Published online by Cambridge University Press: 17 November 2017
The rise in the number of older prisoners in many nations has been described as a correctional “ageing crisis” which poses an urgent financial, medical and programmatic challenge for correctional health-care systems. In 2016, the International Committee of the Red Cross hosted a conference entitled “Ageing and Imprisonment: Identifying the Needs of Older Prisoners” to discuss the institutional, legal and health-care needs of incarcerated older adults, and the approaches some correctional facilities have taken to meeting these needs. This article describes some of the challenges facing correctional systems tasked with providing health care to older adults, highlights some strategies to improve their medical care, and identifies areas in need of reform. It draws principally on research and examples from the United States to offer insights and recommendations that may be considered in other systems as well.
1 He, Wan, Goodkind, Daniel and Kowal, Paul, An Aging World: 2015, US Census Bureau, International Population Reports, P95/16-1, US Government Publishing Office, Washington, DC, 2016 Google Scholar.
2 United Nations (UN) Office on Drugs and Crime, Handbook on Prisoners with Special Needs, New York, 2009 Google Scholar, available at: www.unodc.org/pdf/criminal_justice/Handbook_on_Prisoners_with_Special_Needs.pdf (all internet references were accessed in May 2017).
5 Bureau of Justice Statistics (BJS), Prisoners Series: 1990–2010, US Department of Justice (DoJ), Office of Justice Programs (OJP), Washington, DC, available at: http://bjs.ojp.usdoj.gov/index.cfm?ty=pbse&sid=40.
6 BJS, Aging of the State Prison Population, 1993–2013, DoJ, OJP, Washington, DC, May 2016, available at: www.bjs.gov/content/pub/pdf/aspp9313_Sum.pdf.
7 Office of the Inspector General, The Impact of an Aging Inmate Population on the Federal Bureau of Prisons, DoJ, Washington, DC, February 2016, available at: https://oig.justice.gov/reports/2015/e1505.pdf.
8 BJS, above note 6; BJS, Prisoners in 2015, DoJ, OJP, Washington, DC, December 2016, available at: www.bjs.gov/content/pub/pdf/p15_sum.pdf.
9 B. A. Williams et al., above note 4.
10 Aday, Ron H., Aging Prisoners: Crisis in American Corrections, Praeger, Westport, CT, 2003 Google Scholar.
13 Maschi, Tina, Viola, Deborah and Sun, Fei, “The High Cost of the International Aging Prisoner Crisis: Well-Being as the Common Denominator for Action”, The Gerontologist, Vol. 53, No. 4, 2013 CrossRefGoogle Scholar; Ahalt, Cyrus, Trestmann, Robert L., Rich, Josiah D., Greifinger, Robert B. and Williams, Brie A., “Paying the Price: The Pressing Need for Quality, Cost and Outcomes Data to Improve Correctional Healthcare for Older Prisoners”, Journal of the American Geriatrics Society, Vol. 61, No. 11, 2013 CrossRefGoogle ScholarPubMed.
17 Office of the Inspector General, above note 7.
21 Andrew Coyle, “Standards in Prison Health: The Prisoner as a Patient”, Prisons and Health, WHO, 2014, available at: www.euro.who.int/__data/assets/pdf_file/0008/249191/Prisons-and-Health,-2-Standards-in-prison-health-the-prisoner-as-a-patient.pdf?ua=1; citing, e.g., European Court of Human Rights (ECtHR), Mouisel v. France, Application No. 67263/01, 14 November 2002; ECtHR, Hénaf v. France, Application No. 65436/01, 27 November 2003; ECtHR, McGlinchey and Others v. United Kingdom, Judgment, Application No. 50390/99, 29 April 2003.
