Hospice behind bars

NICK EICHER, HOST: Coming up next on The World and Everything in It: Aging in prison.

As of last year, the U.S. median age had hit its highest level ever, almost 40 years old. In the U.S. prison system you really see it. Soon, one in three inmates will be 50 or older. We’re talking 400,000 prisoners.

MARY REICHARD, HOST: Are prisons equipped for the challenges of aging? Are taxpayers going to be able to pay the costs? And are there other options?

Here’s WORLD’s Anna Johansen Brown.

ANNA JOHANSEN BROWN: In 2006, a New York prison made headlines for creating the nation’s first dementia unit. There, prisoners could wander through brightly lit rooms that looked more like nursing home rooms than prison cells.

Today, specialized units designed to accommodate aging prisoners are more widespread. Michigan’s Department of Corrections has two specialized units for prisoners who need some level of assistance on a daily basis.

MARTI KAY SHERRY: You know, if they have dementia or if they're having difficulty, you know, needing some prompts with their activities of daily living, then they might be candidates for these two units.

Marti Kay Sherry is the Health Services Administrator for Michigan’s department of corrections.

SHERRY: We classify, you know, our older prisoners as 50 years and older. And mostly that's just because the chronic health conditions that they come into are more complex than what a community member would have.

Prisons were designed for young, healthy individuals. But now 30% of American inmates serving life sentences are 55 or older. And working with older inmates requires a level of care and training that some facilities aren’t equipped to offer.

SHERRY: You know, We're seeing an increase in our prisoners needing wheelchairs, either permanent wheelchairs. We are converting and making more wheelchair accessible beds.

In some cases, elderly inmates will spend their final days behind bars. Staff train younger prisoners to serve older prisoners in the state’s hospice program.

SHERRY: They realize that at some point this could be them, or it could be a family member, and they wouldn't want them to be alone, so it’s typically our younger prisoners that are doing that.

The growing mismatch between America’s birth rate and retirement rate means that caring for the elderly continues to be a widespread challenge. But past policies also played a role in why so many of America’s elderly are behind bars.

WRIGHT: This is essentially due to two things that happened around the same time.

Rachel Wright is the national policy director for Right on Crime, a conservative criminal justice reform initiative. She points to a combination of factors: improvements in healthcare and politicians imposing lengthy sentencing guidelines for a variety of violent and drug-related crimes.

WRIGHT: So when these individuals were in their 20s and 30s, committing crimes and receiving a decades long mandatory minimum sentence, they're now in their 60s, 70s and 80s and still serving time.

States spend between $25,000 and $300,000 per prisoner every year. A 2013 study found that older prisoners cost prisons up to nine times more than younger, healthier inmates.

WRIGHT: The goal of rehabilitation is extremely easy to lose when our prisons are becoming nursing homes. Your elderly prison population is just growing really, really rapidly.

So is turning prisons into assisted living centers the only solution? Some criminal justice advocates say changing the rules for sentencing and release could help.

Heather Rice-Minus is the president and CEO of Prison Fellowship:

RICE-MINUS: Although we don't support the release of prisoners solely due to advanced age, we work diligently to reform sentencing practices to address unduly harsh penalties that, in effect, have more men and women spending time in their later years in prison.

Changing sentencing rules would help ease the strain on prisons down the road, but what about for those currently behind bars? One option is moving inmates to detention at home or other facilities. The Federal Bureau of Prisons ran a home detention pilot program for elderly inmates between 2019 and 2023. Non-violent offenders who were over 60 or suffering from a terminal disease could serve out the last third of their sentence confined to their homes.

Here’s Rachel Wright.

WRIGHT: So it was a good use of the taxpayer dollar, a good balance of that accountability and rehabilitation. It is currently lapsed, and Congress is not currently considering reauthorization for this program.

Another option is called compassionate release. Every U.S. state except Iowa allows for some form of compassionate release, often referred to as medical parole. But applying for it is not an easy process.

WRIGHT: And so some argue for expansion of eligibility, meaning that statutorily, it should talk about terminally ill patients or perhaps bringing down the age range.

Research shows that elderly inmates are less likely to reoffend. But proposals to expand compassionate release across the board pose critical questions about justice.

WRIGHT: It should not be a knee jerk, wholesale, if-you-are-this-age-you-get-out. That is not an effective policy that puts victims' voices at the table.

Some inmates should spend the rest of their lives in prison. But Heather Rice-Minus says prison officials and ministries like Prison Fellowship can still ensure they are treated with dignity and compassion as they age.

HEATHER RICE-MINUS: You know, where justice requires that a person remains in prison until their death we believe that corrections officials should be resourced and accountable to provide care that reflects the God given dignity of the elderly, even if they're in prison.

This story was written and reported by Addie Offereins. For WORLD, I’m Anna Johansen Brown.

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