Incarceration is the major form of punishment for criminals in the United States. Prison populations are a diverse group of people. Inmates are all ages, all races and both genders. In the majority of prisons, men, women and children are housed separately. Unfortunately, among the mix, there are inmates who are elderly, mentally ill and disabled. These are prisoners with special needs who get lost in the criminal justice system. Periods of prison reform created temporary improvements, but history proves that reform is an ongoing process.
In the earliest years of America there were different forms of deterring crime. Public humiliation was used in the form of stocks and pillory or whippings. Banishment was used as a last resort for unrepentant and repeat offenders. Death was only used for extremely serious crimes. America’s first prisons came about in the late 1700’s. They were referred to as either poor houses or work houses. Although they were created to house the indigent who were unable to take care of themselves, they also housed the elderly, the disabled and the mentally ill. Work houses were a means of controlling the undesirables of society. The poor couldn’t afford to pay any fines, so they were forced to remain in the work houses. The idea of prisons providing a means of reform came about in the late 1700’s due in part to such social reformers as John Howard, Dorothea Dix, and Samuel June Barrows.
John Howard was a social reformer in Britain. He’s often called the “Father of Reform.” Howard’s efforts were contributory to parliament passing two penal reform acts. One act cleaned up prisons and made them more sanitary and the second act improved the quality of health care in prisons. Many British reformers paved the way for reformers in America. Reformers from both countries would often visit prisons in both countries to see for themselves and learn first-hand what did and didn’t work.
Dorothea Dix was born and raised in Maine. She was a school teacher who was often side-lined by an upper respiratory throughout her life. In 1836 she moved to Liverpool, England, only to return to the United States in 1937. In 1841 she began teaching a Sunday school class in a woman’s prison. Dix was shocked by the conditions in the prison. The prison wasn’t heated and the inmates were not segregated. The mentally ill, the elderly and disabled were among the serious criminals. Dix acquired a court order to improve living conditions in the prison where she taught. She learned that the deplorable conditions were the norm for all prisons. Dix was especially concerned for the mentally ill, many of whom were elderly prisoners. She embarked on a one-woman crusade and visited several jails throughout Massachusetts. She collected information about prisoners and took detailed notes on conditions within the different prisons. She discovered that many of the mentally ill and elderly inmates were chained up in the basements. They were cold, undernourished and chained in their own feces. There was no ventilation, so the smell was nauseating. Due to Dix’s research and efforts, in 1843, the Massachusetts legislature earmarked funds for the expansion of the State Mental Hospital. She continued her efforts in New York, New Jersey and Pennsylvania. Dix also traveled to other countries where she visited prisons and worked to bring about reform. Sadly, her accomplishments did not remain. The expansions and new institutions became over-crowded and conditions began to deteriorate.
In 1870 the National Prison Congress was founded and a Declaration of Principles was established. These “principles” would regulate prisons for the next one-hundred years. Later in 1895, Samuel June Barrows was chosen by President Cleveland join the International Prison Commission. One year later, as a member of Congress, Barrows continued efforts to bring about prison reform. In 1901, he developed the first probation laws in New York State.
After the Civil War, the northern states leased prisoners to the private sector in order to produce goods that could be sold. In the south, however, prisoners were leased to landowners to work in the fields. Prisoners replaced slave labor in the south. Landowners treated the prison laborers poorly regardless of their health. Elderly prisoners were often worked to death. Under the horrific conditions, the life expectancy of prisoners was only about six or seven years. The life span of elderly prisoners was even less than that. Occasionally, there would be stories or reports on the deplorable conditions which would stir up talk about reform, but there were no real improvements made until the 1940’s. The changes were minimal at best. The running of the prisons was left up to the wardens.
In the 1950’s there was an outbreak of prison riots. Reports about the riots brought a heightened awareness that something needed to be done. Doctors of sociology, psychiatry and psychology became involved in assessing the mental and physical health of the prisoners and then in their placement in appropriate facilities. Despite the heightened awareness, prisons in the south that were already known for their brutality, continued on. The horrific treatment of “healthy” prisoners shortened their life spans, but for elderly prisoners, the same treatment was often a death sentence. Prisoners worked in the fields in the wintertime without coats or shoes and they were often thrown into dark holes for extended periods of time without food or water. Inside the prison walls elderly prisoners were kept within the general population of the prison. They were often attacked and brutalized by other inmates. Their need for medical care was usually ignored and they would lie in their own feces for days.
Periods of reform, over the years, has only brought about minimal change. Across the nation, there is an estimated 39,000 elderly inmates. According to the Census Bureau, by the year 2030, elderly inmates will comprise nearly one third of the prison population. Due to harsher sentencing including the “three strikes” law, many inmates are growing old in prison. It costs around $69,000 a year to house an elderly inmate. That’s three times the cost of younger prisoners.
