We urgently need to resource research and change practice in line with the evidence, writes Dr Bruce Stevens.
Older people are the fastest growing segment of the prison population.
There are many reasons for this including our ageing population and contributing factors such as mandatory minimum sentences (note the incarcerate rate in Northern Territory), longer sentences for serious crimes and the reluctance to release some offenders.
But how do we define being old? Generally this is defined 50 years or older (with 45 years for indigenous). This is not surprising since most in prison abuse alcohol and/or drugs, smoke, have poor diet and do not seek medical treatment. The result is bodies older than their years and an early onset of frailty, dementia and chronic conditions.
Older people in prison face many challenges. This includes the unsuitability of facilities for aged prisoners. Many prisons were built in the 19th century to ‘house’ younger offenders.
How does a person in a wheelchair get down stairs to enter the courtyard? How can he or she use a walking stick or frame when such objects might be considered potential weapons?
The issues continue with medical and mental health needs – naturally both are more prevalent inside. There is a need for age appropriate activities, when almost all programs target young offenders. Indeed, activity directors are often a soft target for staff cut backs. And there are difficulties associated with release and re-integration into society, especially with sex offenders (36 per cent of males over 50).
Victimisation is a problem. This is especially the case with sex offenders, who tend to be older when convicted and are among the most stigmatised people in our society. There have been reports of prisoners expecting payment to provide basic assistance to older offenders.
The picture, however, is not completely bleak. The 2015 report by NSW Justice, Old and inside: Managing offenders in custody talked about prisoners who had responsibility for common areas, called “sweepers”, generously supporting older prisoners.
In my literature review, which was sponsored by Aged Care Plus (Salvation Army) and assisted by Rebecca Alexander, examples of good practice were identified.
Modifications were made for the aged at Silverwater Women’s Correctional Centre including ramps and wider corridors.
The Kevin Waller Unit at Long Bay is an example of an integrated aged care unit. There is the Marlborough Unit at Port Philip Prison for intellectual disability.
And there are specialists who assist the incarcerated including optometry, podiatry, psychology, forensic psychiatry and geriatric physicians. However, demand generally outstrips supply of services. I have heard that New Zealand has programs for the aged in prison but unfortunately this has not been reported in journals.
There are encouraging signs from international services. In the UK there are examples of specialised units in prisons. In the US and Germany there are moves towards ‘nursing homes behind bars’ and palliative care. The True Grit program in Northern Nevada is a structured living program for the aged with healthy activities.
There is an urgent need to resource research, initiate pilot programs and evaluate and change practice in line with evidence-based research.
However, the real barrier is: who cares?
Dr Bruce Stevens is a clinical psychologist and Wicking Chair of Ageing and Practical Theology at Charles Sturt University.
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I am a carer….my passion being dementia. I have often wondered how the elderly, behind bars are cared for. Thank you, i really enjoyed your article. If there is anything else i can read on this subject, i would love it, thank you
Glad to read this article as I tried to raise the issue (without success) of this population group within my last workplace which has a large correctional centre within its boundary. I am curious about segments of older adults who, for several and complex reasons, are older at younger ages. There are sub issues within this population such as the impact of drugs, disability, chronic health and so on.
I look forward to reading more about programs, practices and research in this population group, as I am in sub-groups with inequitable access to aged care.
Sorry there are no votes or much empathy for anyone in prison, let alone the elderly. Being a senior and behind bars would not be much fun. Having worked in Juvenile Justice and both Men’s and Women’s Prisons in Victoria. JJ would get funding more easily than the others or that’s the way it seems.
Have worked with many women behind bars over 50, life is tougher than it is for men the same age. Access to heath professionals is not easy. I remember one woman who was not very popular with the inmates or the Officer’s, she waited months to get in to see a Dentist, when she was obviously in a lot of discomfort. She was simply overlooked and it becomes apparent fairly quickly there is no point in complaining.
We must remember the subculture in jails is very different to be being outside. People need to be fast learners or suffer the consequences. It is not easy to make friends and trusting and exposing vulnerability is a problem. Chances are it will be used against you. The lack of services or empathy is simply something one has to learn to live with.
A lot of work needs to be done in this area, sadly I doubt it will be.