The first day of October has been designated by the United Nations as the International Day of Older Persons to highlight the global growth in the older population and the way governments and societies are adapting to meet the needs of older people.
There are now almost 700 million people over the age of 60 worldwide and the UN is concerned to make sure that human rights – including the right to the highest attainable standard of physical and mental health, freedom from torture, inhuman or degrading treatment and equality before the law – apply to older people in the same way as everyone else.
As our general population ages, so does the prison population. Ministry of Justice projections indicate that the number of older prisoners (aged over 50) is set to rise to nearly 14,000 by 2020, making up 17% of the overall prison population. Through their regular monitoring of prisons, IMBs are questioning whether the needs of older prisoners are being met, particularly in relation to health and social care, but also in relation to appropriate purposeful activity and the physical environment of the prison. A more elderly population also means higher numbers of prisoners with a range of disabilities or terminal illnesses.
In August 2017, IMBs assessed how well the needs of older prisoners were being met at their establishments, providing a snapshot from across England and Wales. Their findings included:
Accessibility concerns included the lack of grab rails in showers, the need for lifts and stair lifts to reach certain parts of the prison including healthcare, adequate space for wheelchair users and the unsuitability of bunkbeds for disabled or elderly prisoners with mobility problems.
Some prisons have good relationships with local hospices and organisations such as Macmillan where prisoners can receive good specialist care, outside of prison where necessary. One prison with a very high proportion of older prisoners has its own end of life suite in its healthcare unit, but it had never been used.
IMBs were concerned about the treatment of prisoners with degenerative brain disease such as dementia and ensuring that they received appropriate healthcare. There was a consensus view that dementia patients cannot be well cared for in a prison environment.
Other Healthcare Concerns
Some IMBs reported concerns relating to the lack of healthcare staff at weekends and prisoners not receiving the same level of care as their contemporaries in the outside world. For example, in one establishment the IMB noted that preventative screening for diseases such as bowel cancer in the older population was not taking place in the prison whereas routine screening every two years would be available in the community.
There were concerns about the over-reliance on younger prisoners to provide basic social care through a ‘buddy system’ and the impact this had on relationships between older and younger prisoners.
There was often a lack of suitable purposeful activity for older people, who may not be capable of the work carried out in prison workshops. Being past retirement age, programmes developed as part of rehabilitation and improving job prospects were less relevant for some. As a result, older prisoners received lower earnings from which to purchase goods.
These examples are just a snapshot of IMBs’ concerns relating to older prisoners, but they illustrate some very real ways in which prisons, like other public services, need to adapt to the needs of older people in their care.