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Options for the elderly
By Sarah Etter, News Reporter
Published: 06/26/2006

Jails and prisons continue to deal with overcrowding, but corrections officials are now facing the additional burden of managing aging inmates. As an overwhelming number of offenders make their way through the nation's correctional systems, officials are struggling to field the health care costs associated with a bulging population created by the incarcerated elderly.

“As the inmate population gets older and sicker, it's definitely putting a strain on our budgets to deal with them,” says Anthony Batson, Assistant Warden of Operations for Louisiana Department of Corrections' Forcht-Wade Correctional Facility. “Ambulance trips are not budgeted, medications are not budgeted; you can do projections, but you cannot see how it will affect your annual budget until it happens.”

And the effect on the industry's budgets is anything but small. The typical cost for an inmate is around $33 per day, but for inmates over the age of 55, the cost triples to about $100 per day. Since people age faster behind bars, the price of caring for these inmates continues to increase.

“In prison, doctors add about ten years onto the calendar age of an inmate to estimate their biological age,” says Corey Weinstein, a medical consultant for corrections and for the human rights organization California Prison Focus. “Physicians use this mark, not only because prison enhances aging conditions but also because those who wind up in prison have often lived lives that involve malnutrition and drug and substance abuse.”

To address the age factor, states nationwide are building facilities to house geriatric inmates, contemplating early release for elderly inmates, and establishing hospice programs for the terminally ill.

Batson estimates that roughly 35 percent of the Louisiana's inmate population is considered elderly.

“This is an enormous problem for us,” Batson says. “We're dealing with an influx of older inmates. They present very expensive medical problems to treat. We're dealing with elderly inmates who have cancer, HIV and hepatitis C. Medical costs are skyrocketing.”

Officials hope to relieve some of this pressure for facilities that house a large majority of life-term offenders, like the Angola State Penitentiary, with the July 1 opening of a 50-bed geriatric unit at Forcht Wade. The facility will provide a hospice program and care for the aging population. It was initially slated to open last January, but Hurricane Katrina delayed the opening.

“Our budget was reinstated for the ForchtWade addition, and we were very pleased about that,” says Batson. “We have so many inmates in hospice programs right now, and we're hoping that we can help. But this is not a permanent solution. It won't take long to fill this facility.”

Batson adds that Forcht Wade has even opened its geriatric unit, but it is already backlogged.

Elderly inmates afflicted with terminal illnesses also pose a challenge. Since courts have affirmed that corrections systems are responsible for end-of-life care, Oregon officials decided to provide comfort for terminally ill inmates, and have developed a specialized jail hospice program.

“We started Corrections Health in 1990. We contracted with a local hospital for hospice care. It's just the humanitarian thing to do for someone who is going to die in custody,” says Lynne Wiley, Health Services Administrator for Multnomah County's health department and Sheriff's Department.

At the Sheriff's Office, the hospice program's extra comforts include Bibles, walkers, and hospital-issued beds.

“If you want to establish a hospice program, you just have to make sure you address the security aspect,” Wiley says. “Ensure that all officials are on board with the program. Don't be afraid to reach out to the community for resources. Some hospice programs will even take care of the medications needed for offenders. They will also provide a social worker and a bath aid, which is a huge help for corrections staff.”

States like Pennsylvania are taking a legislative to approach to their geriatric issues. Recently, lawmakers considered releasing aging offenders. A 47-person advisory board is currently working on a report, to be released in early July, about the issue and is recommending an elderly inmate release system.

However, families of the victims oppose early release, saying that offenders should serve their full sentences. Some experts point respond to this with the issue of  “criminal menopause”, a term based on the idea that after a certain age, inmates will no longer feel the need to participate in criminal activity. Weinstein believes criminal menopause has merit and the state is on the right track.

“We should have fewer hospice programs and instead let these people out of prison. These are disabled and sick people who are within a year or two of their lives ending. Some of them are physically incapable of committing crimes, but we keep them behind bars anyway,” Weinstein says.

As the debate about how to handle elderly inmates heats up, corrections officials continue to consider hospice programs, early release programs, and specialized geriatric facilities to ensure that aging offenders get the help they need.

“I think everyone is aware that this is a big problem,” says Batson. “Everyone is working together to find a solution that works both financially and public safety wise. We work every day to come up with a solution to this and it's just not easy.”



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