Prison life shortens the life expectancy of most inmates by six to eight years. There are several contributing reasons for this. Stress plays are large part. Elderly inmates deal with many stressors including a change in environment, isolation from friends and family, living with the knowledge that the rest of their life will be lived out within prison walls and living with a constant fear of being brutalized by other inmates. Lifestyle choices also shorten life expectancy. Bad choices like drug and alcohol abuse, and deviant sexual behavior all shorten life expectancy. Often these bad choices continue after incarcerations. Lack of proper health care over the course of their lives is also a contributing factor.
Inmates over the age of fifty-five can expect to acquire at least three chronic illnesses over the course of their incarceration. Yet another factor that contributes to the increased cost of housing the elderly. Besides physical illnesses, elderly inmates have a higher chance of developing depression. The depression generally stems from, age, physical deterioration, and confinement. Elderly inmates endure physical, intellectual and emotional stress that creates resentment. Elderly inmates may also require certain dietary needs due to either medical conditions or just the normal aging process.
The ability to identify specific needs and conditions of elderly inmates also require additional training for the corrections officers. Cumulatively, these factors cause an increased cost of care. Despite the cost, prison reform is still needed.
Many prisons throughout the United States are lacking in providing adequate medical care for the inmates. The majority of lawsuits by the prisoners are due to deprivation of sufficient medical care. AIDS kills approximately 1500 inmates every year. About twenty percent of the prison population has a severe mental illness. Some prisons have separate housing for elderly inmates and for the mentally ill, but not nearly enough of them.
Violence in prisons is also a serious problem. There are no specific numbers, but it’s estimated that there are approximately 26,000 severe assaults in prisons every year. Not surprising that the elderly live in fear. Rape is another form of violence in the prison system. It’s estimated that 290,000 prisoners are raped each year. One-hundred inmates a year commit suicide, one-hundred are killed by other inmates and two-hundred fifty die from unknown, un-natural causes. About eighty-five percent of violence in prisons is attributed to gangs within the prison system.
The use of segregation is used in prisons to maintain control over the inmates. The four types of segregation are disciplinary, voluntary, administrative and medical. Psychiatric wards, suicide watch wards and wards for the elderly or seriously ill, make up the medical segregation.
Prisons have been referred to as “schools of crime” for many years. Prison life tends to cause a great deal of resentment in the prisoners. When they re-enter society they take that resentment with them as well as a variety of criminal tricks of the trade. Prisoners that enter the prison system as non-violent offenders, often leave as hard-core, violent offenders. It’s estimated that two-thirds of prisoner’s who re-enter society are back in prison within three years. There are three types of personalities or lifestyles that define prisoners. The “doing time” lifestyle is adopted by inmates who just want to do their sentence and get out. They try to avoid any behaviors or conflicts that might lengthen their time in prison. The “jailing” lifestyle is acquired by prisoners who have spent or will spend the majority of their life behind prison walls. The “gleaning” lifestyle is developed by prisoners who really want to better themselves in such ways as finishing their education or learning a trade. They haven’t lost hope and they look forward to becoming a positive member of society. The last lifestyle is known as the “disorganized.” These are prisoners who have physical, emotional, or mental disabilities or the elderly who are outcasts in the prison society.
Some states have made efforts to establish programs that address elderly inmates. In 2004, Alabama representatives presented the Medical Release Bill. Under this bill, inmates who were convicted of a non-capital crime could be released from prison by the Board of Pardons and Paroles, for medical or geriatric reasons. According to his bill when inmates are incapacitated due to illness or age, confinement as a punishment is no longer valid. At this point, the qualifying inmate is in need of residential medical care. Although this is a positive step, it would have little effect on over crowding because prisoners convicted of murder or sexually assaulting a minor and those serving a life without parole sentence are exempt from the Medical Release Bill. In Hamilton, Alabama there’s a state run geriatric center for elderly inmates. However, a lawsuit has been filed against the center, claiming deplorable conditions. Arkansas also has a medical or compassionate release program. They also have a post-release program that prepares inmates for a smoother transition back into society. Florida and Kentucky have similar programs. Angola state penitentiary in Louisiana has a completely functional medical center as well as a “Prison Hospice Program.”
Over crowding seems to be the theme in prisons across the United States. As a result alternative forms of housing for the elderly are being considered. Providing separate and specialized housing for elderly inmates would greatly reduce cost. Separate housing would solve other problems facing elderly inmates besides medical care. The elderly who stay within the general population of the prison are often targets for attack. If they are frail and sick, there chances of being victimized increases. Separate housing would provide a safer environment for the elderly and stress wouldn’t take a toll on their mental or physical health.
Research proves that many elderly parolees commit crimes knowing that they will return to prison. They are so accustomed to prison life that they are afraid to live in society. They have a feeling of safety and comfort in the confines of prison walls where their lives are structured. Pre-release or transitioning programs are needed to aid the elderly in adjusting to life outside prison.
There are some people who believe that any kind of suffering that a prisoner endures while they’re in prison is deserved. They are after all, in prison to be punished. Regardless of that belief, reform is still needed. Over crowding poses a very real threat to prison guards and other prison staff. The easiest solution would be separate housing for those inmates who are no longer a threat because they are either too old or too sick.
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