End-of-Life Care Behind Bars: A Canadian Perspective - Barry R. Ashpole

THE AGING PRISON POPULATION, the quality of prison healthcare services and, in particular, the quality of end-of-life care, is emerging as a universal public health issue. Geriatric and end-of-life care in correctional facilities are not as equitable as care in the “outside world.”

The aging of the prison population, with the corresponding increase in chronic illness, cognitive impairment, disability and frailty, is a world-wide phenomenon. For a disturbing number of elderly inmates, prison will be their “final resting place.” This interactive presentation offers a Canadian perspective, reflecting on “lessons learned” in other countries.

In some countries, community hospices have successfully partnered with local prisons to provide training for both staff and inmates. In particular, the training of inmates as hospice volunteers is gaining ground.

This training, typically, is “face-to-face, homegrown, and variable in content.” Some correctional facilities are also extending this training to prison staff.

Such initiatives are consistent with the philosophy and practice of hospice and palliative care: improving the quality of end-of-life care for one of society’s most vulnerable and marginalized populations, recognizing also the potential capacity of correctional facilities to help inmates rebuild – not destroy – souls.

Where volunteer inmates have been trained to care for those living with a life-limiting or terminal illness, the concept of prison hospice has also served to work against the sense that the incarcerated are of little or of having no value.

As one prison hospice volunteer has remarked: “I’m somebody that nobody thought I could be.”

To see related PPT presentation click here or access via pdf below:

2026-end-of-life-care-behind-bars-a-canadian-perspective-spotlight

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Footnote: Launched in May 2024, the End-of-Life Care Behind Bars website (i.e., End-of-Life Care Behind Bars.com) fills a critical information and advocacy gap for a unique, often overlooked population. While prison healthcare in general has gained attention, keeping pace with research on palliative care within correctional facilities remains a challenge for busy health professionals.

As a dedicated advocacy, teaching, and research hub, this website streamlines access to essential knowledge. Users can find the latest developments, including curated reviews of articles and reports, in the monthly bulletins on the “Current Thinking” page, while the “Spotlight” page offers commentaries on key issues, for example, the aging prison population and compassionate release for prison inmates living with a terminal illness, which have become inextricably linked.

As this resource grows, it aims to foster a necessary shift in societal attitudes toward the care and dignity of incarcerated individuals at the end of life. BRA

N.B. Submit questions, comments etc., at: https://bit.ly/4vCyICE

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Barry R. Ashpole, Ontario, CANADA Biosketch: https://bit.ly/3XMTRs4

BARRY R. ASHPOLE is an educator and communications consultant living in Ontario, Canada. Now semi-retired, he has been involved in palliative and end-of-life care since 1985. He established the End of-Life Care Behind Bars website (https://bit.ly/4dU4qmi), an advocacy, teaching and research “tool” to inform and, hopefully, affect a seismic shift in society’s attitudes towards the health and well-being of the incarcerated. Regular postings include annotated listings of current articles, reports, and so on, culled from the professional literature, the news media and other sources.

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