Barriers and enablers to health and social services for older prisoners transitioning to community

Purpose When properly designed and implemented, prison-to-community transition programs targeting older prisoners could potentially save resources, reduce reoffending rates and contribute to improved public protection and safety. However, older prisoners transitioning to community are often neglected and overlooked, and thus, interventions targeted to address their needs are limited. The purpose of this study was to identify barriers and enablers to health and social services for older prisoners transitioning to community. Design/methodology/approach A qualitative study was conducted using focus group discussions with corrections officers, community corrections officers and parole officers (n = 32) in four correctional centres, two community corrections offices (CCOs) and one parole unit in New South Wales (NSW) in 2019. The authors used thematic analysis to analyse the findings. Findings The study identified three main themes relating to barriers and enablers: organisational, social and economic and individual and family and seven sub-themes: planning the transition, communication, assisting prisoners, transition programs, officers’ knowledge and scope of work, social and economic issues and offenders’ conditions Research limitations/implications The processes required to ensure effective prison-to-community transition of older prisoners are not well-developed suggesting the need for more systemic and organised mechanisms. Implications of the barriers and enablers for policy, research and practice are discussed. Originality/value This study identified a composite of barriers and enablers to health and social services for older prisoners in NSW prisons and CCOs.

Self-rating of depression in elderly prisoners in North Rhine-Westphalia, Germany

Aim: Against the background of the rising number of elderly people being incarcerated and the rare data on this special subgroup, the aim of our study was to collect first empirical data on the affective state of elderly prisoners in North Rhine Westphalia, Germany. Methods: Data were collected in nine German prisons. We included elderly prisoners from pretrial prevention, penal sentences, open enforcement, preventive detention and from special detention units for elderly inmates. For the evaluation of the affective state, we used the Patient Health Questionnaire (PHQ-9). Sociodemographic and crime-related characteristics were documented. Findings: In total, n=116 prisoners (91.4% male) were included. The age ranged from 53 to 91 years (65.6±6.3 years). In our sample, 48% reported at least mild depressive symptoms, which is a significantly higher prevalence of depressive symptomatology than in the general population aged 60 years and older. Differences were found with regard to the type of detention, as prisoners in open enforcement showed significantly less symptoms compared to those in pretrial prevention and preventive detention. The participants reported in general more somatic symptoms as sleep disturbances and fatigue compared to mood items as feelings of sadness. Originality: It is the first study assessing the affective state of older prisoners in Germany. The high rate of depressive symptoms in our sample is in line with findings from international studies underlining the need for adequate diagnostics and therapy. In addition, in a previous study depression was indirectly linked with a greater risk of re-incarceration, fortifying the need for successful treatment of depression in prison both for the individuum and for society.

No Place for Old Men? Meeting the Needs of an Ageing Male Prison Population in England and Wales

Recent years have witnessed significant increase in numbers of older men imprisoned in England and Wales; a phenomenon experienced across the western world. Those aged fifty and over represent the fastest-growing demographic group in prison in England and Wales. This article summaries explanations for and implications of this increase and the characteristics, needs and lived experiences of this population, before critically reflecting on current policy and practice responses; and how responses highlight definitional and policy ambiguities around older prisoners. The article discusses a multi-agency initiative developed at one prison in northern England that recognised the uniqueness of older prisoners, modified regimes and changed physical environments. Impact is benchmarked against Her Majesty’s Inspectorate of Prisons four tests of a healthy prison, followed by discussion of findings and implications for policy and practice. The article argues for expanded collaboration to better manage challenges posed by older prisoners, supported by a national strategy.

Equivalence of care? Accessibility and availability of dialysis services for older prisoners in Switzerland

Purpose According to the principle of equivalence of care, health care in prison has to be of the same standard and quality as in the general population. This study aims to determine the geographic accessibility of dialysis services for older prisoners and the older general population in Switzerland and whether accessibility and availability of dialysis care are equivalent. Design/methodology/approach Spatial accessibility analysis incorporated four different data types: population data, administrative data, street network data and addresses of prisons and hemodialysis services. Findings Analysis revealed that the average travel time to the nearest dialysis service was better for prisoners (11.5 min) than for the general population (14.8 min). However, dialysis service for prisoners is hampered by the necessary lead-time in correctional settings, which, ultimately, leads to longer overall access times (36.5 min). Accordingly, the equivalence of dialysis care for older Swiss prisoners is not entirely respected for availability and accessibility. Originality/value The strength of the study lies in the combination of ethical principles and the highly tangible results of a spatial accessibility analysis. The ethics-driven empirical analysis provides arguments for policy-makers to review the current practices.

