Elderly prisoners: the future of corrections in the United States

Citation

Fellner, J. (2012), "Elderly prisoners: the future of corrections in the United States", International Journal of Prisoner Health, Vol. 8 No. 2. https://doi.org/10.1108/ijph.2012.62108baa.002

Elderly prisoners: the future of corrections in the United States

Article Type: Guest editorial From: International Journal of Prisoner Health, Volume 8, Issue 2

Prisons in the USA contain an ever growing number of aging men and women who cannot readily climb stairs, haul themselves up to the to the top bunk, or walk long distances to meals or the pill line; whose old bones suffer from thin mattresses and winter’s cold; who need wheelchairs, walkers, canes, portable oxygen, and hearing aids; who cannot get dressed, eat, go to the bathroom or bathe without help; and who are incontinent, forgetful, suffering chronic illnesses, extremely ill, and dying. There are prisoners suffering Alhzeimer’s or other severe cognitive impairments who do not know their own age or remember why they are in prison.

The number and proportion of older men and women in US prisons is growing markedly:

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  Between 1995 and 2010, the number of US prisoners under state or federal jurisdiction age 55 or older nearly quadrupled (281.95 percent), while the number of all prisoners grew less than 50 percent (47.94).

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  Between 2009 and 2010, the number of prisoners age 65 or older increased 56.8 percent (from 16,700 to 26,200), even though the overall prison population declined that year by 0.6 percent.

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  Between 2005 and 2009, the number of prisoners age 55 and over increased by 40.6 percent and the number of those prisoners aged 75 and over increased 41.3 percent. The number of prisoners under age 55 grew by only 2.1 percent.

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  Between 1995 and 2010, the proportion of state and federal prisoners who were age 55 or older increased from 3.2 to 7.7 percent of the total.

The growing number of aging prisoners in US prisoners is the predictable result of harsh “tough on crime” laws – long mandatory minimum sentences, the increased imposition of life sentences, and reduced or eliminated opportunities for parole. Some of the older men and women in prison today entered when they were young or middle-aged, and some committed their crimes when they were already well along in years. But the long sentences many received, particularly for crimes of violence, mean they are not likely to leave prison before they are in their 80s and even 90s. One in ten aged prisoners is serving a life sentence – and they may never be released. Over 11,000 have been sentenced to life without parole, i.e. they have been sentenced to grow old and die behind bars.

Prison officials face daunting challenges to house and provide medical and mental healthcare to their aging and dying wards. Older prisoners develop mobility impairments, hearing and vision loss, and cognitive limitations, including dementia. Older prisoners are also more likely than younger to have chronic, disabling, and terminal illnesses, putting huge demands on correctional medical and mental health budgets. Those who continue to age behind bars will eventually require assisted living and nursing home levels of care while incarcerated. Prison officials look at the projected increase in aging prisoners in their systems and realize in the very near future they will need to operate specialized geriatric facilities. Some already are.

Age does not change the rights of people who are incarcerated but it changes what prison officials must do to ensure those rights are respected in particular cases. For example, for someone who is old and frail, the right to safe conditions of confinement may mean not being required to live in a dorm with younger persons prone to violence and extortion. The right to decent conditions of confinement may mean older persons should be given extra blankets and clothing in the winter because it is harder for them to stay warm. Prisoners have a right to activities to promote rehabilitation, and older incarcerated persons should be provided age-appropriate educational, recreational, and vocational opportunities. Ensuring an older offender is treated with respect for his humanity may mean providing staff or prisoner aides who can help him to change his clothes and clean up his cell when he has an “accident” due to incontinence.

What officials must do to for older prisoners is frequently the same as what they must do for prisoners of any age who suffer from illness or physical incapacitation. For an older offender who is mobility-impaired, accommodation of that disability may require assignment to a lower bunk and permission to take shortcuts to walk to the chow hall, or the assignment of someone to help push his wheelchair. For the older offender who breaks prison rules and whose mental capacities are weakening, or who is suffering from dementia, staff need to modify their disciplinary responses in recognition of the fact that the prisoner is not engaging in willful disobedience.

Providing medical care to older sentenced individuals comes with a steep price tag because of their far greater medical needs. The average annual medical expenditures for older persons in prison ranges from three to seven times greater than for younger. The country is shouldering the burden of paying for expensive prison security and control measures for individuals who, because of their age and infirmities, pose a negligible safety risk.

Absent significant changes in sentencing and release policies, the aging and infirm will constitute an ever growing proportion of the US prison population. This burgeoning geriatric population has important financial, practical, and moral implications for the USA. It is also a cautionary lesson for other countries. While no other nation has the high-incarceration rates of the USA, many western nations are beginning to confront a rise in the number of older prisoners. Taking stock now of the housing and medical needs of older prisoners, and the causes for their incarceration, may enable the sort of sensible thinking about the purposes of imprisonment and the best use of limited financial and human public safety resources that has thus far eluded US decision makers.

Acknowledgements

This guest editorial, written by Jamie Fellner, Senior Advisor to the US Program, Human Rights Watch, is adapted with permission from the Human Rights Watch report she authored, Old Behind Bars: The Aging Prison Population in the United States, published January 2012, accessed on 17 July 2012 at www.hrw.org/sites/default/files/reports/usprisons0112webwcover_0.pdf

Jamie Fellner