Special populations in corrections: Elderly inmates

There is a saying in life: Time marches on. You cannot stop the clock. Senior citizens understand this more clearly than most people. Not only do many of us want to “hang around” as long as we can, but we also strive to live our lives in the most healthy and productive ways that we can.

The truth is, getting older is not easy. Physically, our bodies change, as aches and pains become more noticeable. We visit our doctors more often and our eyesight and hearing both tend to get worse. We need to take more prescription medications and live in fear of hearing bad news from the doctor.

We feel the mental effects of aging as well. If we’re fortunate to be surrounded by family and friends, we embrace aging, accept it, and live in a way that sets an example for younger folks. We enjoy ourselves, trying to make every day a good day. This helps to keep stress and anxiety at bay. Some days we feel great, and on other days we feel every year of our lives.

For those spending their post-retirement “golden” years confined inside a corrections facility, the natural aging process is much more difficult. Most people assume corrections facilities are filled exclusively with young offenders — teenage delinquents, gang members and younger career criminals. We read of violent offenders in rough facilities. However, there is another segment of that population: the older offender.

When trainers discuss special populations such as the LGTBQ+ community, juvenile/youthful offenders, females, the mentally ill, ethnic minorities and foreign-born persons, they often forget about elderly offenders. As a correctional officer (CO), you are bound to find older offenders in your units. To properly supervise them, you must know some things about the problems they experience while in confinement.

Imagine if you were over age 55, pushing 60 or older. For whatever reason, you find yourself in jail or sentenced to prison. Those aches, pains and physical ailments may be tougher to deal with in a correctional facility. The mental strain, fear and anxiety may make life inside very tough — possibly even a “living hell.”

This article will discuss elderly inmates, giving advice on how to deal with them as a CO. To make it simple, we are defining “older offender” as an incarcerated person who is age 55 and older. The goals are:

• Provide information on the scope of the incarceration of older offenders.
• Discuss what problems older offenders have while doing time, including physical and mental health challenges.
• Identify several things COs can do to safely supervise older offenders.
• Give advice on how to manage older offenders with dementia.

The scope of the problem

People enter jails and prisons from all walks of life, all races, ethnic groups, genders and ages. According to the Bureau of Justice Statistics, at the end of 2021, 178,200 inmates ages 55 and older were incarcerated in U.S. state and federal prisons. This represented a 7% increase in the number of older inmates at the end of 2020, which was 166,600.

Jails are seeing this trend as well. In 2020, the number of local jail inmates ages 65 or older was 7,400. A year later, in 2021, the number had increased by 27% to 9,400. Inmates aged 55 to 64 increased from 33,100 in 2020 to 40,700 in 2021 — a jump of 23%. In 2021, 8% of the nation’s jail population was age 55 or older.

Every CO reading this article has encountered older inmates. And you probably have asked why older people are being incarcerated at higher rates. After all, by the time a person reaches his or her mid-50s, their thoughts are supposed to be of retirement, family, and comfort, right? However, there are several reasons we are seeing so many older offenders incarcerated. According to the Prison Policy Initiative, these reasons include:

• Mandatory minimum sentencing and increased sentence lengths.
• “Tough on crime” sentencing statutes.
• Three strikes laws: Longer sentences for offenders convicted of three felonies.
• “Truth in sentencing” policies: Offender must serve at least 85% of their sentence before becoming eligible for parole consideration.
• Abolishing parole in many states.
• Less time earned for good conduct.

While some offenders commit crimes and are adjudicated at an older age, many elderly inmates were convicted when they were younger. These offenders may enter corrections facilities in their 20s or 30s. Their sentences may be so long that they will be incarcerated for most if not all their lives. And when that happens, they will grow older and die inside a correctional facility.

When we see a youth convicted of homicide and sentenced to life without the possibility of parole, they will eventually become an elderly inmate. Those convicted of multiple crimes with sentences running consecutively will also spend a great deal of their life in confinement. In a prison, COs will see inmates age. Inside a jail, on the other hand, the booking officer may process in an older offender arrested for driving while intoxicated, assault, sex offenses, and so on. Older offenders are throughout the system.

Researchers have generally separated older incarcerated offenders into three groups. The first group, as mentioned above, includes offenders who have been given long prison sentences at a young age and serve a long time inside. The second group is comprised of offenders who commit and are convicted of crimes in their later years. The third group involves offenders described as “aging recidivists,” who go into the correctional system and get released after serving sentences, over and over. These groups of older inmates experience incarceration in different ways and at different times in their lives. However, there is one thing that ties all of them together: the stress of incarceration.