22 A. Coyle, above note 21.
23 US Supreme Court, Estelle v. Gamble, Case No. 75-929, Judgment, 30 November 1976.
25 Williams, Brie A., Chang, Anna, Ahalt, Cyrus, Chen, Helen, Conant, Rebecca, Landefeld, C. Seth, Ritchie, Christine and Yukawa, Michi, Current Diagnosis and Treatment: Geriatrics, 2nd ed., McGraw-Hill Professional, New York, 2014 Google Scholar.
28 Williams, Brie A., Lindquist, Karla, Sudore, Rebecca L., Strupp, Heidi M., Willmott, Donna J. and Walter, Louise C., “Being Old and Doing Time: Functional Impairment and Adverse Experiences of Geriatric Female Prisoners”, Journal of the American Geriatric Society, Vol. 54, No. 4, 2006 CrossRefGoogle ScholarPubMed.
31 Loeb, Susan J. and AbuDagga, Azza, “Health-Related Research on Older Inmates: An Integrative Review”, Research in Nursing and Health, Vol. 29, No. 6, 2006 CrossRefGoogle Scholar; Baillargeon, Jacques, Black, Sandra A., Pulvino, John and Dunn, Kim, “The Disease Profile of Texas Prison Inmates”, Annals of Epidemiology, Vol. 10, No. 2, 2000 CrossRefGoogle ScholarPubMed.
36 Landefeld, C. Seth, Palmer, Robert M., Johnson, Mary Anne, Johnston, C. Bree and Lyons, William L., Current Geriatric Diagnosis and Treatment, McGraw-Hill, New York, 2004 Google Scholar.
38 C. S. Landefeld et al., above note 36.
39 Tinetti, Mary E. and Kumar, Chandrika, “The Patient Who Falls: ‘It's Always a Trade-Off’”, Journal of the American Medical Association, Vol. 303, No. 3, 2010 Google Scholar.
44 B. A. Williams et al., above note 25, pp. 123–133.
45 WHO, The Epidemiology and Impact of Dementia, Geneva, 2015 Google Scholar, available at: www.who.int/mental_health/neurology/dementia/dementia_thematicbrief_epidemiology.pdf.
46 Simmons, B. Brent, Hartmann, Brett and DeJoseph, Daniel, “Evaluation of Suspected Dementia”, American Family Physician, Vol. 15, No. 84, 2011 Google Scholar.
48 B. A. Williams et al., above note 4.
49 R. H. Aday, above note 10.
50 Williams, Brie A., Baillargeon, Jacques, Lindquist, Karla, Walter, Louise C., Covinsky, Kenneth E., Whitson, Heather E. and Steinman, Michael A., “Medication Prescribing Practices for Older Prisoners in the Texas Prison System”, American Journal of Public Health, Vol. 100, No. 4, 2010 CrossRefGoogle ScholarPubMed.
51 Williams, Brie A., Lindquist, Karla, Hill, Terry, Baillargeon, Jacques, Mellow, Jeff, Greifinger, Robert and Walter, Louise C., “Caregiving Behind Bars: Correctional Officer Reports of Disability in Geriatric Prisoners”, Journal of the American Geriatric Society, Vol. 57, No. 7, 2009 CrossRefGoogle ScholarPubMed.
52 B. A. Williams et al., above note 28.
54 B. A. Williams et al., above note 4.
56 B. A. Williams et al., above note 28.
57 Walling, Anne D. and Dickson, Gretchen M., “Hearing Loss in Older Adults”, American Family Physician, Vol. 85, No. 12, 2012 Google ScholarPubMed, available at: www.aafp.org/afp/2012/0615/p1150.html; Allen L. Pelletier, Ledy Rojas-Roldan and Janis Coffin, “Vision Loss in Older Adults”, American Family Physician, Vol. 94, No. 3, 2016, available at: www.aafp.org/afp/2016/0801/p219.html.
58 Hill, Terry, Williams, Brie A., Cobe, Gail and Lindquist, Karla, Aging Inmates: Challenges for Healthcare and Custody, Report, Lumetra, San Francisco, CA, 2006 Google Scholar, available at: www.cphcs.ca.gov/docs/resources/AgingInmatesByLumetra0506.pdf.
