Inmates over the age of 50 comprised 11.2% of the Australian prison population in 2010, up from 8.3% in 2000. "In terms of raw prisoner numbers, this equates to approximately 1,500 additional older inmates — an increase of 84% — across Australian prisons over the past decade", with the greatest growth among those aged over 65, whose numbers rose over 140% in the decade from 2000 to 2010. "This far exceeds the increase in the national prison population, which was only 36 percent over the same time period".
The authors comment that -
Older prisoner populations present a number of challenges for governments, correctional administrators, healthcare providers and community agencies.They go on to highlight issues, including -
In 2010, inmates over the age of 50 comprised 11.2% of the Australian prison population. This contrasts with the situation in 2000, when only 8.3% of prisoners were aged 50 years and over. In terms of raw prisoner numbers, this equates to approximately 1,500 additional older inmates—an increase of 84% — across Australian prisons (ABS).
In 2010, the numbers of older Indigenous prisoners were relatively lower, comprising only 9.5% of males (294) and 7% of females (15) aged 50 years and over but this may reflect the lower median age of death of Indigenous Australians compared with non-Indigenous Australians (52.5 years for men and 61.3 years for women in 2009; ABS 2009).
Indigenous prisoners would therefore be expected to be affected by age-related health issues at a younger age than other prisoners and this should be accounted for in future research and practice – for example, by altering the definition of ‘older’ for Indigenous prisoners to 45 years and over.
The paper also examines issues such as the costs of responding to rising healthcare needs, and infrastructure issues surrounding accommodation and correctional programs for older prisoners such as disability needs. This may include the establishment of special needs units for older prisoners and the employment of specialist staff, and specialised post-release services.
Health concerns
As with older people in general, the most immediate and apparent issues facing older prisoners are those related to ageing and associated declines in mental and physical health. Furthermore, considering the accelerated biological ageing process, a prisoner who is chronologically 50 years of age is generally expected to display the onset of age-related health concerns of a 60 year old in the general population . Such concerns include coping with chronic disease and/or terminal illness, fear of dying, pain management, reduced levels of mobility, disability, loss of independence and cognitive impairments. The rising numbers of older prisoners has specific implications for prison health services (eg in screening, preventative healthcare and chronic disease management) as well as custodial management of older prisoners (in terms of accommodation needs and program delivery, for instance). Access to current Australian data characterising the prevalence, nature and impact of health-related issues among older prisoners is essential for both healthcare and custodial planning in this area and should therefore be a priority for local research.
Mental health and adjustment
Research suggests that although older prisoners are generally less disruptive than younger prisoners, a considerable number experience depression and other psychological problems, suggestive of institutional adjustment difficulties. Historically, it seems that little attention has been paid to issues relating to older prisoners, partly due to the perception of prison staff that older prisoners are ‘compliant’ and therefore, not (overtly) a ‘problem’. This is reflected in national and international research concerning mental health among older prisoners, of which there is ‘strikingly little’.
International research indicates that up to 40 or 50 percent of ageing prisoners experience mental health issues, including a high prevalence of depression. Further, research has also identified that prevalence rates of mental illness among prisoners are likely to be higher than estimates which rely on prison records due to a number of reasons. First, mental illness may develop during the course of incarceration after initial screenings have been completed and second, prisoners may also not disclose symptoms of mental illness due to fear of consequences, such as eligibility for parole and fear of judgment. This may have implications for older prisoners upon release, particularly those with unidentified mental health needs, as they may be unable to access various health and social services, leaving them vulnerable and at risk of reoffending.
Increasing costs
Corresponding with the rise in numbers of older prisoners, many writers have highlighted an increase in healthcare costs as a concern for policymakers, prison administrators and government. Research in both Australia and the United States has identified that the cost of accommodating older prisoners is approximately three times greater than it is for their younger counterparts. In addition to actual and potential costs, many prison administrators are considering, or have responded to, older prisoners’ health needs through hiring specialised staff (eg in palliative care or gerontology) and/or the creation of nursing or ‘older prisoner’ units. The rising numbers of older inmates in Australia therefore has implications for correctional budgets and there is a subsequent imperative to identify and adopt cost-effective strategies, particularly in relation to healthcare delivery, for this prisoner group.
Prison environment and regime
It is commonly understood that correctional environments are primarily designed for the young and able-bodied, who comprise the majority of prisoners. As such, many researchers have argued that older prisoners’ health concerns are exacerbated by many prison environments and regimes. Research findings support this and suggest that prison environments and regimes poorly cater for the needs of older prisoners with physical disabilities, such as limited mobility (eg requiring the use of ramps, wheelchairs, walking frames or sticks), hearing or vision impairments, infirmity or incontinency.
Some writers have described this situation as a ‘double punishment’, concluding that difficulties with, or lack of access to, prison facilities (eg baths and showers and upper bunk beds) and programs (such as exercise and education) creates a harsher prison environment for older prisoners. Others have described the lack of adaptation as ‘not only disadvantageous, but dangerous in some cases’.