Older offenders: Problems doing time

Think of the older relatives that you have. Some prefer peace and quiet. Many think the house is cold and are constantly turning up the heat. Some have gastric problems and have to be mindful about what they eat. Some like to go to bed early; others reduce their sleep and stay up late. As mentioned above, aging takes a toll on both the body and the mind. Research published in 2018 by the Osbourne Association showed that an incarcerated person aged 50 has a physiological age of a person 10 to 15 years older. Also, an estimated 40 to 60% of older inmates have mental health issues.

Incarcerating an older offender has a severely detrimental effect on the inmate’s lifespan. According to the Prison Policy Initiative, years of poor access to medical care, limited resources for older inmates and understaffing in correctional facilities can subtract two years off an offender’s life expectancy. It is also expensive; in 2013, the Federal Bureau of Prisons spent $881 million — 19% of its total budget — on the housing and care of older inmates.

Being incarcerated is stressful, and doing time as an older inmate is not easy. COs should keep in mind the following about older inmates:

• They may have medical conditions and physical handicaps that require wheelchairs, crutches, canes and other assistance. Correctional officers might think, justifiably, that an older inmate with a mobility assistance device may have it taken away and used as a weapon by predatory inmates. Such decisions should not be made lightly, but after careful consideration by a classification committee or a unit management team. Input is also definitely needed from the medical staff.
• They may require more trips to outside medical facilities, due to chronic medical conditions. Examples include treatment for heart conditions and kidney dialysis.
• They may require a lower bunk, due to dizzy spells, heart problems, shortness of breath and other medical conditions.
• They may have digestive and gastric issues that require a special diet.
• They may be victimized by predatory inmates.
• They may have difficulty getting along with younger, immature and violent inmates, which may lead them to request a change in housing assignment.
• They may benefit from programs and activities that give them a sense of purpose. They may want to help tutor younger inmates and assist programs staff. This can be good for their mental health.
• They may have chronic diseases (including terminal illnesses) associated with aging.
• They should not be misjudged and viewed as “nice old senior citizens.” Don’t forget these men and women have been charged with or convicted of breaking the law. They can still manipulate staff, so everyone must be on their guard.

Older offenders: Mental health

There is also the factor of mental health. Whether they’re incarcerated at an older age or growing older in a facility, older inmates are prone to seeing life passing them by. They miss birthdays, anniversaries and holidays. They miss their grandchildren, miss their graduations and weddings. They look out the window and see life on the outside, then turn around and see the tedious, routine and boring existence inside a facility. They may be in an overcrowded unit, being forced to live with people they would never associate with on the outside. They may prefer peace and quiet but find themselves housed in a unit with younger inmates who engage in loud horseplay. In my career, I’ve had older inmates ask me if they could be moved — one pleaded with me that he could not “take the noise” of the younger inmates. Others asked me for a quiet unit so they could feel safer.

For many reasons, depression is a real possibility with older offenders. Family members and loved ones may shun them, not visiting, declining phone calls and failing to write to them. Spouses may divorce them. These inmates spend their “golden years” confined to a housing unit, enduring regimentation, high walls and locked doors. Suicidal ideation and behavior are always a real possibility.

Managing elderly inmates

Correctional officers must take steps to manage older offenders safely, securely and humanely. Some tips include:

• Keep an eye on the environment of the unit, with particular attention to the older inmates’ safety. Are younger, more violent inmates harassing the older ones? Are they taking food off their trays or stealing their canteen items? Are they verbally harassing them? Take immediate action and be sure to inform shift supervisors and classification. Enforce the disciplinary rules. Break up groups of predatory inmates.
• Stay in frequent contact with older inmates and listen to their concerns. Look for signs of assault, such as bruises or bleeding. They may tell you that they are being victimized, are not getting their medications or are experiencing medical or mental health problems.
• Pay attention to what other inmates say. Many inmates watch out for each other. An inmate may clue you in about an older inmate in distress — mentally, physically, or as a result of the actions of other inmates.
• Make sure older inmates receive all medical, dental and mental health services. They require more assistive services than their younger peers.
• Get to know them. By doing so, you will be more likely to notice changes in behavior and appearance, which may be indicators of dementia and depression. Educate yourself on the reasons for depression in older inmates: life passing them by, terminal illnesses, health issues, abandonment and scorn from family. Always be on the lookout for suicidal behavior.
• Activity is good for older inmates. Encourage participation in programs and recreation.
• Remember safety and security: Even though an older inmate may remind you of an elderly aunt, uncle, parent or grandparent, they are still a criminal offender and may engage in manipulation, taking advantage of your sympathy.