60 Weinstein, Barbara E., Sirow, Lynn W. and Moser, Sarah, “Relating Hearing Aid Use to Social and Emotional Loneliness in Older Adults”, American Journal of Audiology, Vol. 25, No. 1, 2016 Google Scholar; Boi, Raffaella, Racca, Luca, Cavallero, Antonio, Carpaneto, Veronica, Dall'Acqua, Matteo Racca Francesca, Ricchetti, Michele, Santelli, Alida and Odetti, Patrizio, “Hearing Loss and Depressive Symptoms in Elderly Patients”, Geriatrics & Gerontology International, Vol. 12, No. 3, 2012 CrossRefGoogle ScholarPubMed.
61 Williams, Brie A., Ahalt, Cyrus and Aronson, Louise, “Aging Correctional Populations”, in Bruinsma, Gerben and Weisburd, David (eds), Encyclopedia of Criminology and Criminal Justice, Springer, New York, 2014 Google Scholar.
62 Williams, Cynthia M., “Using Medications Appropriately in Older Adults”, American Family Physician, Vol. 66, No. 10, 2002 Google Scholar.
64 S. K. Inouye et al., above note 37.
65 Scott, Ian A., Hilmer, Sarah N., Reeve, Emily, Potter, Kathleen, Le Couteur, David, Rigby, Deborah, Gnjidic, Danijela, Del Mar, Christopher B., Roughead, Elizabeth E., Page, Amy, Jansen, Jesse and Martin, Jennifer H., “Reducing Inappropriate Polypharmacy: The Process of Deprescribing”, JAMA Internal Medicine, Vol. 175, No. 5, 2015 CrossRefGoogle ScholarPubMed; Steinman, Michael A., “Polypharmacy – Time to Get Beyond Numbers”, JAMA Internal Medicine, Vol. 176, No. 4, 2016 CrossRefGoogle ScholarPubMed.
66 B. A. Williams et al., above note 50.
69 B. A. Williams, C. Ahalt and L. Aronson, above note 71; Haugebrook, Sabrina, Zgoba, Kristen M. and Maschi, Tina, “Trauma, Stress, Health, and Mental Health Issues among Ethnically Diverse Older Adult Prisoners”, Journal of Correctional Health Care, Vol. 6, No. 3, 2010 Google Scholar.
73 Lisa C. Barry, Dorothy B. Wakefield, Robert L. Trestman and Yeates Conwell, “Disability in Prison Activities of Daily Living and Likelihood of Depression and Suicidal Ideation in Older Prisoners”, International Journal of Geriatric Psychiatry, January 2016.
74 B. A. Williams et al., above note 50.
76 The Sentencing Project, “Incarcerated Women and Girls”, Fact Sheet, Washington, DC, 2015, available at: www.sentencingproject.org/wp-content/uploads/2016/02/Incarcerated-Women-and-Girls.pdf.
77 BJS, above note 8.
78 UN Office on Drugs and Crime, Handbook on Women and Imprisonment, 2nd ed., New York, 2014, available at: www.unodc.org/documents/justice-and-prison-reform/women_and_imprisonment_-_2nd_edition.pdf.
81 J. Baillargeon et al., above note 35.
82 Natasha A. Frost, Judith Greene and Kevin Pranis, Hard Hit: The Growth of Imprisonment of Women, 1977–2004, Women's Prison Association, New York, 2006, available at: http://csdp.org/research/HardHitReport4.pdf.
84 Parvez, Farah, Katyal, Monica, Alper, Howard, Leibowitz, Ruth and Venters, Homer, “Female Sex Workers Incarcerated in New York City Jails: Prevalence of Sexually Transmitted Infections and Associated Risk Behaviors”, Sexually Transmitted Infections, Vol. 89, No. 4, 2013 CrossRefGoogle ScholarPubMed.
