Aging In Prison Analysis

Getting old is difficult even in the best of circumstances, but getting old in prison—now that is a real challenge. The United States has a growing need for geriatric healthcare services because of the aging baby boomer population, and the situation is no different in the prison system; however, the prison population will get significantly lower quality care than the rest of the population, and so will these aging baby boomers inside prisons. Healthcare for elderly inmates is a controversial issue sparking debates about death penalty, higher taxes and the mandatory minimum sentence requirements, so inmates are aging and dying in prison and the cost is not cheap, the controversy surrounding this issue makes it hard to come up with a solution.

This paper will examine the shift in the prison population, and the barriers to medical help in prison.
In 2010, there were about 246,000 prisoners age 50 and older in state and federal prisons combined, with most of them in state custody, the American Civil Liberties Union said in a report titled “At America’s Expense: The Mass Incarceration of the Elderly.

Prisons are overcrowded, with inmate populations over 2 million Americans the report goes on further to say the four jurisdictions with the highest actual number of prisoners age 50 and older are California (27,680), Texas (27,455), Florida (17,980), and the federal prison system (25,160)” (American Civil Liberties Union, 2012). According to Sari Horowitz in an article for the Washington Post titled The painful price of aging in prison, “Prisoners 50 and older represent the fastest-growing population in crowded federal correctional facilities” (Horowitz, 2015). As the numbers of aging inmates go up, the demand for healthcare also increases. It is hard to pinpoint why our prisons are so crowded. The major topics of discussion seem to be our countries get though on crime attitude, harsher sentencing policies and the declining number of criminals receiving the death

penalty.
In prison, an inmate is considered elderly if they are over the age of 55. This is confusing to people who aren’t familiar with life behind bars. These days 55 is almost considered just over middle age. The lifestyle of prisoners and the harsh environment in prison is said to age people faster than on the outside. Physiologic ages are thought to be 10-15 years older than the prisoners chronological age (Penrod, 2014).“The stresses of life behind bars (including separation from family and friends, physical confinement, poor healthcare, and the threat of victimization) plus the lack of access to healthcare and healthy lifestyles before imprisonment exacerbate the risk of physical and mental illness and accelerate the aging process.” (ACLU, 2012). There comes a time when a person is no longer able to get up to go to the bathroom or feed themselves, when they are perceived as no longer a threat to society. Some people believe elderly prisoners should be released when their condition is bad enough. But the security of the general public is always the top priority in prisons. Elderly inmates are dying in prison without much hope for getting out. Some inmates are eligible for early release through a process called Compassionate Release, which is a procedure by which inmates may be eligible for early release due to extraordinary circumstances or major health problems, but the petitions for compassionate release are often denied to maintain security.
The state prison system is a complex hierarchal organization managed by the Department of Corrections.

“The motto of the DOC is care, custody, and control, and the DOC tends to slide toward custody and control. Care is often viewed with some suspicion” (Penrod). Inmates in a state prison become wards of the state, and while they don’t have access to privately funded healthcare, they do have a constitutional right to tax-payer funded healthcare. For aging prisoners this cost is very high. The 2012 Report by the ACLU states “Because of healthcare and physical needs that prisons are ill-equipped to handle, each aging prisoner on average costs taxpayers $68,270 per year—approximately double what it costs to incarcerate an average prisoner” (2012). Because the elderly prison population is increasing, the demand for prison healthcare is increasing, leading to more costs and, eventually, higher

taxes.
Another problem with giving elderly patients medical attention in prison is the need for constant security of the inmates and of the staff. Security is of paramount concern, and this can deter decision-making when it comes to caring for prisoners. If a nurse were to give an inmate compassionate care, it could have the potential to be misunderstood by the inmate or the other staff (Penrod, 2014). Nurses are taught to be free of biases and prejudice when caring for their patients, but this could be hard when your patient is a convicted child molester or murderer. “On the outside, maybe you would give a patient a hug or he would hug you. Here, you have to be able to maintain your borders. It’s a prison” (Horowitz, 2015). People see inmates as criminals and not human beings who need medical help, and its hard to know where to draw the line between safety and care.
The care prisoners get while in prison is questionable. According to the American Civil Liberties Union website advocating for prisoners rights “chronic illnesses go untreated, emergencies are ignored, and patients with serious mental illness fail to receive necessary care.” They go on to say that failure to provide prisoners with access to needed health violates the U.S. Constitution and could result in cruel and unusual punishment (ACLU, 2015). Some prisons are keeping up with the needs of the elderly inmates by enlisting other inmates to help with care. The Washington Post article states “younger inmates are sometimes enlisted as companion aides, helping older inmates get out of bed, wheeling them down the halls to medical appointments and helping them take care of themselves” (Horowitz, 2015). Prison culture is hard on aging people. “It is difficult to climb to the upper bunk, walk up stairs, wait outside for pills, take showers in facilities without bars and even hear the commands to stand up for count or sit down when you’re told” (2015).
Undoubtedly there is a high demand for good nurses in prisons. Because of the shift in the prison population and the barriers inmates must face to getting medical care nurses must be highly trained and up to date on all the policies and procedures of the state, facility and government. According to Elaine Clayton RN in an article for Arizona Nurse titled Correctional Nursing “information regarding the number of nurses currently practicing in a corrections environment is limited making it difficult to monitor trends and growth” (2015). In a job description for the Federal Bureau of Prisons on Usajobs.gov it states “we protect public safety by ensuring that federal offenders serve their sentences of imprisonment in facilities that are safe, humane, cost efficient, appropriately secure, and provides reentry programing to ensure their successful return to the community. Our employees at federal correctional facilities are correctional workers first and perform correctional work regardless of their specific occupation”. (USAjobs.gov). In this description its clear to see that safety and security seems to be a correctional nurses first priority. The salary range for a full time clinical nurse in a federal prison is $34,265.00 to $71,066.00 / Per Year and the education requirement is for Associates degree in Nursing. The job description says the nurse will “Provide nursing care of a general nature to inmates in the institution hospital/clinic, and may be provided to patients in specific areas, e.g., psychiatric, operating room, orthopedics, geriatrics, etc” (USAjobs.gov, 2015). Additionally the American Nurses Association ANA provides standards for correctional nursing practice through the Correctional Nursing Scope and Standards of Practice (2013) (Clayton, 2015). In conclusion being a correctional nurse is a unique, challenging and rewarding field with many job opportunities opening up and lots of room for growth.