Growing Older: Challenges of Prison and Reentry for the Aging Population

  • Brie Williams
  • Rita Abraldes

In the community, geriatrics is the discipline of medicine specializing in care of the aged, defined as 65 years and older. In prison, the age at which an inmate is deemed “geriatric” varies from state to state (Lemieux, Dyeson, & Castiglione, 2002). In some states, inmates as young as 50 are defined as geriatric; in other states, inmates are not considered geriatric until they reach age 55 or 60 (Anno et al., 2004; Lemieux et al., 2002). Despite these differing definitions, there is consensus that inmates undergo a process of accelerated aging compared to their age-matched counterparts outside of prison (Aday, 2003). Outside of prison, people often encounter new physical, psychological, and social challenges as they age. In prison, an environment designed for younger inhabitants, aging introduces additional challenges in safety, functional ability, and health. As older ex-prisoners reenter their communities, they may face additional challenges such as being frail in an unsafe neighborhood, having multiple medical conditions with limited access to medical care, and leaving the familiarity of the place they have lived in for decades.

In this chapter, we describe some of the special challenges related to the aging of the population both inside prison and on reentry into the community. Despite the public health and economic implications of the surging geriatric prison population, little research has been conducted in these areas, particularly regarding reentry.


Hearing Loss Urinary Incontinence Prison Population Geriatric Syndrome Limited Life Expectancy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. ADA. (1990). Americans with Disabilities Act of 1990.Google Scholar
  2. Aday, R. H. (2003). Aging prisoners: Crisis in American corrections. Westport, CT: Praeger Publishers.Google Scholar
  3. Anno, B. J., Graham, C., Lawrence, J. E., & Shansky, R. (2004). Correctional health care: Addressing the needs of elderly, chronically ill, and terminally ill inmates. Middletown, CT: Criminal Justice Institute.Google Scholar
  4. Baillargeon, J. B. S., Pulvino, J., & Dunn, K. (2000). The disease profile of Texas prison inmates. Ann Epidemiol, 10, 74–80.PubMedCrossRefGoogle Scholar
  5. Bess, F. H., Lichtenstein, M. J., Logan, S. A., Burger, M. C., & Nelson, E. (1989). Hearing impairment as a determinant of function in the elderly. J Am Geriatr Soc, 37, 123–128.PubMedGoogle Scholar
  6. Bogardus, S. T., Jr., Yueh, B., & Shekelle, P. G. (2003). Screening and management of adult hearing loss in primary care: Clinical applications. JAMA, 289, 1986–1990.PubMedCrossRefGoogle Scholar
  7. Boyle, B. A. (2002). The Maryland Division of Correction hospice program. J Palliat Med, 5, 671–675.PubMedCrossRefGoogle Scholar
  8. Braithwaite, R. S., Col, N. F., & Wong, J. B. (2003). Estimating hip fracture morbidity, mortality and costs. J Am Geriatr Soc, 51, 364–370.PubMedCrossRefGoogle Scholar
  9. Brown, C. J., & Norris, M. (2006a). Falls. In PIER, Physicians’ Information and Education Resource. Philadelphia: American College of Physicians.Google Scholar
  10. Brown, C. J., & Norris, M. (2006b). PIER, Physicians’ Information and Education Resource. Philadelphia: American College of Physicians.Google Scholar
  11. California Prisoners and Parolees 2004. (2005). California Department of Corrections and Rehabilitation, Offender Information Services, Estimates and Statistical Analysis Section, Data Analysis Unit. Sacramento.Google Scholar
  12. Carey, E. C., Walter, L. C., Lindquist, K., & Covinsky, K. E. (2004). Development and validation of a functional morbidity index to predict mortality in community-dwelling elders. J Gen Intern Med, 19, 1027–1033.PubMedCrossRefGoogle Scholar
  13. Colsher, P. L., Wallace, R. B., Loeffelholz, P. L., & Sales, M. (1992). Health status of older male prisoners: A comprehensive survey. Am J Public Health, 82, 881–884.PubMedCrossRefGoogle Scholar
  14. Crawley, E., & Sparks, R. (2006). Is there life after imprisonment? How elderly men talk about imprisonment and release. Criminology and Criminal Justice, 6, 63–82.CrossRefGoogle Scholar