The Gray Pains of Imprisonment: Examining the Perceptions of Confinement among a Sample of Sexagenarians and Septuagenarians

While the overall United States prison population has decreased over the last 10 years, the number of sentenced individuals above the age of 50 nearly doubled during the same period. The focus of this study, the pains of imprisonment experienced by the aging, is an under-researched area in the prison literature. Results from a sample of 134 male participants of True Grit, a structured living program for older prisoners, indicate strong agreement among sexagenarians, among septuagenarians, and between them. Previous studies of the pains of imprisonment found similar evaluations of the most and least difficult aspects of incarceration. While different instruments were used, collectively these studies suggest some commonality in the greatest hardships and least problematic aspects of incarceration. Policy implications derived from the present research are considered.

Chains, trains and automobiles: Medical transport for prisoners in Switzerland

Imprisoned persons are transported for several purposes including transfers to a different prison, legal-procedural reasons such as court hearings, and to receive medical treatments. The availability and acceptability of transportation may limit access to healthcare if health services cannot be provided within the prison grounds. The aim of this article is to examine the conditions of medical transport for older prisoners in Switzerland and to assess whether or not these practices are in line with international recommendations. Interviews with experts working in the prison context and with older prisoners were conducted. Results show that handcuffing practices and space restrictions during medical transport are not adapted to prisoners’ health condition. Older prisoners risk being exposed and humiliated by transport conditions. The reasons for delayed medical transport can be administrative constraints or erroneous medical judgement. Switzerland’s cantonal system results in a variety of regulations for transports, so that cantonal differences, administrative constraints and inappropriate conditions can delay access to necessary healthcare and increase suffering.

‘A sense of purpose’: Older prisoners’ experiences of successful ageing behind bars

There is growing interest in ageing offenders and their lives in prison. However, this subject is often studied from a deprivation perspective, focusing on issues such as lack of medical care and proper environmental conditions. This article highlights experiences of wellbeing while ageing in confinement, using the conceptual framework of successful ageing. An interpretive phenomenological analysis perspective was used to analyse the narratives of 18 older prisoners. The narratives revealed four themes: ‘Like all other older men’: comparing ageing in prison with ageing within the community; ‘Better than what I have outside’: prison as an escape from a life of loneliness, poverty and delinquency; ‘Here I get some respect’: the older prisoner as a mentor; and ‘I feel accomplished’: experiences of growth and self-discovery as a means for successful ageing in prison. The findings suggest that ageing in prison may not be perceived as a single, unified process, but as a personal and individual phenomenon, and that old age may facilitate positive changes in the lives of ageing offenders in prison.

Prisons, Older People, and Age-Friendly Cities and Communities: Towards an Inclusive Approach

This original and ground-breaking interdisciplinary article brings together perspectives from gerontology, criminology, penology, and social policy to explore critically the nature and consequences of the lack of visibility of prisons, prisoners, and ex-prisoners within global research, policy and practice on age-friendly cities and communities (AFCC), at a time when increasing numbers of people are ageing in prison settings in many countries. In addition, the COVID-19 pandemic continues to pose challenges in the contexts both of older peoples’ lives, wellbeing, and health, and also within prison settings, and thus it is timely to reflect on the links between older people, prisons, and cities, at a time of ongoing change. Just as there is an extensive body of ongoing research exploring age-friendly cities and communities, there is extensive published research on older people’s experiences of imprisonment, and a growing body of research on ageing in the prison setting. However, these two research and policy fields have evolved largely independently and separately, leading to a lack of visibility of prisons and prisoners within AFCC research and policy and, similarly, the omission of consideration of the relevance of AFCC research and policy to older prisoners and ex-prisoners. Existing checklists and tools for assessing and measuring the age-friendliness of cities and communities may be of limited relevance in the context of prisons and prisoners. This article identifies the potential for integration and for cross-disciplinary research in this context, concluding with recommendations for developing inclusive research, policies, and evaluation frameworks which recognise and include prisons and older prisoners, both during and after incarceration.

The Health and Well-Being of African-American Older Adults With a History of Incarceration

African-Americans are overrepresented in the criminal justice system. Longer prison stays and release programs for older prisoners may result in an increased number of community-dwelling older adults with a history of incarceration. In recent years, there has been a substantial increase in research on health-related outcomes for currently incarcerated older adults; however, there has been little inquiry into outcomes for formerly incarcerated African-American older adults following community re-entry. In this study, we used secondary data from the Health and Retirement Study to describe employment, economic, and health-related outcomes in this population. Twelve percent of the 2238 African-Americans in our sample had been previously incarcerated. Those who had been previously incarcerated had higher rates of lung disease, arthritis, back problems, mobility problems, and mental health issues than their counterparts. They also had higher rates of hospitalization and lower use of dental health services. Further, while they did not experience lower employment rates than those with no criminal history, those who had been incarcerated had more physically demanding jobs and reported greater economic strain. Given the disproportionate incarceration rates among African-Americans, the aging of the prison population, and the increase in community re-entry for older prisoners, research that explores factors that impact the health and well-being of formerly incarcerated individuals has broad impact. Future work should focus on addressing the needs of this vulnerable population of African-American older adults.