Monday, March 26, 2012

'Life, With Dementia'

Here's a notable New York Times feature and editorial on some of the unique healthcare problems facing the growing cadre of senior-citizen inmates in American prisons with dementia, a phenomenon resulting from long prison sentences meted out over the last several decades:
Here's a summary tidbit from the main story:
Dementia in prison is an underreported but fast-growing phenomenon, one that many prisons are desperately unprepared to handle. It is an unforeseen consequence of get-tough-on-crime policies — long sentences that have created a large population of aging prisoners. About 10 percent of the 1.6 million inmates in America’s prisons are serving life sentences; another 11 percent are serving over 20 years.

And more older people are being sent to prison. In 2010, 9,560 people 55 and older were sentenced, more than twice as many as in 1995. In that same period, inmates 55 and older almost quadrupled, to nearly 125,000, a Human Rights Watch report found.
The editorial puts it even more starkly, echoing themes regular Grits readers will recognize: "According to a report from Human Rights Watch, in 2010 roughly 125,000 of the nation’s 1.5 million inmates were 55 years of age and over. This represented a 282 percent increase between 1995 and 2010, compared with a 42 percent increase in the overall inmate population. If the elderly inmate population keeps growing at the current rate, as is likely, the prison system could soon find itself overwhelmed with chronic medical needs."

Most of the main story is about a California program that trains inmates with good behavior records to provide care for inmates with dementia, Alzheimer's, or other such disabilities. But Texas and other high-incarceration states face similar dynamics. Older prisoners are both one of the fastest growing segments of the inmate population and among the most costly, mainly because of high healthcare expenses.

Just as society increasingly uses prisons and jails in lieu of mental hospitals, they're beginning to also replace nursing home beds for a small but rapidly growing class of elderly prisoners. Over the next five to ten years Grits expects this to become one of the central challenges of modern prison management, not to mention a source of increasingly poignant moral conundrums for the legislature and the parole board. There are no easy answers for the questions that arise when the end of life nears, either for families when tasked with such decisions or the state when acting in loco parentis.


ckikerintulia said...

The state(s) should not be able to shuck the financial responsibility for these aged and ill people by simply granting them release in any form. We put them there; we shouldn't simply put the burden of care on their families when they are physically or mentally incapacitated.

Rev. Charles

Lee said...

Scott, I am not fan of the death penalty but isnt this the result of the life without parole? I am perfectly content with welding the cage shut.

Gritsforbreakfast said...

For every LWOP sentence, Lee, there are a dozen or more Very Long Sentences that are not formally LWOP but will still keep the defendant there into their twilight years. LWOP is relatively new, but even regular, parole-eligible "life" sentences stack up. Parole eligible doesn't mean they WILL be paroled, only that it's a theoretical possibility.

Prison Doc said...

Rev. Charles' point is a very good one, "compassionate release" often isn't very compassionate at all. Many of these guys are estranged from or deserted by their families and have nowhere to go, except for perhaps another state agency.

Nurseypooh said...

So true:
Point in case.
Our unit received an inmate 50 yr old, Insulin dependent diabetic, htn, CHF, COPD, Asthma, Obese the list goes on and on she got 10 yrs for theft of some sort and she had 2 priors when she was 18 and 20. My feeling is the taxpayers would have been better off to have put him or her on some kind of house arrest probation, ankle monitoring system etc.him or her healthcare is going to cost a lot during this ten years. I doubt he will be able to tolerate the heat which is coming this summer.

Word is UTMB is going to turn us back over to TDCJ in August we are very short handed and have submitted several applicants to be cleared but no word for over a month now I think they're going to just not hire anyone and let us just try to make it with what we've got to save money. I'm tired!

Prison Doc said...

Yeah Nurseypooh glad to see you're still out there; things miserable at our unit too. Short staffed, everybody pissed off, worst thing is that nobody has any feeling of hope for improvement in the foreseeable future.

Nurseypooh said...

Prison Doc, glad to see your hanging in there also. I'm not opposed to working for TDCJ again but not sure what kind of changes they will make. The uncertainty isn't stressing me out much because I'm way to busy to think about it much. After the last 3 yrs I don't believe anything until it happens.

Dementia-I don't think anyone is prepared for the increase in volume of offenders who will require long term care as it stands now they have to be pretty bad off dementia wise before they can be shipped to a unit that can take care of them and then once they get approved a bed has to come open before they can go and that wait is to long in some instances so often they end up having to be sent to Skyview (mental hosp. unit) Not enough beds anywhere for special needs offenders. We have so many inmates who have damaged their brains with meth and other substance most are young and have health problems you would not normally see in one so young so no telling how old they will be when some sort of dementia begins I would speculate they are very high risk for earlier than normal dementia like symptoms since they already have mental health issues due to drugs.