  15. Enders, S. R., Paterniti, D. A., & Meyers, F. J. (2005). An approach to develop effective health care decision making for women in prison. J Palliat Med, 8, 432–439.PubMedCrossRefGoogle Scholar
  16. Faiver, K. L. (ed.). (1998). Health care management issues in corrections. Lanham, MD: American Correctional Association.Google Scholar
  17. Fazel, S., Hope, T., O’Donnell, I., Piper, M., & Jacoby, R. (2001). Health of elderly male prisoners: Worse than the general population, worse than younger prisoners. Age Ageing, 30, 403–407.PubMedCrossRefGoogle Scholar
  18. Federal Interagency Forum on Aging-Related Statistics. (2004). Older Americans 2004: Key indicators of well-being. Washington, DC: U.S. Government Printing Office.Google Scholar
  19. Fick, D. M., Cooper, J. W., Wade, W. E., Waller, J. L., Maclean, J. R., & Beers, M. H. (2003). Updating the Beers criteria for potentially inappropriate medication use in older adults: Results of a US consensus panel of experts. Arch Intern Med, 163, 2716–2724.PubMedCrossRefGoogle Scholar
  20. Fields, G. (2005, May 18). Life and death: As inmates age, a prison carpenter builds more coffins. Wall Street Journal.Google Scholar
  21. Gill, T. M., Robison, J. T., Williams, C. S., & Tinetti, M. E. (1999). Mismatches between the home environment and physical capabilities among community-living older persons. J Am Geriatr Soc, 47, 88–92.PubMedGoogle Scholar
  22. Harrison, P. M., & Beck, A. J. (2004). Prisoners in 2003 (Publication No. NCJ 205335). Washington, DC: U.S. Department of Justice.Google Scholar
  23. Hill, T., Williams, B. A., Cobe, G., & Lindquist, K. J. (2006). Aging inmates: Challenges for healthcare and custody. A report for the California Department of Corrections and Rehabilitation. San Francisco.Google Scholar
  24. Holman, B. (1998). Nursing homes behind bars: The elderly in prison. Coalition for Federal Sentencing Reform, 2(1), 1–2.Google Scholar
  25. Hornung, C. A., Anno, B. J., Greifinger, R. B., & Gadre, S. (2002). Health care for soon-to-be-released inmates: A survey of state prison systems. In The health status of soon-to-be-released inmates. Vol. 2. National Commission on Correctional Health Care.Google Scholar
  26. U.S. Preventive Services Task Force (USPSTF), Agency for Healthcare Research and Quality. Retrieved August 15, 2006.
  27. United States Census Bureau Website. Retrieved October 20, 2005.
  28. (2005). Florida Department of Corrections 2004–2005 Annual Report. Retrieved August 10, 2006.
  29. George Washington Law School Website. Retrieved April 1, 2004.
  30. (2003). Reentry Trends in the United States. Retrieved August 1, 2006.
  31. Koenig, H. G., Johnson, S., Bellard, J., Denker, M., & Fenlon, R. (1995). Depression and anxiety disorder among older male inmates at a federal correctional facility. Psychiatr Serv, 46, 399–401.PubMedGoogle Scholar
  32. Kratcoski, P. C., & Babb, S. (1990). Adjustment of older inmates: An analysis of institutional structure and gender. Journal of Contemporary Criminal Justice, 6, 264–281.CrossRefGoogle Scholar
  33. Landefeld, C. S., Palmer, R. M., Johnson, M. A., Johnston, C. B., & Lyons, W. L. (2004). Current geriatric diagnosis and treatment. New York: McGraw–Hill.Google Scholar
  34. Legislative Analyst’s Office, Analysis for the 2003–2004 Budget Bill. (2003). Sacramento.Google Scholar
  35. Lemieux, C. M., Dyeson, T. B., & Castiglione, B. (2002). Revisiting the literature on prisoners who are older: Are we wiser? Prison Journal, 82, 440–458.CrossRefGoogle Scholar
  36. Linder, J. F., Enders, S. R., Craig, E., Richardson, J., & Meyers, F. J. (2002). Hospice care for the incarcerated in the United States: An introduction. J Palliat Med, 5, 549–552.PubMedCrossRefGoogle Scholar
  37. Lindquist, C. H., & Lindquist, C. A. (1999). Health behind bars: Utilization and evaluation of medical care among jail inmates. J Community Health, 24, 285–303.PubMedCrossRefGoogle Scholar
  38. Lurigio, A. J., Rollins, A., & Fallon, J. (2004). The effects of serious mental illness on offender reentry. Federal Probation, 68(2), 45–52.Google Scholar
