Current state
About 200,000 adults aged 55 and above are incarcerated in the United
States. From 1999 to 2015, the number of elderly incarcerated people in
federal and state prisons increased 264%, and the elderly inmate
population rose from 3% to 11%. Of the 17,00 men who are incarcerated
in WA state, roughly 9.8% are 55 and older. Some demographics are
overrepresented in elderly prison populations nationwide. 93% are male,
32% are African-American, 14% are Hispanic, and people from
impoverished backgrounds are also disproportionately represented.
Our increasingly aging prison populations are largely a result of the
passage of stricter sentencing laws: “tough on crime” policies, three strikes
legislation, mandatory minimums, and subsequent longer prison terms.
These policies have lead to prisoners incarcerated until old age and dying
in prison or shortly after their release.
Institutionalizing and providing care for elderly population comes at great
financial cost to society: $2.1 billion every year, 3 times more than
younger prisoners.
While incarcerated, many have a complex array of health, social service
and legal needs that often go unaddressed. Those with health issues -
mental and physical disabilities and terminal illnesses - are apart of the
special needs population. 7 out of 10 older inmates report some type of
medical problems. Incarcerated people have been shown to have an
accelerated aging process. A biologically 50 year old person in prison has
the health status of a 60 to 65 year old. This is a result of personal histories
as well as conditions of confinement.
Somewhat ironically, research suggests that adults aged 55 and older are
less likely to recidivate, posing a low risk to society.
What is currently being done for older and/or
disabled inmates at Twin Rivers Unit?
At TRU, Access Assistants are inmates employed as caregivers for elderly
and/or disabled inmates. Typically a single Access Assistant will be
assigned to an individual inmate in need of help. They are in charge of
watching over the older prisoners which often entails pushing those in
wheelchairs, making sure they eat, take care of their personal hygiene and
complete everyday tasks that might be difficult for older or disabled folks.
The screening process is a random computer generated list. Almost
anyone can become an access assistant under this system, which can cause
problems like elder abuse. Training is one-time and only a few hours.
Unfortunately at TRU, those who need Access Assistants cannot always
expect adequate care under the current system. As one TRU student
writes, “Wheelchair pushers regularly rush their charge towards a steel
door that is swinging shut, in an attempt to get there before the door slams
shut all of the way. This is extremely dangerous for the person in the
wheelchair… For men that need Access Assistants, having an unreliable
assistant is worse than not having one at all.”
In-prison solutions
Gold Coats
In order to ensure adequate care of elderly men, we propose using a
model from California that could be successful at TRU. The Gold Coats
program was started at the California Men’s Colony, a medium-security
prison, in the 1990s. There are Gold Coat programs at 11 California
prisons.
The Gold Coats program enables inmates with dementia and other age-
related impairments to be cared for by healthy inmates, who wear gold-
colored jackets and have good records. The Gold Coats assist patients with
daily tasks such as dressing, shaving, and showering. They escort patients
to the dining hall and doctor. They act as companions, protecting their
patients from being bullied, and make sure they get food at meal time.
The Gold Coats also lead exercise classes and activities designed to
stimulate memory. Often Gold Coats have better knowledge of impaired
prisoners’ conditions than many prison guards! There are limits to what
Gold Coats can do. They can file patients’ fingernails, for instance, but not
clip them because that constitutes a professional caregiving responsibility
that cannot legally be delegated to inmates. Gold Coats are paid a coveted
$50 a month.
TRU could revamp its Access Assistants program to align more with the
Gold Coats program in several ways:
• Selection process. Much like California, TRU should select
its Gold Coat candidates based on their behavior record. TRU’s
dog program requires an application process and does not
arbitrarily select candidates from a list. The same should be
applied to a job that is supposed to protect the health and
wellbeing of other inmates. A board of prisoners and staff could
potentially evaluate applicants to ensure that elderly inmates
would be in good hands.
• Training. Gold Coats in CA receive training on dementia by
the Alzheimer’s Association, and a similar nonprofit organization
could come into TRU to train Gold Coats.
• Compensation. Access Assistants are currently paid $55 a
month as a “Class 3” job, the same wage made by janitors at
TRU. We propose that Gold Coats be reclassified as “Class 2”
jobs because of the training and responsibility that are essential
to this job. Class 2 jobs can pay significantly more than $55 a
month. However, this proposal may not be currently feasible at
TRU.
