Improvements in medical care, longer jail terms because of stricter sentencing guidelines and an increase in the number of older adults being sent to prison have had a significant effect on the U.S. prison population: The average age of inmates is rising.

According to a report by Reuters, “In California, seven percent of the state’s 130,000 prisoners were over the age of 60 in 2016, the most recent year for which data is available, compared to just 1 percent 20 years earlier, according to a report by the California Department of Corrections and Rehabilitation.”

Because of this, states are finding ways to care for their older inmates. In California, for example, authorities are creating a dementia unit at the main prison medical facility in Stockton.

“We have identified a specific need for a specialized unit for our dementia population and are in the very early phases of concept development,” Elizabeth Gransee, spokesperson for California Correctional Health Care Services, told Reuters.

Joseph Bick, chief medical executive at the California Medical Facility in Vacaville, told the news service, “We and all of the jails and prisons around the country need to be able to do a better job with individuals who have cognitive impairment.”

Prisons across the country are facing similar challenges, and the economic toll is costly. Reuters reports that medical care for inmates has reached $3 billion annually. Reuters photographer Lucy Nicholson visited a couple of California prisons recently to try to document how that state is dealing with the challenges presented by an aging prison population. Here’s what she saw.

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