85 BJS, above note 8.
86 Covington, Stephanie S. and Bloom, Barbara E., “Gendered Justice: Women in the Criminal Justice System”, in Bloom, Barbara E. (ed.), Gendered Justice: Addressing Female Offenders, Carolina Academic Press, Durham, NC, 2003 Google Scholar.
87 C. S. Landefeld et al., above note 36.
88 Anne C. Looker, Lori G. Borrud, Bess Dawson-Hughhes, John A. Shepherd and Nicole C. Wright, “Osteoporosis or Low Bone Mass at the Femur Neck or Lumbar Spine in Older Adults: United States, 2005–2008”, NCHS Data Brief, No. 93, National Center for Health Statistics, Hyattsville, MD, 2012.
89 B. A. Williams et al., above note 28.
90 B. Jayne Anno, Camila Graham, James E. Lawrence and Ronald Shansky, “Correctional Health Care: Addressing the Needs of Elderly, Chronically Ill, and Terminally Ill Inmates”, Criminal Justice Institute, Middletown, CT, 2004; Lindquist, Christine H. and Lindquist, Charles A., “Health Behind Bars: Utilization and Evaluation of Medical Care among Jail Inmates”, Journal of Community Health, Vol. 24, No. 4, 1999 CrossRefGoogle ScholarPubMed.
92 B. A. Williams et al., above note 28.
94 UN Office on Drugs and Crime, above note 2.
95 B. A. Williams et al., above note 4.
96 Alan Blinder, “In U.S. Jails, a Constitutional Clash over Air-Conditioning”, New York Times, 15 August 2016, available at: www.nytimes.com/2016/08/16/us/in-us-jails-a-constitutional-clash-over-air-conditioning.html?_r=0.
97 Human Rights Watch, Old Behind Bars: The Aging Prison Population in the United States, 2012, available at: www.hrw.org/sites/default/files/reports/usprisons0112webwcover_0_0.pdf.
99 B. A. Williams et al., above note 28.
101 T. Hill et al., above note 58.
102 Office of the Inspector General, above note 7.
104 Human Rights Watch, above note 97.
107 UN Office on Drugs and Crime, above note 2; Human Rights Watch, above note 97.
108 Michael Hill, “New York Prison Creates Dementia Unit”, Washington Post, 29 May 2007, available at: www.washingtonpost.com/wp-dyn/content/article/2007/05/29/AR2007052900208.html; Maura Ewing, “When Prisons Need to Be More Like Prison Nursing Homes”, Marshall Project, 27 August 2015, available at: www.themarshallproject.org/2015/08/27/when-prisons-need-to-be-more-like-nursing-homes#.3EYvevSg9.
109 B. A. Williams et al., above note 4.
110 UN General Assembly, The United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules), A/RES/70/175, 8 January 2016, available at: www.unodc.org/documents/justice-and-prison-reform/GA-RESOLUTION/E_ebook.pdf.
111 Metcalf, Hope, Morgan, Jamelia, Oliker-Friedland, Samuel, Resnik, Judith, Spiegel, Julia, Tae, Haran, Work, Alyssa Roxanne and Holbrook, Brian, Administrative Segregation, Degrees of Isolation, and Incarceration: A National Overview of State and Federal Correctional Policies, Yale Law School, Public Law Working Paper, 2013 Google Scholar.
113 M. F. Holick, above note 41; C. M. Perissinotto, I. Stijacic Cenzer and K. E. Covinsky, above note 75; Gillespie, L. D., Robertson, M., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M. and Lamb, S. E., “Interventions for Preventing Falls in Older People Living in the Community”, Cochrane Database of Systematic Review, Vol. 2, 2009 CrossRefGoogle Scholar.
