End-of-life care in jail: Translating prison experiences into practice in New York City jails

Target Audiences: Correctional Healthcare Professionals, Hospice Professionals Key Words: End-of-Life Care, Inmates Background: The United States has one of the highest incarceration rates in the world, and this population is rapidly ‘graying' with federal Bureau of Justice Statistics reporting that the number of incarcerated persons age 55 and older grew 76 percent between 1999 and 2008. While hospice services entered into correctional healthcare in the 1980's, its practice has been largely limited to prisons. The successes of prison hospice programs haven't always translated to jail setting. Purpose: Providing better end-of-life care for jail inmates represents a significant benefit to the community, and incarcerated population. This review seeks to contribute to the limited body of evidence approaching hospice and palliative care in jails, while addressing the fundamental differences in practice between jails and prisons. Methods: In September, 2010 a literature review was conducted on end-of-life care in prisons and jails. A summary analysis of this literature was used to outline successful practices, which were applied to the context of New York City's jail system. This analysis found that while there are many shared practices, jails face barriers to continuity of care and services primarily due to short lengths of stay for inmate. Conclusions: Today's correctional medical providers face a multitude of daunting tasks and challenges associated with wide array of medical diagnoses, austere clinics and often difficult clientele. Treating terminally ill patients represents one area of practice where performance calls for improvement and academic discourse must be generated to achieve more.