Prisons around the world are fast finding that they need to learn to deal with older inmates – one more societal institution to be affected by the aging population. A recently released study undertaken by the Urban Institute found that the number of prisoners aged 50 or older in prison in America increased by 330% from 1994 to 2011. An even steeper growth curve is expected in the coming years. By 2019 the report estimates that the proportion of older prisoners will have risen to 28%.
Exacerbating the problem, prisoners are particularly at risk of accelerated aging and deterioration of health due to the impact of living in a prison environment, along with other demographical factors, which means that their physiological age may be up to 15 years greater than their actual age.
This is of concern not only because it is much more expensive for society to ‘keep’ older inmates (double the cost of a younger offender), but also because as a society we need to insure prisoners are allowed to age with dignity and receive any essential day-to-day help they may require to live safely. In general prisons are designed for the young and able-bodied. Older prisoners require more treatment and medical care, and often more time and effort from prison staff. Older prisons are also more vulnerable to victimisation.
So what can be done to start to deal with the problem? For a start, the report recommends expanding data-driven knowledge about older prisoners and developing cost-effective management plans for them. Other solutions also include:
- Increasing the exercise of compassionate or geriatric release on a case by case basis. This would involve extending existing hospice care, palliative care, or compassionate release programmes to greater numbers of older prisoners.
- Developing an easy-to-use assessment/screening tool. A set of guidelines for assessing the health of older prisoners would help correctional officers detect common geriatric symptoms (e.g., sensory impairment, functional impairment, incontinence, and cognitive impairment) as well as prison-based functional impairment (e.g., getting from cell to dining hall and hearing orders from staff). A screening tool could also provide useful baseline information about the needs of aging prisoners and serve as an early intervention point for preventive care.
- Training correctional officers about aging and the needs of older prisoners. Training would also help staff identify older prisoners who need to be monitored for health and safety concerns.
- Expanding the use of preventive health care/dental care, early diagnosis, and early treatment among aging prisoners. These practices can help prisoners avoid more serious health problems and lead to savings in health care costs.
To give some context to the exercise of compassionate or geriatric release, this graph shows the rates of recidivism by age in America in a three year follow up:
Recidivism rates do get less as people age, giving some strength to the argument that it isn’t as beneficial for society – or older people – to have older people in jail given both the cost to them and the financial cost to society. In saying that we also want to deter people from committing crimes, and not have them think they will necessarily get out of their sentences early if they’re older. We would also have to be careful to screen those who do remain a risk to others in society. Would purpose built retirement home like facilities be another option? In any case, the issues brought by an aging prison population are something that societies around the world have to get a handle on.