practical living
Old and
inside
Ageing prisoners are challenging the system
inside and out.
By Tracey Johnstone
P
hil Goulding stopped talking. It was only for a few moments,
but the silence was noticeable. Up until then our conversation
had been flowing freely. You see, we were talking about the
face of ageing prisoners in Australia, and it was quickly evident that
there is a lot of sensitivity around the subject.
Goulding is the deputy general manager of operations at
Melbourne’s Wintringham, a specialist aged care provider for the
homeless and disadvantaged. He is a member of a growing cohort
of professionals across Australia gradually peeling back the layers to
reveal the challenges for ageing prisoners in custody, rehabilitation
or on release from prison, and for the corrective and justice
healthcare workers managing them.
The professionals are focused on people aged 50 or older. In the
prison system, they are considered ‘ageing’. Many have entered the
system with chronic health issues brought on by drugs, alcohol,
poor nutrition, lack of medical care and, for some, after spending
much of their life in prison and juvenile detention. All of this
escalates age-related illnesses.
Matthew Willis, an Australian Institute of Criminology (AIC)
researcher, says these factors often result in high levels of physical,
mental health and cognitive impairment, and higher vulnerability to
victimisation within the general prison population.
These ageing prisoners fall loosely into four categories: recidivists,
first-time older prisoners, inmates growing old in prison due to
long sentences, and those who committed a crime as a result of
cognitive damage or decline.
GOING UP
The number of senior prisoners is increasing, and so too is the cost
of providing appropriate aged care health support and facilities,
which they have a right to access as stipulated under the UN Human
Rights Committee in its International Covenant on Civil and Political
Rights. In particular, this states the right of a prisoner to be treated
with humanity, dignity and respect while in detention.
As of 30 June 2018, there were 5554 prisoners aged 50 years
or older (94.3 per cent male and 5.7 per cent female), adding to
Australia’s burgeoning prison population.
This is an increase of 81.6 per cent between 2001 and 2010, and
another increase of 67 per cent from 2010 to 2018.
20 agedcareinsite.com.au
At the same June date, there were 1156 prisoners aged 65 years
and over (97.2 per cent male and 2.7 per cent female).
Between 2001 and 2010 there was an increase of 128 per cent,
and a further increase of 119 per cent during the years to 2018.
The ABS, in its Prisoners in Australia Report 2018, noted that
62 per cent of the prisoners aged 65 and over had a “serious
offence/charge of sexual assault and related offences”.
The increase in numbers isn’t due solely to an ageing Australian
population. “Another part of it is some of the changes we have had
to sentencing laws and parole laws,” Willis says.
Parole is now harder to get, which can result in people staying
in prison for longer. There have also been improvements in DNA
technology, investigative techniques and information handling,
which have all impacted on prosecuting old offences, including sex
offences which can carry long sentences.
The consequence of the growth in older prisoners is an increase
in remand costs due to specialist service delivery and facilities,
changes to prison activities and upskilling correction and health
services staff to cater for this cohort.
In 2013–14 it cost $292 per prisoner per day according to the
Report on Government Services 2015.
The 1999 AIC report Elderly Inmates: Issues for Australia
calculated that cost increases threefold for ageing prisoners.
WHO’S IN CHARGE?
Currently eight jurisdictions look after prisoner welfare in Australia,
each with its own ageing prisoner management approach.
UNSW Kirby Institute researcher Dr Natasha Ginnivan suggests it’s
time for a national policy approach to deal with accelerated ageing.
“Because there isn’t a management plan in place for dementia,
cognitive impairment or frailty, or pre-frailty, which is a measure that
has been used in population ageing, we don’t know the prevalence
of some of the muscular-skeletal and mild cognitive concerns
within this population,” she says.
“We know that when they get to a certain stage it becomes very
expensive to house them when they are frail, notwithstanding the
human rights issues around providing appropriate care.”
NSW, then Queensland and Victoria, have the greatest number
of ageing prisoners. In NSW, a Corrective Services spokesperson
reports that most of the state’s older inmates are in mainstream
facilities, and their medical or disability concerns are considered,
including placement in bottom bunks or ground floor placement.
“The infrastructure at some facilities has also been modified
with handrails above beds and in bathrooms, easy-to-use taps and
ramps in yards,” the spokesperson says.
Elderly and frail inmates are located in the Long Bay Aged Care
Rehabilitation Unit and the Kevin Waller Unit.
Old-age and neuropsychiatrist Dr Sharon Reutens says NSW
had speciality psychiatrists and geriatricians, and speciality units to
address the problems around dementia in ageing prisoners.
Corrections Victoria (CV) developed a framework for 2015–2020
which identifies actions around designing and managing its
correction services to meet the needs of its ageing prisoners.
Subsequently, CV recently entered a contract with Wintringham.
Goulding said: “We’ve been asked to provide advice on older
prisoners and assess them for their care needs. It’s a positive step.
It’s the first time there is an acknowledgement that there is a gap.”
Over the next three years they will look at two prisons to identify
aged care needs, including where some prisoners won’t admit their
needs as they don’t want to be transferred.
“At the end of the project, further planning will be done.”