations, the social worker, who typically functions as a case manager, will provide services to support the inmate who is dying, offer care for other inmates, and work with families. This last point is a particularly challenging element of care, as many prisoners have either outlived their families or severed ties over the years, but efforts to either reconnect families or offer support for individuals who are losing a loved one is a common part of hospice care.

A Reuters report detailing one prison hospice program describes a situation in which many efforts are made to create comfort, including setting up gardens, providing inmates with curtained cubicles and colorful quilts, and offering similar amenities that add a level of care that is often out of reach in correctional settings.

How an MSW can help you prepare for prison hospice social work

MSW degrees provide students with opportunities to explore the more clinical, care-focused elements of the social work industry. In particular, the online MSW at Regis College emphasizes clinical care as part of the learning opportunities. Developing these skills can be helpful either in supporting mental health programs in prisons or providing care to those dealing with the grief of loss or fear of death that are commonly associated with end-of-life care. Want to learn more about how an MSW can help you get started in prison social work? Contact Regis College today. We’d love to talk.


Recommended Readings:

Explore a career as a clinical social worker

Is a career as a correctional social worker right for you?



End of Life in Prison: Talking Across Disciplines and Across Countries from The Journal of Correctional Healthcare

End-of-Life Care in Prison from Social Work Today

Growing Old in Prison from Social Work Today

Inside the Prison Hospice Where No Inmate Dies Alone from Reuters