Hospice care in prisons is a growing need. Forty three states in the U.S. have prison hospice programs to help people die. Missouri is one of them.

Carol McAdoo has been working to foster hospice in prison programs. She says the U.S. incarcerates more inmates than China. More life sentences are handed out each year. That means more inmates are dying behind bars.

More than 85 percent of the 5,100 inmates at the Louisana State Penitentiary at Angola die there. McAdoo says although it's one of the most violent prisons in the U.S., a successful hospice program is working so well that this man's grandson was able to spend the night with him during his final days. A photo exhibition, "Grace Before Dying," is at the First Presbyterian Church in Jefferson City through Oct. 25.

McAdoo says there are those who says inmates are the scum of the earth and don’t deserve special considerations. She recalls an inmate named “Animal” who had 187 felony charges. He was caring for another dying inmate. She says he tells her providing hospice care has shown him he has a heart and that he can make a better use of the rest of his life.

McAdoo has lots of stories about seeing kindness and compassion in prison hospice programs. She says beyond the human factor, hospice programs save money and lower violence rates in maximum security prisons. Regardless of wrongdoing, no one wants to die alone, she says.

McAdoo says it’s time barriers and myths are broken down and all prisons intitute a programs to let lifers … die.

Her statistics show that in four years, life sentences increased 83 percent, and with that, the need for palliative care in prisons becomes more necessary.

“When I started doing this, there were ten hospice programs … there are now 79; 79 is not enough. “about” is because it’s hard to sustain programs,” McAdoo says. “The only states i know that don’t have programs — Alaska, Delwaware, Georgia, Hawaii, Nevada, New Hampshire, North Dakota.”

“We have a huge educational prison community,” she says, “but there’s an uneasy relationship between community hospice programs and prison hospice programs. Only 16 percent of physicains … in prisons have special training.”

McAdoo says skeptics should look at the financial aspect. The cost breaks down to about $50,000 a year for a healthy inmate. That number doubles to $100,000 for an inmate over 55, and for someone who is chronically ill, taxpayers provide more than $150,000 for care.”

“One death cost $1.7 million, another cost $2.1 million — they had no other options — now they have a hospice programs.”

Years ago, the often-fatal diseases most prevalent among inmates were HIV and Cancer, she says. Now, hypertension tops that list, followed by arthritis, heart disease and mental illness.

McAdoo has interviewed more than 400 inmates throughout the U.S. She shares some of them here:

Carol McAdoo talks about death in prisons [Listen Mp3, 57 min.]

Jessica Machetta reports [Listen Mp3, 1:16 min.]