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Article Excerpt
Truth-in-sentencing laws, mandatory minimums, and three-strikes-and-you're-out rules established over the past several decades are keeping more offenders confined in prison for longer periods of time (van Wormer & Bartollas, 2007; Yorston & Taylor, 2006). These laws have created a "stacking effect," whereby older adult inmates have grown both in proportion and in number due to sentencing statutes that hold inmates long into their geriatric years (Kerbs, 2000b; U.S. Department of Justice, 2004). This trend has converged with the fact that, like other segments of the population, inmates are living longer. In addition, the number of older adults who are being prosecuted as first-time offenders is increasing (Kerbs, 2000a).
This aging of the prison population has created a host of policy and practice issues that encompass justice considerations, cost-containment issues, and biopsychosocial care needs (Mara, 2004; Yates & Gillespie, 2000). The older prisoner's physical, social, and psychological needs are complex and necessitate gerontologically based service delivery systems (Kerbs, 2000b).
CHARACTERISTICS OF OLDER ADULT INMATES
No clear consensus has arisen in terms of defining an age beyond which one is considered old in terms of criminological research (U.S. Department of Justice, 2004). Studies vary as to the age at which researchers deem an inmate to be old, but for many investigators the cutoff begins at 55. This lower bound age for defining an elderly offender is considerably different than what is used in the general population. The main reasons for this are the shorter life expectancy and lower health status of criminal offenders (Auerhahn, 2002; Williams & Rikard, 2004).
In 2006, the adults age 55 and older comprised 5.5 percent of the total U.S. male prison population and 3.5 percent of the total female population (Bureau of Justice Statistics [BJS], 2007). Although the number of older female prisoners is increasing (van Wormer & Bartollas, 2007; Wahidin, 2004; Williams & Rikard, 2004), 92 percent of older prisoners are male (BJS, 2007). The majority of aging female inmates are serving first-time, long-term sentences for nonviolent crimes that are drug- or property-related (Aday, 2003). Only about one-third of older prisoners are married (Aday, 2003). The majority of older inmates test at a sixth-grade level, and over one-third of the older female population tests at an IQ level below 70 (Aday, 2003). Few inmates have marketable employment skills or sufficient literacy to maintain gainful employment upon release; one-third of all prisoners were unemployed at the time of their most recent arrest (Petersilia, 2003).
The majority of offenders age 55 and over currently housed in state and federal prisons are non-Hispanic white individuals. However, the older prisoner population includes a disproportionate number of African Americans (Kerbs, 2000b). Using recent incarceration tabular data from the BJS (2007), which provides a breakdown of numbers of prisoners by age, race, and gender, we have calculated that 53.1 percent of male inmates over age 55 are white, 27.8 percent are black, and 14.9 percent are Hispanic. For older female inmates, 59.5 percent are white, 21.6 percent are black, and 13.5 percent are Hispanic. Furthermore, southern states typically incarcerate a greater proportion of African Americans than do states in other regions of the country. For example, of the 4,054 older prisoners incarcerated in Georgia prisons, 51 percent are African American, 48 percent are white, and 1 percent are Native American (Georgia Department of Corrections, 2004).
Older inmates are a diverse group that might first be differentiated as geriatric and nongeriatric. Geriatric inmates include those with functional impairments who require assistance with activities of daily living (ADL) such as eating, bathing, or using the toilet; they are sometimes housed in separate units to accommodate their extensive long-term care needs (U.S. Department of Justice, 2004). A second group of geriatric offenders is composed of inmates who need extra assistance but are not totally dependent. They may require environmental supports such as ramps and elevators that will aid in their mobility. Nongeriatric offenders are older adults who may have health ailments and other special needs but are still able to function independently; they are typically housed with the general population.
SPECIAL NEEDS AND SERVICE DELIVERY ISSUES
Health
On average, older adult offenders require more attention in the areas of chronic illness, nursing, diet, medication, and physical therapy than younger inmates (Mara, 2002; U.S. Department of Justice, 2004). Having typically entered the prison environment from a disadvantaged background, the onset of serious health problems appears earlier among older adult inmates when they are compared with aging individuals in the general population (Yorston & Taylor, 2006). Such health problems often require physical therapy, skilled nursing care, special diets, and other supportive services (U.S. Department of Justice, 2004). With an increase in the onset of these types of health-related issues, correctional facilities will have to expend more fiscal resources as geriatric inmates struggle with declining health, ADL, and impending death.
Older inmates may have limited mobility and thus require special equipment, such as walkers, wheelchairs, prosthetic devices, and special shoes,...
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