Themed Collection: Older people 2018

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WEPHREN supports International Day of Older Persons on 1st October 2018  by collecting and sharing  resources  from around the world for prisons on the WEPHREN website. 

OLDER PEOPLE IN PRISON

There are over 10 million people in prisons or other prescribed places of detention worldwide but it is uncertain how many of these are older people. We can however be reasonably confident that there are millions of older people in prison across the world. Of course exactly when someone is classified as an ‘older person’ in prison is also unclear although consensus is emerging around the age of 50 years and over because people in prison often have rates of morbidity and functional abilities similar to peers in the community 10 years their senior.

What is clear is that in many countries the number of people in prison defined as “older” is increasing at a disproportionately high rate. In the United Kingdom the proportion of older people in prison has increased by 169% over the last 15 years to 15.6% of the whole prison population and it is estimated that by 2021, nearly 1 in 5 prisoners will be 50 years or over. In the United States of America, the proportion of older people in prison has increased from 10.3% to 19.2%. It is unlikely to be a phenomenon confined to high income countries; it is simply that data is more readily available in these countries. If you work with older people in prison in a low or middle income country, please do contact WEPHREN WEPHREN@phe.gov.uk.

Older people in prison in Switzerland

 by Dr Tenzin Wangmo

Older prisoners, defined as those 50 years and older, constituted 14.6% of the Swiss prison population in 2016. When 60 years is used to demarcate old from young, only 4.5% of the total prison population is ‘older’[1]. Like elsewhere, the age from which a prisoner is an ‘older prisoner’ is yet to be standardized in Switzerland. For the research project ‘Agequake in Prisons’, we used 50 years of age and older to denote older prisoners, and 49 years and younger for younger prisoners. Our nationwide study (2011 – 2016) collected data from medical records of older and younger prisoners in addition to interviews with older prisoners. Our study revealed new and lacking findings on the health, healthcare, and age-related needs of older prisoners in Switzerland. First, study findings highlight that older prisoners live with more somatic conditions and that their disease burden increases with age group[2]. Consequently they need greater access to healthcare[3] than younger prisoners. Second, the discussions with older prisoners brought out different recommendations on their environmental, social, and end-of-life needs. As prisons are designed for young individuals who are expected to leave after serving their time, the prison environment is poorly adapted for the health and social needs of older prisoners, who either enter prison at old age, or have aged there. Thus, questions such as how the prison infrastructure should be adapted, where older prisoners should be placed, or whether they should be separated from younger prisoners require critical and more in-depth analysis[4]. Related to aging in prison is the imminent issue of death and dying[5], and the (im)possibility of obtaining early/compassionate release.[6] End-of-life brings forth the question if a prisoner should die in prison or outside. Older prisoners who have lived many years in prison, lack social support in the community, and for whom other prisoners are their support group, could consider prison as their ‘home’. Thus, end-of-life wishes - including the question of assisted suicide, which is available to older and ill persons in Switzerland - remain an open issue requiring further attention. Specific concerns of older female prisoners[7] and older prisoners with mental health problems and/or serving therapeutic or security measures remained unexplored and are currently being addressed (Agequake in Prisons II[8]). Much attention is needed to translate existing knowledge on older prisoners into practical solutions that respond to their health, social, and end-of-life needs, and ensure the balance between protecting the population and respecting the dignity of older prisoners.     

Dr. Tenzin Wangmo is a Senior Researcher at the Institute for Biomedical Ethics, University of Basel. She has PhD in Gerontology and Venia Docendi in Biomedical Ethics. Her research interests are in the intersection of aging, vulnerability, and social policy.