Behind Bars

Over the past few weeks I’ve seen several documentaries about our criminal justice system. Prisons focused on treating abuse and addiction in meaningful ways, and providing programs that boost prisoner self-esteem, and provide educational advancement and job training seem to work better than programs focused on punishment.

And then there are the old people behind bars, generally defined as prisoners aged 50 years or older. Experts have determined that this group ages prematurely because of overall prison conditions including stress, substandard health care and nutrition, as well as histories of poverty and high levels of mental health problems.

Currently, there are an estimated 131,000 people age 55 or older in state prisons nationwide, housed at a cost of some $9 billion annually. By 2030, an estimated one in three people in federal or state prisons will be aged 55 or older—more than triple the proportion in the early 1990s because of an era of long sentences driven by harsh criminal-justice policies on drugs.

Older prisoners are diverse, including first time offenders, aged recidivists, those serving long or life sentences, and those incarcerated for short periods late in life. The aged in prison face many challenges beginning with the unsuitability of facilities. Many prisons were built in the 19th century with younger offenders in mind. Problems include wheelchair accessibility to outdoor courtyards, and being disallowed walking sticks or frames because they might be considered weapons.

Other issues range from who should change sheets for incontinent prisoners to problems with frailty, mobility, safety, and medical and mental health needs. Also, there is a need for age appropriate activities since nearly all programs target young offenders. In some prisons there is gym equipment, but older prisoners may be given lower priority for access or pushed off. There is also the potential for victimization, especially in the case of sex offenders, who tend to be older when convicted and are among the most stigmatized in our society. 

For state prisons, the consequence of taking care of the older prisoner is the cost, which can be four to eight times higher than for younger prisoners. In 2013, nearly half the $58 million that Virginia spent on off-site prisoner health care went to the care of older prisoners.

Many states have taken steps to reduce their prison populations by releasing nonviolent inmates or by diverting some offenders to community programs before sending them to prison. However, corrections officials say those reforms alone do little to decrease the population of older prisoners who are serving mandatory sentences or have committed violent crimes.

Several states have adopted programs such as early release for geriatric patients or “compassionate release” for the dying (See NY Times article below). But advocates for prisoners say the programs are often so cumbersome and restrictive that few older prisoners are able to take advantage of them. When aging prisoners do reach the end of their sentences, corrections officials often have a hard time placing them in private nursing homes because the homes do not want to take them.

On the positive side, a number of states have chosen to add services for an elderly population, including a special dementia unit for prisoners in New York State, and housing units just for the elderly in Ohio. In 2012, Connecticut contracted with a private nursing home to care for elderly and infirm inmates granted parole. But even there, the state is locked in a battle with the federal government over whether the facility qualifies for Medicare or Medicaid reimbursement.

Louisiana, Ohio and Virginia have “geriatric conditional release” laws that make old age grounds for consideration for an early release. In Virginia, prisoners are automatically considered for release if they are age 60 and have served 13 years, or if they are age 65 and have served five years.

Studies have found that older ex-offenders are less likely than younger ones to commit additional crimes after their release. But politicians and the public don’t seem willing to release former murderers, rapists and sex offenders, even though they are decades removed from their crimes and physically incapable of repeating them, said the president of a nonprofit association that works on behalf of ex-offenders.

Learn More:

• https://theconversation.com/do-we-care-about-old-people-behind-bars-and-should-we-68343
• http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2016/03/17/elderly-inmates-burden-state-prisons
• https://www.thenation.com/article/our-prison-population-is-getting-older-and-older
• http://www.washingtonpost.com/sf/national/2015/05/02/the-painful-price-of-aging-in-prison/?tid=a_mcntx&utm_term=.2a134ad1926e
  
• https://www.nytimes.com/2018/03/07/us/prisons-compassionate-release-.html?utm_campaign=KHN%3A%20Daily%20Health%20Policy%20Report&utm_source=hs_email&utm_medium=email&utm_content=61176393&_hsenc=p2ANqtz--9JrpgeqQYO2fqQC066REVsrTNJQ20BpCIXiGzjqF46wBM8VD2y6hU98R8tlm1AWbthTD3T7CwVvpq15nozpEUXVlTSg&_hsmi=61176393