Aging Prisoners: New Frontier for Research Practice

1. Aging Prisoners: New Frontier for Research & Practice Ronald H. Aday, Ph.D.

2. General Profile of Older Inmates

3. Types of Older Inmates New Elderly Offender � 1st incarcerated after age 50 Chronic Offenders � multiple recidivist or career criminal Long-Termers � serving 20+ years; sentenced before age 50

4. Almost 500,000 persons ages 50+ arrested each year 17% involved in serious felonies: murder, sex offenses, drugs, robbery, aggravated assault, burglary, larceny

5. Criminal Activity (cont) 42.6% convicted over age 55+ are for violent crimes, compared to 28.5% for ages 45-54. Common convictions of older offenders are for sexual crimes, homicide, aggravated assault

6. Graying of American Prisons Current estimate = 150,000 inmates over age 50 in state/federal prisons. Lifers and long-termers (20+ yrs) make up 22.6% of total state & federal prison population. 2/3 of older inmates incarcerated for less than 5 years. 1 in 4 behind bars for under a year.

7. Growth Examples of 50+ Prison Population Alabama (2001) = 1925; (2006) = 3167 (increase from 6.2% to 11.3% of total population Georgia (2001) = 3426; (2006) = 5588 (increase from 7.8% to 10% of total population

8. Convergence of Trends Increasing numbers of older adults in general population Number of serious crimes committed by elderly citizens Massive increase in prison beds Shift to punitive response to crime Curtailment of early release

9. Health Concerns of Older Inmates

10. Factors Leading to Higher Health Care Expenditures

11. Physical Health Issues 1/2 � of Older Inmates reports their health as poor Prevalence of chronic health problems: hypertension, diabetes, arthritis, cancer, emphysema, kidney problems, heart problems, sensory losses

12. Physical Health Issues (cont) Older inmates report, on average, 3 chronic illnesses. New inmates have unrealistic expectations about prison health care. Functional health status of older inmates can deteriorate quickly

13. Physical Health Issues (cont) Prison health mandates/costs Many have had little previous access to health care. Introducing managed care into the prison setting Emerging caregiving models

14. Case of California In 2022, there will be at least 30,200 inmates 55 and older compared to 7,580 now 1 out of 6 are lifers 17% suffer from severe mental illness

15. Mental Health Issues Suffer from social losses and death of family members Grief reaction to losses (physical health, life without parole, etc. Anxiety disorders, emotional problems, alcohol/drug abuse Older Inmates express need for greater privacy.

16. Mental Health Issues (cont) Suffer from loneliness, depression, and general low morale Fear of dying in prison, unsafe living environment, and possible victimization Estranged from families due to violent crimes committed against family members

17. Mental Health Issues (cont) Violent offenders may experience guilt about sexual offenses or homicide and often have suicidal thoughts. Prison shock a frequent reaction to late life imprisonment. Some Suffer from early stages of dementia and personality rigidity

18. Mental Health Issues cont. Over half of females have suffered from physical/sexual abuse Drug/Alcohol problems Poor self esteem

19. Special Needs of the Older Offender

20. Responding to Aging Prisoner Special Needs Counseling services and individual and group therapy Lack adequate work skills to find employment on outside Locating family/community members willing to accept aging inmates

21. Special Needs (cont) Safety from predators and safe environment Medical/mental health counseling Accessibility to clinic and food services Special diets

22. Voices from Georgia �We need to be seen faster & by the same doctor.� �To be housed closer to medical department.� �For the health care people not to get upset with what we the prisoners need � more understanding.�

23. Special Needs (cont) Discharge planning and community placement orientation Need assistance with daily living activities Health promotion and wellness activities

24. Special Needs Cont. � Less likely to maintain contacts with outside world � Many have outlived family members or have disengaged Suffer from institutional dependence and feel secure with prison setting.

25. Tennessee Sample Statements � �In TN prepaid LD calls are $4.17 to connect and 53 cents per minute.. I have to work 2 wks to pay for a 10 min. call.� �It becomes a strain on the family and pretty soon it fizzles.�

26. Special Needs (cont) Appropriate housing and accessibility Recreational services and programs Accommodations for impaired, frail, and handicapped Hospice/end of life services

27. Special Needs (cont.) Importance of work if health permits or jobs available Prison pastimes (Recreation) Religious activities Prison friendships and supports Educational pursuits

28. Thoughts about dying in prison from Mississippi �My main fear of growing old in prison is dying here.� �I�ve watch a few people die here and I wouldn�t want to.� �You�re just a number, that�s all. Dying would be a great relief�

29. Special Needs Cont. Specialized vs. mainstream housing options Emergence of geriatric facilities Prison nursing homes Community alternatives

30. Future Issues for Management of the Older Offender

31. Barriers to Correctional Response Overcrowding and financial constraints frequently take first priority. Rising costs of medical care Small number of aging inmates in some prisons or some states

32. Barriers to Correctional Response (cont) Diversity of aging inmate population Lack of trained staff and knowledge Lack of correctional policies/facilities/ programs focusing on aging inmates

33. Barriers to Correctional Response (cont) Emphasis on life without parole in many states Lack of community support Staffing for special needs offenders

34. Research & GeneralInformation Needs Incarceration alternatives Nature of Family Relationships Coping strategies of those entering prison late in life Common sentencing and parole policies

35. Research & GeneralInformation Needs (cont) Future projections of impact of life without parole Impact of sentencing law changes Effects of long-term institutionalization Identifying costs of long-term incarceration of infirm prisoners

36. Research & GeneralInformation Needs (cont) Impact of special programming Assessment of facilities providing for special needs Identifying support measures for frail inmates Identifying resources available for released older inmates

37. Older Incarcerated Females in the South Mental/Physical Health Needs Institutional Supports External Support Network Activities/Work/Pastimes Death Anxiety Prison Adjustment