Nautilus

The Oldest Problem in American Prisons

No prison demographic is growing as fast as the elderly. In 2015, there were 6.7 million people under correctional supervision (“more than were enslaved in antebellum America and more than resided in the Gulag Archipelago at the height of Stalin’s misrule,” Adam Gopnik recently pointed out in the New Yorker). And over 10 percent of them were geriatric (55 years or older)—a 400 percent demographic increase since 1993, according to a 2013 report by the Bureau of Justice Statistics. From 2009 to 2014, while the overall prison population shrank by 3 percent, the geriatric prison population doubled. As 1 in 10 state prisoners serve life sentences, this population will only continue to grow.

The trend poses both a health crisis and an economic crisis. Older prisoners come with a range of complex medical and social demands. Simply walking, eating, and bathing can become complicated undertakings. Though an aging prison population is an inevitable result of harsh sentencing policies combined with an aging population, prisons are often unprepared.

I started to think about aging and ultimately, dying in the criminal justice system.

And yet some of these inmates need critical medical treatment every day. For doctors, prison care often means making more from less. When Brie A. Williams, a geriatrician at the University of California, San Francisco, and an expert in geriatric prison care, began her career, there were only two studies about the needs of older prisoners: “A dated one about older prisoners in a U.S. jail, and

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