Managing older offenders requires both awareness and communication. Correctional officers should be aware that:

• Older offenders may not move or react as quickly as younger inmates. Be patient.
• Older offenders may need more time for eating, bathing, using the toilet, walking and dressing.
• Older inmates may have difficulty hearing your commands or instructions.
• Older offenders may show signs of medical or mental difficulties, including dementia. Be sure to communicate clearly and promptly with the mental health and medical staff if you have suspicions about an older inmate’s health.
• Older offenders may worry about their family, spouse, loss of job, home or other serious matters.
• Older offenders who have been incarcerated a long time may experience fear, anxiety and depression when facing impending release. If you suspect this, inform the offender’s case manager or your facility’s social worker.

The problem of dementia

Older inmates may develop dementia, which causes memory loss and may lead to other symptoms such as depression and anxiety. According to the Mayo Clinic, dementia is a degenerative condition caused by “damage to or loss of nerve cells and their connections in the brain.” The most common cause of dementia is Alzheimer’s disease. No matter the cause, though, the person suffers brain atrophy and loss of brain function. Dementia can have serious impacts on multiple areas of an inmate’s life. Memory is affected. Offenders may forget how to tie shoes, make their bunk, brush their teeth or even use the toilet. An inmate may not be able to remember going to court earlier in the day but can tell you about where they went to high school 40 years ago.

Orientation is often affected by dementia. Inmates may not know where they are, what time it is, what month it is or why they are locked up. This disorientation can result in them entering the wrong unit, wandering into the wrong room or venturing inside restricted areas. Behavior may be affected as well, with the inmate becoming unpredictably angry, hostile, assaultive and agitated.

Even more importantly, inmates with dementia may have their judgment affected. They may get in arguments with other inmates and members of staff. They may give away food and canteen items. They may become paranoid and delusional. Special care must be taken to protect these inmates from others, and others from these inmates.

Advice for handling offenders with dementia

According to Timothy Manley, MSW, LCSW retired from the Forensic Unit at the Fairfax County, Virginia Adult Detention Center, correctional officers should be trained to practice the following when interacting with offenders with dementia:

• Make sure that you have the offender’s attention. Being in a quiet area may help, as does talking face-to-face in a relaxed tone. Dementia reduces the ability to listen and comprehend.
• Speak slowly and allow the inmate time to understand what you are saying. Ask the inmate to repeat an order or direction back to you. You may have to repeat yourself.
• Be patient. You may have just told the inmate a few minutes ago what you wanted them to do. People with dementia can forget instructions in a few minutes. You might have to re-introduce yourself and repeat commands multiple times.
• Use gestures. When escorting an inmate to the shower, he or she may blankly look at you. Make gestures like taking a shower. If you have to search an inmate, you may have to put your hands on the wall or pat your pockets to show him what you mean. Inmates with dementia often alternate between thinking clearly and not thinking clearly. Do your best not to embarrass them.

Summary

Doing time is stressful no matter what age an inmate is. Some offenders start out young and grow old inside the walls. Others get arrested at an older age or cycle in and out of institutions throughout their lives. Policies such as truth-in-sentencing laws, longer sentences and being tough on crime have resulted in more older offenders being incarcerated. With this population comes physical problems and mental issues, including dementia and depression. Correctional officers should be familiar with how to safely manage elderly inmates, including communication, notifying mental health and medical staffs, dealing with inmates suffering from dementia, and keeping older inmates safe from violent, predatory inmates. Remember — we all grow old and it is tougher if you are inside the walls.

References

1. Carson E, Carson A. “Prisoners in 2021-Statistical Tables.” Bureau of Justice Statistics, NCJ 305125, 12/2022. Accessed 3/22/2024 via https://bjs.ojp.gov/sites/g/files/xyckuh236/files/media/document/p21st.pdf
2. Cornelius G. The Correctional Officer: A Practical Guide, Third Edition. Durham, NC: Carolina Academic Press, 2017.
3. Cornelius. G. The High-Performance Correctional Facility: Lessons on Correctional Work, Leadership and Effectiveness. Kingston, New Jersey: Civic Research Institute, 2022.
4. Manley TP. In-Service Training Handout, Managing Special Populations. Managing Inmates with Dementia. July 27, 2014.
5. Stojkovic S. Elderly Prisoners: A Growing and Forgotten Group. Managing Special Populations in Jails and Prisons, Volume II. Kingston, NJ: Civic Research Institute, 2010.
6. Widra E. “The aging prison population: Causes, costs, and consequences.” Prison Policy Initiative. 8/2/2023. Accessed 3/22/2024 via https://www.prisonpolicy.org/blog/2023/08/02/aging/
7. Zhen Z. “Jail Inmates in 2021: Statistical Tables.” Bureau of Justice Statistics. NCJ 304888. 12/2022. Accessed 3/22/2024 via https://bjs.ojp.gov/sites/g/files/xyckuh236/files/media/document/ji21st.pdf