114 Hawkley, Louise C., Thisted, Ronald A. and Cacioppo, John T., “Loneliness Predicts Reduced Physical Activity: Cross-Sectional and Longitudinal Analyses”, Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, Vol. 28, No. 3, 2009 CrossRefGoogle Scholar; Cacioppo, John T., Huges, Mary Elizabeth, Waite, Linda J. and Thisted, Ronald, “Loneliness as a Specific Risk Factor for Depressive Symptoms: Cross-Sectional and Longitudinal Analyses”, Psychology and Aging, Vol. 21, No. 1, 2006 CrossRefGoogle ScholarPubMed; Larson, Eric B., Wang, Li, Bowen, James D., McCormick, Wayne C., Teri, Linda, Crane, Paul and Kukull, Walter, “Exercise Is Associated with Reduced Risk for Incident Dementia Among Persons 65 Years of Age and Older”, Annals of Internal Medicine, Vol. 144, No. 2, 2006 CrossRefGoogle ScholarPubMed.
115 C. M. Perissinotto, I. Stijacic Cenzer and K. E. Covinsky, above note 75; Teguo, M Tabue, Simo-Tabue, N., Stoykova, R., Meillon, C., Cogne, M., Amiéva, H. and Dartiques, J. F., “Feelings of Loneliness and Living Alone as Predictors of Mortality in the Elderly: The PAQUID Study”, Psychosomatic Medicine, Vol. 78, No. 8, 2016 Google Scholar.
116 Bolano, Marielle, Ahalt, Cyrus, Ritchie, Christine, Cenzer, Irena Stijacic and Williams, Brie A., “Detained and Distressed: Persistent Distressing Symptoms in a Population of Older Jail Inmates”, Journal of the American Geriatrics Society, Vol. 64, No. 11, 2016 CrossRefGoogle Scholar; Williams, Brie A., Ahalt, Cyrus, Cenzer, Irena Stijacic, Smith, Alexander K., Goldenson, Joe and Ritchie, Christine S., “Pain Behind Bars: the Epidemiology of Pain in Older Jail Inmates in a County Jail”, Journal of Palliative Medicine, Vol. 17, No. 12, 2014 CrossRefGoogle Scholar.
117 B. A. Williams et al., above note 4.
118 Human Rights Watch, The Answer Is No: Too Little Compassion Release in US Federal Prisons, 30 November 2012, available at: www.hrw.org/report/2012/11/30/answer-no/too-little-compassionate-release-us-federal-prisons; Office of the Inspector General, above note 7.
119 Ashley Nellis and Ryan S. King, No Exit: The Expanding Use of Life Sentences in America, Report, The Sentencing Project, Washington, DC, 2009, available at: www.sentencingproject.org/wp-content/uploads/2016/01/No-Exit-The-Expanding-Use-of-Life-Sentences-in-America.pdf.
120 Brie A. Williams, “Testimony of Brie Williams, MD, MS”, United States Sentencing Commission: Public Hearing on Compassionate Release and Conditions of Supervision, 17 February 2016, available at: www.ussc.gov/sites/default/files/pdf/amendment-process/public-hearings-and-meetings/20160217/williams.pdf.
122 Goldstein, Nathan E. and Morrison, R. Sean, Evidence Based Practice of Palliative Medicine, 1st ed., Elsevier, Amsterdam, 2013 Google Scholar.
124 B. A. Williams, above note 120.
128 N. E. Goldstein and R. S. Morrison, above note 122.
131 National Hospice and Palliative Care Organization, Quality Guidelines for Hospice and End-of-Life Care in Correctional Settings, 2009, available at: www.nhpco.org/sites/default/files/public/Access/Corrections/CorrectionsQualityGuidelines.pdf; National Prison Hospice Association, Prison Hospice Operational Guidelines, 1998, available at: http://prisonhospice.files.wordpress.com/2011/11/prison-hospice-guidelines-revised3.doc.
132 Writing, Kevin N. and Bronstein, Laura, “Creating Decent Prisons: A Serendipitous Finding about Prison Hospice”, Journal of Offender Rehabilitation, Vol. 44, No. 4, 2008 Google Scholar.
