THE ELDERLY IN PRISON, A DILEMMA



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ELDERLY IN PRISON, A DILEMMA

As a nurse working in the hospital at California Men’s Colony (a California State Prison) in San Luis Obispo, I was surprised at the number of inmates who stayed in the hospital for months, sometimes years. They were blind, used walkers, used wheelchairs, suffered from dementia, had chronic conditions that required frequent monitoring, needed oxygen or many other conditions. If they were free, not prisoners, they would have been cared for by family members, been in nursing homes or have been supported by other programs, they would NOT have been in the hospital indefinitely. Because of my awareness of this issue I decided to research the problems of the elderly in prison.

There are about 1.7 million prison inmates in the United States (Maker, 2000). By 2010, it is estimated that 20% of the inmates will be over 55 years of age (Maker, 2000). This trend is expected to continue so that by 2030, it is predicted that over 30% of prisoners will be over 55 years of age (Maker, 2000). Prisoners are considered “elderly” at age 55 because of poor previous medical care, high-risk behaviors (alcohol, drugs, smoking), and poor nutrition. All of these factors contribute to chronic diseases at an earlier age than in the “free” population (Rylander, 2000). The number of elderly in prisons is increasing for many reasons. “Longer sentences, tighter parole restrictions and the aging of a whole generation add up to a prison population that is growing grayer as it grows larger” (Online Athens, 2000).

With the increasing number of elderly in prison comes a new set of problems for the prison system. One problem is the increased cost of caring for an elderly prisoner. The cost of caring for one “average” prisoner in Georgia is $8.25 a day. In contrast, each elderly prisoner costs three times as much at $27 a day (Online Athens, 2000). There are many reasons for this increased cost for elderly prisoners. According to Jonathan Turley, a law professor and advocate for elderly inmates, “The geriatric prison population has very specialized needs that most facilities are very poorly suited to handle. The result is that most gerontological problems go untreated until they are chronic” (Schreiber, 1999). The cost for elderly inmates increases when they are hospitalized. One reason that elderly inmates are hospitalized are chronic conditions that require oxygen use, special diets, special treatments, the use of canes or the use of wheelchairs. Another reason for the hospitalization of the elderly inmates is that the prison environment can adversely affect chronic medical conditions. Prisoners must stand in line for meals, walk distances for medical care or medications, use stairs, and there is usually no air conditioning (Rylander, 2000). Hot days can be hard on the elderly, especially those with chronic diseases. Air conditioning is rarely available in prisons. For example, Texas has only one 60-bed geriatric ward that has air conditioning (Rylander, 2000).

No matter where the elderly are cared for in prison, security is an issue that must be considered first. Elderly inmates sometimes must use canes or walkers. The elderly are sometimes put in the prison hospital because the younger inmates can take the canes and walkers from them and use these items as weapons. Having the elderly in the hospital keeps canes and walkers from becoming weapons used to harm staff, the elderly inmates or other inmates. Another reason that the elderly are in prison hospitals is that "older inmates feel unsafe and vulnerable to attack by younger inmates” (Maker, 2000).

These situations all lead to hospitalization of elderly prisoners so that they can easily obtain meals, medical care, medication, and appropriate environmental controls. The number of inmates who need 24-hour care is increasing. In July 2000, Texas had 200 inmates who needed 24 hour care (Rylander, 2000.) Only seven states have separate facilities for their elderly prisoners (Schreiber, 1999).

What is the answer to the dilemma of elderly in prison? I believe that there is a multi-tiered answer. First, the prison systems must increase the number of facilities for the elderly who must remain in prison. These facilities should be similar to nursing homes, but with security. There are some prisoners who should never be paroled like violent offenders and those who offended when they were elderly, such as some pedophiles. Second, for those offenders who can be paroled, but still need close monitoring, a sort of “half-way house” would be appropriate. As an example, Texas has a secure nursing home for those who have been paroled with special needs (Rylander, 2000). Third, some elderly prisoners could be paroled with home electronic monitoring, especially if there is a family member who would be willing to care for that elder. Fourth, there should be a compassionate release program for the elderly who would be of minimal threat to society. Currently there is such a process in a few states, however, the majority of the inmates die while awaiting the review process (Rylander, 2000). In Texas “elderly, nonviolent inmates who have significant medical problems and have served half of their sentences are good candidates for special needs parole” (Rylander, 2000). Paroling an elderly inmate decreases the cost for the state by transferring the cost of care to another agency, possible Medicare. It can also be argued that a compassionate society should release elderly prisoners who are no longer a threat to society to allow them to die with their family rather than to die in prison.

The number of elderly inmates is expected to rise. Prisons are not equipped to handle the current number of elderly inmates, let alone the increase that is expected. The public safety can be maintained by early parole of selective inmates. Those who must remain in prison due to the nature of their offense or other reasons must be cared for in appropriate facilities that have yet to be built. The prison systems must consider building nursing homes within the prison system to appropriately care for their increasingly elderly population. This situation must be addressed soon because it will only be getting worse!

Bibliography

“Effects of Three Strikes Legislation.” Criminology and Public Policy, (July 2002):

4 paragraphs. Online.



(17 September 2002).

“Elderly Inmates (Ages 55 and Older) in the Prison Population.” January 4, 2001.

cjpc.state.tx.us/StatTabs/Programs/00programinformationsection6.pdf.

(17 September 2002).

“Elderly Inmates Swell Georgia’s Prison Rolls, Add to Medical Costs.” Online Athens,

(3 December 2000): 28 paragraphs. Online.

(14 October 2002).

Maker, Joshua. “The Quality of Care of Elderly Inmates in Prison.” May 2000.

(17 September 2002).

Rylander, Carole Keeton. “Recommendations of the Texas Comptroller.” December

2000. (14 October 2002).

Schreiber, Chris. “Behind Bars.” Nurseweek, (19 July 1999): 13 paragraphs. Online.

(14 October 2002).

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