Aging in Prison

by the Gray Panthers, Pennsylvania State Correctional Institution Graterford chapter

From PHN Issue 27, Winter 2016

Elderly people are now 12% of Pennsylvania’s prison population. The number of people 50 years of age or older in Graterford prison alone has increased to 25% of its total population, and the state’s hospice care facility was expanded. The Department of Corrections’ definition of elderly is those over age 50, for good reason. Prison culture stressors and lack of access to holistic healthcare cause “physiological aging” that could mean aging arrives up to 15 years sooner for people in prison. Prison age 50 is the new age 65!

Longer periods of incarceration only compound existing health issues and heighten the risk of further health problems that have a deteriorating effect on the bodies and minds of incarcerated people. It’s a hidden death penalty, particularly for those incarcerated long-term. Physiological age is a broad measure of health and well-being, related to the ability to withstand stress. Prisons are loaded with stressors!

Mental health

Mental health issues become a serious stressor concern. Unfortunately, mental health issues among aging people in prison remain both underreported and undertreated. One study found that 40% of older people in prison had a diagnosis of cognitive impairment, a rate that far exceeds that of their peers in the community.

Early warning signs for the onset of dementia and other mental health diagnoses are often hidden by the rigid routine of prison life. For example, abuse of older people begins and is maintained through layers of authority in the prison environment. It begins with contact levels of authority blaming older people for not doing something—even though the incarcerated elderly person has no idea of what it is that hasn’t been done—and continues on unchecked through administrative levels. An older incarcerated person as a result is often put in an accusatory and defensive mode of thought that becomes habitual.

Older adults in prison with head traumas, many undiagnosed, and other mental health issues are often subjected to victimization and bullying from younger people in prison that goes unreported and becomes habitual. The elderly become subjected to additional disciplinary actions if their self-defense mechanisms turn violent and get reported inaccurately.

Unsafe facilities

Prisons were simply not designed to be long-term care facilities by today’s standards of care. There are also architectural limitations that pose significant problems to the aging population and would be costly to fix, such as stairs and narrow doorways, wheelchair inaccessibility, and the lack of hand rails throughout showers or ladders for the elderly to safely get into upper bunks.  

Additionally, cafeterias, medical units, visiting areas and other essential facilities may be spread far apart as a security provision within a prison, making daily life difficult for individuals with mobility impairments. Aging individuals require structures to lean on for long waits in lines and additional time to eat meals. In addition, they often struggle getting to and from bed, especially if assigned to a top bunk.

Cost

On average, nationally, it costs almost twice as much to incarcerate someone aged 50 or over ($65,000) as a younger able-bodied individual ($34,000). That seems to be the price of keeping the elderly in prison!

These runaway costs are the consequence of policies enacted in the 70s and 80s imposed upon a population that now has significant medical needs. It is clear that any long-term use of prisons as makeshift nursing homes is financially unsustainable. That ultimately takes away from early childhood education and other equally essential programs.

Public safety

Despite the mounting costs of incarceration, the elderly in prison have extremely low recidivism rates and pose almost no threat to public safety.

The majority of existing research suggests that length of time served has no clear relationship to recidivism rates. Rather, it is age that serves as an accurate predictor of recidivism. Arrest rates among older adults decline to a mere 2% by age 50 and are close to 0% by age 65.

Solutions

In Pennsylvania, a life sentence means life without the possibility of parole, and there is little hope for pardon or commutation of sentence. The age problem will only get larger with a do-nothing mindset.

Victim and community safety can be given the highest assurances with electronic monitoring and/or house arrest detentions at significantly reduced costs to taxpayers.

Drafting legislation that will facilitate the release of elderly, geriatric and seriously or terminally ill people in prison makes real sense.