  39. Mara, C. M. (2003). A comparison of LTC in prisons and in the free population. Long-Term Care Interface, November, 22–26.Google Scholar
  40. Marquart, J. W., Merianos, D. E., & Doucet, G. (2000). The health-related concerns of older prisoners: Implications for policy. Aging and Society, 20, 79–96.CrossRefGoogle Scholar
  41. Marshall, S. W., Runyan, C. W., Yang, J., Coyne-Beasley, T., Waller, A. E., Johnson, R. M., et al. (2005). Prevalence of selected risk and protective factors for falls in the home. Am J Prev Med, 28, 95–101.PubMedCrossRefGoogle Scholar
  42. Mitka, M. (2004). Aging prisoners stressing health care system. JAMA, 292, 423–424.PubMedCrossRefGoogle Scholar
  43. Mulrow, C. D., & Lichtenstein, M. J. (1991). Screening for hearing impairment in the elderly: Rationale and strategy. J Gen Intern Med, 6, 249–258.PubMedCrossRefGoogle Scholar
  44. Newcomer, R. J., Clay, T. H., Yaffe, K., & Covinsky, K. E. (2005). Mortality risk and prospective Medicare expenditures for persons with dementia. J Am Geriatr Soc, 53, 2001–2006.PubMedCrossRefGoogle Scholar
  45. Pogorzelski, W., Wolff, N., Pan, K. Y., & Blitz, C. L. (2005). Behavioral health problems, ex-offender reentry policies, and the “Second Chance Act”. Am J Public Health, 95, 1718–1724.PubMedCrossRefGoogle Scholar
  46. Pratt, D., Piper, M., Appleby, L., Webb, R., & Shaw, J. (2006). Suicide in recently released prisoners: A population-based cohort study. Lancet, 368, 119–123.PubMedCrossRefGoogle Scholar
  47. Reuben, D. B., Seeman, T. E., Keeler, E., Hayes, R. P., Bowman, L., Sewall, A., et al. (2004). The effect of self-reported and performance-based functional impairment on future hospital costs of community-dwelling older persons. Gerontologist, 44, 401–407.PubMedGoogle Scholar
  48. Skiest, D. J., & Keiser, P. (1997). Human immunodeficiency virus infection in patients older than 50 years. A survey of primary care physicians’ beliefs, practices, and knowledge. Arch Fam Med, 6, 289–294.PubMedCrossRefGoogle Scholar
  49. Strupp, H. M., & Willmott, D. J. (2005). Dignity denied: The price of imprisoning older women in California. San Francisco: Legal Services for Prisoners with Children.Google Scholar
  50. Taylor, D. H., Jr., Schenkman, M., Zhou, J., & Sloan, F. A. (2001). The relative effect of Alzheimer’s disease and related dementias, disability, and comorbidities on cost of care for elderly persons. J Gerontol B Psychol Sci Soc Sci, 56, S285–S293.PubMedGoogle Scholar
  51. Terhune, C. A., Cambra, S., Steinberg, S. J., Duveneck, S., Baumgardner, E., & Cummings, C. (1999). Older inmates: The impact of an aging population on the correctional system.Unpublished manuscript.Google Scholar
  52. Turley, J. (2003). Statement of Professor Jonathan Turley: California’s aging prison population. Paper presented at the Joint Hearing of the Senate Subcommittee on Aging and Long Term Care, Senate Committee of Public Safety and the Senate Select Committee on the California Correctional System.Google Scholar
  53. Verbrugge, L. M., & Jette, A. M. (1994). The disablement process. Soc Sci Med, 38, 1–14.PubMedCrossRefGoogle Scholar
  54. Voelker, R. (2004). New initiatives target inmates’ health. JAMA, 291, 1549–1551.PubMedCrossRefGoogle Scholar
  55. Walter, L. C., Bertenthal, D., Lindquist, K., & Konety, B. R. (2006). PSA screening among elderly men with limited life expectancies. JAMA, 296, 2336–2342.PubMedCrossRefGoogle Scholar
  56. Walter, L. C., & Covinsky, K. E. (2001). Cancer screening in elderly patients: A framework for individualized decision making. JAMA, 285, 2750–2756.PubMedCrossRefGoogle Scholar
  57. Williams, B. A., Lindquist, K., Sudore, R. L., Strupp, H. M., Willmott, D. J., & Walter, L. C. (2006). Being old and doing time: Functional impairment and adverse experiences of geriatric female prisoners. J Am Geriatr Soc, 54, 702–707.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Brie Williams
    • 1
  • Rita Abraldes
    • 2
  1. 1.University of California School of MedicineSan FranciscoUSA
  2. 2.Independent ResearcherSan FranciscoUSA

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