Aging in Our Correctional Facilities

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The aging of our inmate population within our correctional facilities in this country is becoming a national epidemic. The cost to the taxpayers to house and treat this special offender type is increasing exponentially year after year. Medical costs associated with the incarcerated elderly inmate continue to tax state economic development specifically in the Appalachian Region. We must find reasonable accommodations to be both fiscally responsible and accountable to the victims of this group of individuals. The question is raised to a new generation of criminal justice idealists to find sensible solutions as we face economical deficiencies state by state.

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Aging in Our Correctional Facilities; How Old is Too Old?The correctional system in the United States of America has evolved from the simplistic Walnut Street Jail in the late 1700s. John Howard’s concept of the Quaker code placing inmates in individual cells as penance for their criminal offenses has evolved into the complex and futuristic facilities that we are constructing today. We have marveled in the technology associated with the design and implementation of these buildings. However, one fact that remains the goal of the correctional industry is the safety and well-being of those individuals assigned to each facility. The goal of local, state, and national correctional agencies is to house and care for each inmate they are tasked with. This goal has not changed but the circumstances associated with this simple goal has changed exponentially in the past few decades. xThe United States has seen highest of highs and the lowest of lows associated with the “tough on crime” models and the “rehabilitate and retrain” models. Incarceration numbers has steadily increased from the late 1700s until the 1980s where the numbers hovered around 1.8 million (BJS, 2012). It was at this time that correctional population began to rise at a record pace. By December 2016, the U.S Correctional systems supervised more than 6.6 million (BJS, 2018).

From 1993 until 2013, one of the largest increases in this population was state and federal prisoners older than 55 years of age. The number of prisoners fitting in this age range increased nearly 400% from 26,300 to 131,500 during that time frame (BJS, 2018). These numbers are reflective of an ongoing trend with prisoner ages rising at much higher rates than other demographics. An Aging Complex in CorrectionsAt the time of this Bureau of Justice Statistics study showed that 10% of the total inmate population was older than 55 years old. This number is also reflected within the State of West Virginia’s own inmate population. The West Virginia Department of Corrections and Rehabilitation’s Fiscal Year 2017 Annual Report shows that an ever-increasing population of older inmates. For the ages 50-59 years of age, there were 12.99% of the total population (732); for the 60-69 years of age group, there were 5.76% of the total population (338); for the 70-79 years of age group, there were 1.67% of the total population (98); and finally, in the over 80 years of age group, there was 0.19% of the total population (11) [WVDOC, 2018]. These numbers also are reflective regionally as the State of Ohio reports more than 5,422 inmates over the age of 55, for more than 11.22% of the total inmate population. The projections for these numbers are also not expected to decline in the near future. In fact, projected growth of this demographic shows that the opposite trend. By the year 2030, prisoners older than the age of 50 could account for more than 28% of the total inmate population (Kim, Peterson, 2014). This is a far cry from the range of around 18-20% they have now. This is also a trend nationally in the population outside of corrections, where the United States Census Bureau estimates that in 2056, for the first time in our history, the older population, age 65 and older, is expected to outnumber the youth in America under the age of 18 (CENSUS, 2012).

Medical Treatment for the Aged Population

A survey of correctional facilities in the year 2009 showed that 39-43% of all inmates in federal, state, and local prisons had at least one chronic disease. More shocking than this number is that between 46-69% of the inmate population was prescribed and using medication for a mental health condition (Hollenbeak, Schaefer, Penrod, Loeb, & Smith, 2015). This number becomes far more intriguing when known medical beliefs that the older that a person becomes, the more likely the need for medical procedures and medication increases. Also studied is the fact that inmates tend to experience accelerated aging in the prison setting. A previous study shows that the health of an older male inmate was comparable to community-dwelling men who were fifteen years older (Hollenbeak, Schaefer, Penrod, Loeb, & Smith, 2015). The known costs to house an inmate in the State of West Virginia according to their FY 2017 report shows $26,081 per year, or $71.45 daily (WVDOC, 2018). The national opinion is it is estimated to house an elderly inmate averages $70,000 per year, or $191.78 each day (Martin, 2003). This, simply put, is an economic crisis for states and the federal prison systems. Many states have seen medical costs skyrocket. For example, many studies have shown a minimum of twice the cost to medicate and treat inmates over the age of 50 compared to their youthful cohorts. The average inmate aged 55 years of age or older typically has a minimum of three chronic conditions (Seiter, 2016).

