Needs of the Elderly While Incarcerated

iStock 174820656 — Close up of jail cell door

Spending time in jail (or prison) in the later years of life, can be very detrimental both mentally and physically. These older offenders are often considered a special population because of their distinctly different needs. Currently, about 20% of inmates are considered “elderly”, but by 2030 this is expected to rise to as much as 33.3%.

Elderly Incarceration

An increasing number of inmates are older or elderly in the prison system, in part due to the consequences of sentencing guidelines. From “tough on crime” to “truth in sentencing”, mandatory minimums, increased sentence lengths and challenges achieving parole–all of these contribute to more elderly persons remaining incarcerated. The population of elderly inmates can generally be broken down into three groups:

Long prison sentences: Those who were likely convicted at a much younger age, but have to serve a lengthier sentence.
Late offenses: Individuals who committed crimes later in life.
Repeat offenders: These are sometimes called “aging recidivists”, and are those who go into and out of the correctional system. They often are released, but then commit another offense and are incarcerated again.

Regardless of the group, age, or type of offender–incarceration causes a lot of stress. Inmates are affected both physically and mentally, and research estimates that years of life are lost due to incarceration.

Read more in our other article: Jail time decreases lifespan in the elderly

Physical Challenges

Aging in general is a tough process, taking its toll on both the body and mind. Most of the elderly individuals people know have their own “ways” about them. Sticking to unusual schedules, having very particular food and hygiene needs, as well as very irregular sleep schedules. Many of these routines (or perhaps needs) are not always possible to keep while in jail.

A strict schedule for everyone means that sleep patterns may be disrupted from what is “normal” for an individual. Nutrition and food choices suddenly become limited, and are often not of the caliber needed. Bedding and seating options could be more physically challenging to manage. The limited clothing permitted could also mean they have trouble regulating their body temperatures. And they may find themselves surrounded by a generation they are not familiar with, or perhaps don’t get along with.

Mobility

In general, falls are a primary reason for those over age 65 having injury-related emergency room visits. These falls also are the leading cause of accidental deaths too. In correctional facilities, the risk of falls is much greater. Between bunkbeds, stairs, walking long distances and crowded facilities–elderly inmates can be at a much higher fall risk.

General Functioning

While services for the elderly in prison are often geared towards Activities of Daily Living (ADL), they often neglect other functions unique to incarceration. ADLs usually focus on the regular tasks a person may need to perform on a daily basis such as eating, bathing, and toileting. Knowing whether someone can accomplish these tasks independently helps guide interventions, or disability services.

However, there are other areas relevant to the incarcerated that are termed “functional health” capacities, and these include:

Dropping to the floor for alarms.
Standing for head count.
Getting to and from the dining hall.
Hearing orders from staff.
Climbing on to and off of the top bunk.

Understanding and addressing the ability of an inmate to perform these tasks is very important with the elderly population. Noting that the environment, and other other interventions can mitigate many of these challenges.

Mental Challenges

Being incarcerated means people miss out on a lot of life and special events. That alone can take a toll on someone, knowing they may have missed a “once-in-a-lifetime” moment. As they age, offenders may also become more concerned about how their loved ones are aging, or perhaps realizing they may not be released in time to be with them again.

At other times, just the noise and being forced to cohabitate with others can be stressful. Especially if it is an inmate that is used to, or needs, a quieter space or has sensory issues.

Safety can also be a mental stressor. As the elderly inmates age, they also can lose their place in the systems’ pecking order. They may no longer have the strength, stamina or wits to stay safe from predatory or younger inmates.

Losing connection with the outside world and loved ones is also a reality of incarceration. Whether it is a decline in visitors, a lack of access to communication, divorces, or children growing up and not knowing them–it all can affect their mental well-being.

The specific challenge of dementia or Alzheimers is particularly notable as it can leave an inmate confused, concerned, less able to comply with instructions and affect their judgment. There is often no great solution for this situation other than relying on correctional staff and other inmates to be kind, patient and work with the inmate to help them feel safe and secure.

Potential Solutions

Incarcerating the elderly is not just harmful to the individuals, but also is hard on the system itself. About 19% of prison budgets go towards the care and housing of elderly inmates. And often, many facilities are noticing that jails or prisons are becoming “nursing homes behind bars”. Some states have even gone so far as to create special units for the elderly or those who are too sick or frail. Some of the approaches to mitigate these challenges could include:

Providing medical assistive devices for mobility. Despite the possibility these could be used by other inmates, or for nefarious purposes, it is important to provide inmates with the equipment needed to remain as mobile as possible.
Understanding the need for more medical trips, or visits to the healthcare practitioner on site.
Consideration for a lower bunk to minimize fall risks due to potential dizzy spells or other medical conditions.
Providing a special diet can help with gastric and other digestive issues experienced by the elderly.
Changes in housing assignments if there are generational challenges amongst inmates.
Extra precaution for predatory inmates or the elderly being taken advantage of.
Conduct fall screenings routinely and use interventions that will help improve the inmates well-being.

It is also important that correctional officers understand the unique needs of inmates. The action of an inmate moving slower or one that is hard of hearing could easily be misinterpreted and escalate situations unnecessarily.

If you or a loved one is elderly and has experienced challenges while in jail, consider reaching out to one of our experienced attorneys to see if we can help.

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