Dementia Behind Bars

by Christine Kennard Health Professional

A combination of lengthy mandatory minimum prison sentences, increasing numbers of life sentences and reduced opportunities for parole means that prisons are having to care for much higher numbers of aging men and women. Human Rights Watch's report, published January 2012, highlights a number of issues caused by an aging prison population. In the US there are now 26,200 prisoners aged 65 or older. We know that age is a risk for Alzheimer's and some other types of dementia so this inevitably affects the prison population.

The Human Rights Watch report found the number of US state and federal prisoners age 65 or over grew at 94 times the rate of the total prison population between 2007 and 2010. The number of prisoners ages 65 or older increased by 63 percent as the total prison population increased by 0.7 percent. In 2010 8 percent of the prisoner population was 55 or older compared with 3 percent in 1995.

Although the statistics do change from State to State the overall picture is one of increasing numbers of older prisoners who require medical expenditure varying from 3 to 9 times higher than for other prisoners. In Georgia, for instance, incarcerated people over 65 years have average yearly medical costs of $5,801 compared with an average $961 for those under 65. Michigan has average estimated health costs that increased with prisoners age from $11,000 in the 55-59 age group to $40,000 for those aged 80 and over.

No matter what our personal opinions about crime and punishment we do have to remember that our societies are judged by, amongst other things, their humanity towards the frail and infirm and the care they receive. Another issue is the amount of pressure we choose to put on people whose job it is to look after others. Human Rights Watch are 'concerned that some elderly inmates are being unnecessarily held in prison despite the fact that their continued incarceration does little to serve the principal purposes of punishment: retribution, incapacitation, deterrence, and rehabilitation.'

Jamie Fellner, author of the of the report, 'Old Behaind Bars:The Ageing Prison Population in the United States', says that US correction officers 'now operate old age homes behind bars'. They are caring for people with dementia, the incontinent, prisoners with mobility, hearing and vision impairments and terminal illnesses. With security paramount, constrained institutional prison regimes, poor training in the needs of this group of prisoners and strict budgets, staff are limited in what they can offer to this highly vulnerable group.

In brief, Human Rights Watch urges State and Federal officials to:

  • Review custody and security rules and their implementation to ascertain which impose unnecessary hardship on older inmates and adopt appropriate modifications to those rules.

  • Consult with older incarcerated men and women directly.

  • Provide training for corrections officers working with older persons, including training in changing physical and mental conditions, and appropriate means of communication.

  • Monitor older prisoners to ensure they are not being victimized, and take the potential for victimization into consideration in their housing decisions.

  • Ensure that a senior official has the specific responsibility for monitoring, assessing, and pressing for improvements in confinement conditions for older prisoners.

Images and Summary and Recommendations of Old Behind Bars:The Aging Prison Population in the US

Christine Kennard
Meet Our Writer
Christine Kennard

Christine Kennard wrote about Alzheimer's for HealthCentral. She has many years of experience in private and public sector nursing care homes for people with dementia. She has worked in a variety of hospital, public and private health settings and specialized in community nursing. Christine is qualified in group analytic psychotherapy, is registered in general and mental health nursing and has a Masters degree.