This month's cover shows an elderly prisoner being handcuffed before transportation to a local hospital. Older inmates like this one represent the fastest growing age demographic in the U.S. prison population: according to the U.S. Bureau of Justice Statistics, the percentage of inmates ages 54 or older nearly tripled (3% to 8%) from 1991 to 2011. The increase, criminal justice experts say, is likely a result of longer sentences that went hand-in-hand with 1980s-enacted antidrug laws. By the end of 2013, there were approximately 270,000 inmates 50 years or older in U.S. prisons.
Caring for aging prisoners' health needs becomes more challenging as their numbers rise-and the issue is exacerbated by limited facility resources. A 2014 report by the Vera Institute of Justice stated that "prisons and jails are generally ill-equipped to meet the needs of elderly patients who may require intensive services" for their medical conditions. The American Civil Liberties Union reports, for example, that correctional staff often lack training for treating age-related illnesses, and that prisons typically don't have the ability to monitor chronic health issues or employ preventative measures. Often inmates are sent off-site for medical treatment beyond what prisons can provide.
An important role in the care of prisoners is often filled by other inmates. The ambulance transporting the prisoner on our cover was staffed by inmates, for example, and inmates can be trained to care for sick prisoners, especially those who are terminally ill. For an in-depth look at the current state of care delivery for dying inmates, read "End-of-Life Care Behind Bars: A Systematic Review."-Diane Szulecki, associate editor