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An aging prison population
Published in Joanne Brooke, Dementia in Prison, 2020
Because of the accelerated aging that is linked to the prison experience, prisoners who are aged 50 and over in the UK are referred to as older prisoners (Age UK, 2019b); this is similar to the regulation of some states within the USA (Williams, 2006). However, a number of states in the USA base their definition on a prisoner’s degree of disability, rather than chronological age (Anno et al., 2004). The Australian Bureau of Statistics (2009) defined older people as those aged 65 or over. However, a report by Baidawi et al., (2011) established that in practise, the age of 50 and over is applied as a functional definition for older prisoners (Grant, 1999; Kerbs and Jolley, 2009; Stojkovic, 2007). Currently, there is no global consensus or definition of an older prisoner. However, this is important to determine in order to support the development of relevant policies relating to prison and healthcare services for older people.
Older people and the criminal justice system
Published in John C. Gunn, Pamela J. Taylor, Forensic Psychiatry, 2014
The case for separate prison wings appears to be stronger. In the USA, by 1998, at least 12 states had set up separate facilities for older prisoners, perhaps in part in response to stated preferences for being away from the noise and aggression of younger inmates (Aday, 2003). In the UK, there are a few, including one in the north-east (HMP Frankland), one in the north-west (HMP Wymott), one in the south-west (HMP Kingston) and east (HMP Norwich). Older prisoners differ from their younger peers in the extent of their physical health problems and disabilities (Fazel et al., 2001b) and their psychosocial needs as well as their psychiatric problems. HM Inspectorate of Prisons (2004) noted, after interviewing 442 male and 47 female prisoners, that high rates of victimization from younger inmates are a concern. The physical condition and structure of the prison – designed for young, active people – can be difficult for older, frailer inmates, and particularly for those with limited mobility. A range of measures to improve the physical environment of prison was suggested in this report. These include housing such prisoners on lower landings, under separate régimes, and improving training for prison staff. Improvements more specifically for older women prisoners were identified in a study by Wahidin (2003).
Advocacy
Published in Diane C. Hatton, Anastasia A. Fisher, Andrew Coyle, Women Prisoners and Health Justice, 2018
Given the challenges to basic human rights and dignity for elders inherent in the prison system, the extremely high cost of incarcerating them (over twice that of younger prisoners), and their low risk to public safety (recidivism rates averaging less than 4%),7 LSPC put the greatest emphasis on the need for alternatives to incarceration for elders. Recommendations include expanding California’s Compassionate Release law to include older and disabled prisoners and establishing a home monitoring program for older prisoners to serve the remainder of their sentences on home confinement.6
The evolution of health care in the Texas correctional system and the impact of COVID-19
Published in Baylor University Medical Center Proceedings, 2021
Sanjana Rao, Kiran Ali, Gilbert Berdine, Victor Test, Kenneth Nugent
Studies in other countries provide additional insight into the health care needs of prisoners. Wangmo et al reported that older prisoners with a mean age of 59 years in Switzerland reported 2.3 times more somatic diseases than younger prisoners with a mean age of 34 years.9 In addition, older prisoners visit general practitioners 1.4 times more frequently than younger prisoners during a 6-month period.10 Older prisoners report three barriers to accessing health care in prison: psychological obstacles (reluctance), concern about possible negative consequences associated with health care utilization, and environmental hurdles related to limited on-site facilities.11 Older prisoners take more medications than younger prisoners and are at increased risk for polypharmacy, defined as ≥5 medications a day.12 Older prisoners have mental health disorders more frequently than younger prisoners and also abuse alcohol more frequently.13 Finally, older female prisoners have a different set of concerns. They may experience three layers of vulnerability when in prison: being in prison, being a woman, and being elderly.14 Clearly, the management of health care needs in older prisoners, both in Texas and throughout the world, requires expertise in geriatrics, women’s health, and mental health.