Quality of Life through Virtual Reality
Another way to improve the lives of elderly prisoners could possibly be to
use V/R to let them experience walking through a park, waves lapping at
the beach, and other sensations that are sorely lacking during
incarceration. Wii Fit has also had wild success in elderly homes and could
potentially be at TRU.
Outside solutions
Compassionate release
What is it?
A process by which inmates in criminal justice systems may be eligible for
immediate early release on grounds of "particularly extraordinary or
compelling circumstances which could not reasonably have been foreseen
by the court at the time of sentencing".
Unlike parole, compassionate release is not based on a prisoner's behavior
or sentencing, but on medical or humanitarian changes in the prisoner's
situation.
In Washington, the compassionate release program is called
“Extraordinary Medical Placement”, covering elderly prisoners, terminally
ill prisoners and prisoners with serious medical conditions, as it is for most
states.
While it is an option that could release elderly prisoners, it is extremely
underused. From 2013 to 2017, the Bureau of Prisons only approved 6%
of the 5,400 applications received while 266 who requested died in
custody.
How can it be improved?
Granting Release and Compassion Effectively (GRACE) Act, a bill that
would make the federal Bureau of Prisons’ (BOP) process for reviewing
the “compassionate release” requests of qualifying elderly and ill federal
prisoners more efficient.
• More visible and regular notice of the availability of
compassionate release for prisoners.
• Permits not only the prisoner but staff and family members or
attorney to assist
• Expedited process for the terminally ill
• Opportunity for families to visit incarcerated loved one within 7
days of the prisoner’s diagnosis of terminal illness
• Permits appeals for denial of compassionate release in a district
court
Overall, reforming the process of compassionate release especially to deal
with the growing elderly prison population. As previously stated, older
people are less likely to recidivate which suggests that release would be a
strong option.
Reentry programs
Once released, elderly men face a host of barriers that must be addressed.
Just because it would be cheaper to release elderly and disabled men does
not mean that it is an inherently humane option. DOC must consider:
• Housing. People with felony convictions are barred from all
public housing, which is a problem for men who have just been
released and have little income. Connecticut has attempted to
create subsidized nursing homes with mixed success.
• Health and social security. Supplemental Security Income
and Social Security Disability are not available when
incarcerated. However, they can resume once released.
Medicare and Medicaid are not available in prison either, but
inmates can apply within 90 days of release so these services will
resume once they are out. Veterans are also eligible for health
care from the VA system upon release from prison.
• Food. Once released, people are also eligible for food stamps. If
convicted of a drug felony, Washington requires completion of a
drug or alcohol treatment program for eligibility.
• Transportation. There are many subsidized options available,
including Hyde Shuttles (door-to-door van service for older
adults and adults with disabilities throughout King County),
King County Metro Regional Reduced Fare Permit, Snoqualmie
Valley Transportation, Vets-Go (available to veterans in King
County), and Solid Ground Transportation (free rides on a fixed
route for people living on low incomes and those who access
health and human services in downtown Seattle).
• Social integration and transitioning. It is particularly
challenging to be released without any family or support
network and there are no easy solutions. Perhaps a state-
sponsored nursing home, or even classes like those promoted by
Aging King County, would help.
References
Age-Friendly Communities, Aging and Disability Services King County.
“Aging inmates prompt creation of assisted living center at Washington
prison,” Associated Press, August 16, 2010.
“Arrested? What Happens to Your Benefits If You Go to Jail or Prison?”
Bazelon Center for mental Health Law, 8/2006.
Belluck, Pam, “Life, With Dementia,” New York Times, 2/25/2012.
Ewing, Mara. “When Prisons Need to Be More Like Nursing Homes,”
8/7/2015.
Executive Order 16-05, “Building Safe and Strong Communities through
Successful Reentry,” Jay Inslee, 4/26/2016.
Kim, Catherine. “Introducing Inmates to Real Life via Virtual Reality,”
U.S. News, 3/15/2018.
Price, Mary. Everywhere and Nowhere: Compassionate Release in the
States.
“Prison Facilities,” WA State DOC, 12/31/2016.
What Is A Compassionate Release From Federal Prison?” Justin Paperny,
White Collar Advice, November 16, 2016.
“Wii Fit for Seniors,” Kristen Hicks.