The same group of inmates has a one in five chance of having a mental illness. The average costs with medical costs can exceed $100,00 annually, and United States correctional system currently is estimated to spend $1.6 billion annually caring for the elderly within their custody (Seiter, 2016). These medical costs also were the sole responsibility of the incarcerating states until only recently when incarcerated offenders became eligible for Medicaid under the Affordable Care Act (2013). The ACA allowed participating states to allow inmates to apply for Medicaid services while being incarcerated, which in turn could ease the costs associated with some medical procedures while imprisoned. Another key medical factor in the care for the elderly inmates in America is mental illness. Anxiety, depression, suicidal thoughts, loneliness, and schizophrenia are just a few of the many issues that medical personnel and correctional staff must deal with day in and day out. The numbers in America to treat dementia has reached more than $202 billion dollars in 2010 (Maschi, Kwak, Ko, & Morrissey, 2012). The number of inmates currently dealing with dementia in the prison systems is unknown, but estimates are that more than 13% of individuals aged 65 and older have some type of dementia related illnesses. Those numbers are expected to rise in general populations as well from 1.7% of total inmates to 1.9% of total inmates by 2030; and triple by the year 2050 to a total of 381,391 inmates experiencing dementia. The main reason for this estimation is also from the accelerated aging process referred to previously (Maschi, Kwak, Ko, & Morrissey, 2012). Where do we house the elderly?In addition to caring for the medical issues that face our aging prison population, we must also consider their safety within the facility from being victims of other prisoners. The elderly posses a frailty that often turns them into prey for much younger, vigorous inmates. Often too older inmates become vulnerable to sexual assault as the hands of predators due to their lack of self-defense skills. Especially elderly inmates suffering from medical conditions such as dementia.

Degenerative bone disorders and arthritis limit the mobility of inmates in the decision to house inmates on or around steps or stairs. Housing inmates in many states has also become a chore as original designs for housing is for one inmate per cell. Due to overcrowding in many facilities, two or more inmates are housed in cells for one inmate. This proves exponentially more difficult when housing older inmates. It is simply unfeasible for the elderly to bunked with youthful offenders. Attempts to house the aged inmate in lower bunks, lower tiers, and when possible by themselves is the best options left for correctional administration. The optimal situation for many states has been to house the elderly within their own units or buildings. This proves to be the most successful in almost every situation. This housing assignment typically allows the inmates to have a sense of safety from violence and allows correctional staff to provide the most adequate services needed for their situations, such as administration of counseling and programs designed for older inmates. Correctional staff can utilize these inmates in special situations and design specific activities for these housing units. Violence with the Elderly While IncarceratedViolence within a prison setting is not surprising at any level. But many factors go into examining violence against the elderly within a prison. First, we must look at the most overwhelming and clear problem in the identification of handling this violence. An elderly or older inmate is just not physically able to withstand the abuse of those twenty, thirty, or even forty years younger. As previously discussed, the older inmate ages at a much higher rate than those aging in the community (Hollenbeak, Schaefer, Penrod, Loeb, & Smith, 2015). So, by using this analysis, an inmate sixty years of age would typically have the body of a seventy to seventy-five-year-old man. It would be absurd to believe that this male inmate could withstand the physical assault from an inmate 30 years of age. To believe that this older inmate could defend himself or his property within a prison setting would be naïve and foolish. Theft of commissary items, personal property, and other items are just a few of challenges facing correctional authorities. A separate issue to examine in the violence of the aging inmate population would be the sexual assault of these specific inmates.

Approximately one in twelve inmates with a mental disorder reported being sexually victimized by other inmates. In the same report one in thirty-three male inmates without a diagnosed mental disorder answered the same (Wolff, Blitz, & Shi, 2007). An aging inmate has very little control once they have been deemed to be physically unable to defend themselves. At times aged inmates have allowed themselves to be sexually assaulted to prevent further physical violence to occur. Special Programs for the Incarcerated ElderlyMany correctional institutions have found ways to assist in the aging process for the population of older inmate. They can range from specific exercise classes designed for wheelchair bound or mobility disabled individuals to diabetic and nutrition classes to assist in medical costs incurred by the states. Other states have done very little to accommodate the living situations for these individuals other than providing the minimal counseling and educational opportunities available to all inmates. In the State of Nevada, for instance, persons over the age of fifty created the Senior Structured Living Program (SSLP). The program allows inmates to participated in cognitive training, various forms of therapy, recreational programs and other activities designed specifically for the them. If a prisoner participates successfully they can receive work credit against their sentence (McCarthy, 2013). The State of Washington has created assisted-living units within their prison systems to aid in the program management of older inmates. Upon reaching the age of fifty, the age of the state’s definition of elderly, inmates can be segregated from the younger population and have opportunities for enhanced treatments. Recidivism RatesRecidivism rates in America studied from 2005 until 2010 by the Bureau for Justice Statistics show that 67.8% of released prisoners were arrested for a new crime within three years. 76.6% of prisoners were rearrested within five years of release (BJS, 2014). However older inmates are much less likely to reoffend. A federal study by the United States Sentencing Commission found that only 13.4% of older prisoners, over 65 years of age, reoffended. That is a staggering number compared to the 67.6% rate of offenders that were younger than 21 years of age (USSC Hunt, 2005). Study after study show that the aged inmate is less likely to reoffend once release from prison. Calculations and predictions into the future show that recidivism rates are being reduced across all platforms and ages. However, predictions are steady in the belief that paroling of the elderly inmate creates a substantially less risk of violent criminal activity upon them returning to the community. Many inmates incarcerated for long periods of time return to communities that have completely changed from the decades they entered prisons.

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