Soaring numbers of older, sicker prisoners are causing an unprecedented health care challenge for the nation's criminal justice system, according to a new UCSF report.As the American penal system confronts a costly demographic shift toward older prisoners, the authors call for an overhaul in health care practices for elderly inmates who disproportionately account for escalating medical expenses behind bars. The recommendations include screening for dementia among prisoners, improved palliative care, and standard policies for geriatric housing units for infirm inmates