Originally published July 22, 2020. Statements about the law were updated in October 2026; the box below gives today’s rules.
The problem with aging prisoners 
More and more people in prison are elderly, but compassionate release is still rarely granted. The process is slow, most requests are denied, and some people die while they wait.
Nearly every state and federal prison in the United States now has a growing number of older people. People age faster behind bars. Many are diagnosed with illnesses usually seen in someone twice their age.
The federal government and forty-five states have a compassionate release program, but it is often underused or simply ignored.
According to the Pew Charitable Trust, Virginia’s elderly inmate population has grown by nearly 20% since 1990. Prison systems across the country, including the Federal Bureau of Prisons (BOP), are seeing the same rise. And with a rise in elderly inmates comes an urgent need to fix how few compassionate releases are granted.
Why compassionate release is far from compassionate
When Congress ended parole for federal prisoners in 1984, it created compassionate release as a more limited way for courts to release people. To qualify, a person must show “extraordinary and compelling” circumstances.
The idea is that, at some point, it may become “inequitable” (unfair) to keep holding certain people in prison. Compassionate release offers an ethical answer in those cases, letting people spend their final days in the care and comfort of their loved ones.
It makes sense in theory, but it is much harder in practice. The process takes a very long time and most requests are denied.
According to a 2018 report by the Marshall Project and the New York Times, the BOP approved only 6 percent of 5,400 compassionate release requests between 2013 and 2017. Of those who applied, 266 died while waiting for a decision.
State prison systems set their own rules. California, for example, requires people to be completely incapacitated or have less than six months to live. That is a problem when the application itself takes months.
Decisions must come faster for older prisoners
The Monterey Bay Justice Project reported that in one 12-month period between 2016 and 2017, 53 qualified people applied for early release. Six were eventually approved. Reverend Keith Knauf, director of Pastoral Care in California’s only correctional hospice unit, said, “We had six granted but some died before release.”
A 2015 study called “The United States Compassionate and Geriatric Release Laws” found that only five states have no laws allowing early release for health or age.
More recently, Congress passed the First Step Act, in part to bring compassionate release back to what it was meant to be in 1984. Federal prisoners can now go directly to court if the BOP denies their request.
What comes next
It is still unclear how well the First Step Act will work to release federal prisoners who are terminally ill or seriously disabled. Even at the end of life, people in prison have families who deserve some consideration as they face a loved one’s failing health and death.
The new law may make compassionate release easier to get, but the process is still complicated. Criminal Center handles federal post-conviction work, including compassionate release.
If you want help with a compassionate release request, book a consultation.
Src: Matthew T. Mangion “MANGINO: Few Prisoners Benefit from Compassionate Release“, 12 March 2018