133 H. C. Hoffman and G. E. Dickinson, above note 129.
134 Cloyes, Kristin G., Rosenkranz, Susan J., Berry, Patricia H., Supiano, Katherine P., Routt, Meghan, Shannon-Dorcy, Kathleen and Llanque, Sarah M., “Essential Elements of an Effective and Sustainable Prison Hospice Program”, American Journal of Hospice and Palliative Care, Vol. 33, No. 4, 2016 CrossRefGoogle Scholar; M. Stensland and S. Sanders, above note 125.
140 Office of the Inspector General, The Federal Bureau of Prisons' Compassionate Release Program, US Department of Justice, Washington, DC, 2013, available at: https://oig.justice.gov/reports/2013/e1306.pdf.
141 Office of the Inspector General, above note 7.
142 Office of the Inspector General, above note 140.
143 B. A. Williams et al., above note 137.
144 B. A. Williams, above note 120.
146 I. A. Binswanger et al., above note 91.
148 Human Rights Watch, above note 97.
149 Frank, Joseph W., Linder, Jeffrey A., Becker, William C., Fiellin, David A. and Wang, Emily A., “Increased Hospital and Emergency Department Utilization by Individuals with Recent Criminal Justice Involvement: Results of a National Survey”, Journal of General Internal Medicine, Vol. 29, No. 9, 2014 CrossRefGoogle ScholarPubMed.
152 Centers for Disease Control and Prevention, Project START, Best Evidence – Risk Reduction, Atlanta, Georgia, September 2015, available at: www.cdc.gov/hiv/pdf/research/interventionresearch/compendium/cdc-hiv-project_start_best_rr.pdf; Wolitski, Richard J. and Project START Writing Group, “Relative Efficacy of a Multisession Sexual Risk-Reduction Intervention for Young Men Released From Prisons in 4 States”, American Journal of Public Health, Vol. 96, No. 10, 2006 CrossRefGoogle ScholarPubMed.
154 Christine Vestal, “For Aging Inmates, Care Outside Prison Walls”, Pew Charitable Trusts, 12 August 2014, available at: www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2014/08/12/for-aging-inmates-care-outside-prison-walls.
155 M. Ewing, above note 108.
156 B. A. Williams et al., above note 4; House of Commons Justice Committee, Older Prisoners: Fifth Report of Session 2013–14, House of Commons, London, 2013 Google Scholar, available at: www.parliament.uk/documents/commons-committees/justice/older-prisoners.pdf.
157 Ahalt, Cyrus, Binswanger, Ingrid A., Steinman, Michael, Tulsky, Jacqueline and Williams, Brie A., “Confined to Ignorance: The Absence of Prisoner Information from Nationally Representative Health Data Sets”, Journal of General Internal Medicine, Vol. 27, No. 2, 2012 CrossRefGoogle ScholarPubMed.
158 T. E. Quill and A. P. Abernethy, above note 123.
159 Meera Sheffrin, Cyrus Ahalt, Irena Stijacic Cenzer and Brie A. Williams, “Geriatrics in Jail: Educating Professionals to Improve the Care of Older Inmates”, presented at the American Geriatrics Society Annual Conference, Long Beach, CA, 2016.
160 Chun, Audrey Ed, Geriatric Care by Design: A Clinician's Handbook to Meet the Needs of Older Adults Through Environmental and Practice Redesign, 1st ed., American Medical Association, 2011 Google Scholar.
161 Saunders, Lynn, “Older Offenders: The Challenge of Providing Services to Those Aging in Prison”, Prison Services Journal, No. 208, 2013 Google Scholar.
163 Office of National Drug Control Policy, “Alternatives to Incarceration”, The White House, Washington, DC, available at: https://obamawhitehouse.archives.gov/ondcp/alternatives-to-incarceration.
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