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Elder Abuse in Prisons: The Call for Elder Justice and Human Rights Protections Behind Bars

by Tina Maschi, Ph.D., LCSW, ACSW

“Prison is a hard place. Pure Hell! As long as you are in khaki, you are considered non-human. The elder suffer the most because there isn’t much for them, us. I have the start of osteoporosis and seeing how some people young and old are treated makes me suffer and deal with it. Overall it’s horrible and wouldn’t wish this on my worst enemy.” – Mary, a 64-year-old incarcerated woman serving a 20-year sentence

As the movements for elder justice and human rights of older persons are gaining national and international momentum, we must not neglect the safety and protection of older adults in prison. So what is meant by elder abuse? According to the World Health Organization, elder abuse is defined as “a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person.” Elder abuse may take many forms and consists of physical, sexual, psychological or emotional abuse, financial exploitation and intentional or unintentional neglect, including medical neglect.

Most of the elder abuse prevention, detection and intervention efforts are geared towards community-dwelling older adults who are abused, neglected and exploited in their family homes, neighborhoods and long-term care or nursing home settings. However, much less attention is given to older adults who are incarcerated.

What differentiates elders in prison is that they have been convicted of crimes, including drug, sex and violent offenses. I argue that regardless of older adults’ past criminal histories they deserve equal rights and protections from elder abuse. Most of the information about elder abuse in prison has been anecdotal. In this article, I provide findings from my 2010-2011 survey of 677 adults aged 50 and older in a northeastern prison system. Many of the experiences described by older adults in prison can be classified as elder abuse, neglect or mistreatment.

Elder Abuse in the Social Context of Prison

In the survey, many incarcerated older adults reported some of the harsh realities of incarceration, ranging from being a victim of and/or witnessing minor to severe trauma, abuse, violence and exploitation. As in the case of Joseph, a 72-year-old man who experienced sexual assault, mistreatment by staff and separation from his family: “I am 72 and I am afraid of being assaulted again. I get stressed out because we are treated like pieces of garbage and always threatened with harm from officers. I have a sister in the rest home and have no contact with her. My son is in prison.”

Some older prisoners also described “being picked on for petty things by guards,” “constant shakedowns,” “canceled recreation” and “being denied medical/medical help and phone privileges for no reason at all”; “being punished for other people’s actions”; and “being accused of things you didn’t do and your job taken away.” Some older adults reported being a victim of and/or witnessing violence and abuse, including being “raped,” a “male guard feeling on my body,” “seeing killings in prison yard and mess hall and guards killing inmate[s],” and being “beaten by corrections officers” and seeing “corrections officers stomping inmates into comas.” Other older prisoners said they experienced “aggression from other inmates,” “being assaulted by a young mental patient” and “being robbed.”

Solitary Isolation and Other Forms of Cruel and Unusual Punishment

Older adults also described experiences of isolation or being victims of and/or witnesses to forms of torture or cruel and unusual punishment. Their comments included: “prison officers confine inmates in 2 cages 15-20 minutes 25 at times...”; “I’ve been locked up in a room for 23 hours a day for the past four months without an explanation from administration”; “locked up in a cell 22 hours a day and not enough recreation time”; “there’s a lack of programs to keep the mind active”; and “there are searches where property becomes destroyed or stolen.” Others reported an environment of “constant noise” and cells that are “constantly lit up.”

Medical Neglect and Healthcare Abuse

Many older adults reported poor nutrition and inadequate healthcare within the prison. Some of their statements included: “food nutrition – poor, variety – poor, balance – none, lack of use of utilities, water – no water to drink for 2 days, food, meat not cooked, not getting out to yard enough,” and “everyone chain smokes around me all the time.” Others reported staff apathy and medical neglect with the following comments: “there is indifference to my need for medical care”; “medical department ignoring medical complaints”; “there’s a failure of medical personnel, malpractice, a failure to treat, negligence, abuse, denial of vital medication, heart meds”; “a failure to follow specialists’ recommendations for treatment of hypertension and pain”; “having to wait 2 to 4 years to participate in a prison program”; and “mismanagement of prison and neglect of serious health issues.”

The Trauma of Family Separation

Most older adults reported separation from family and the community as a form of abuse or mistreatment. Some reported: “I am confined like an animal and kept away from family, treated badly by officers,” “being here away from my family and not having freedoms,” “being transferred to a prison where my loved ones couldn’t visit because of the distance” and “I cannot contact family, I think about my children, grandkids, children in [the Department of Youth Services].” Other barriers to family contact included “poor mail delivery” and “the lack of phones.”

Several survey participants who were close to being released from prison described their bleak options for future employment and economic earning power. They stated, “I worry about when I get out – getting [my] kids a place to live”; “keeping a job to make ends meet”; “job opportunities upon my release, rebuilding relationships with my children” and “not being able to support them.” One respondent wrote, “I believe the intent is for us to die in here.”

“Policy” Abuse and Mistreatment

Some older adults reported a type of policy trauma in response to how sentencing and parole policies impacted their state of physical and mental well-being. Their comments included being put in solitary confinement for 14 years, the use of “malicious disciplinary charges used to lock me up in closed custody illegally,” “waiting endlessly for my court appeal” and” being denied parole eight times.”

Stigma as a Precursor of Abuse and Mistreatment

Other older prisoners described the stigma of incarceration and the loss of identity that heightens the risk of elder abuse or effective responses to such abuse. Their comments included: “you’re identified as a number, and not as a human being” and “as long as you’re in khaki, you are considered non-human.” Several older adults shared significant concerns about how staff often had their own unfair, informal rules and did not enforce formal protective policies. One survey participant noted about correctional officers, “they seem to lack a ‘higher power’ to address prison abuse and neglect.”

Towards Elder Justice and Human Rights for Older Persons in Prison

Based on the World Health Organization’s definition of elder abuse, most of the experiences described above can be classified as a form of elder abuse, neglect or mistreatment. Some existing laws that can be used to protect the rights of older adults in prison include the Prison Rape Elimination Act, compassionate release or medical parole statutes and the Americans with Disabilities Act. However, the application of mandated reporting laws (i.e., requiring certain officials and licensed professionals to report incidents of abuse or suspected abuse) has not been extended to incarcerated older adults as a tool for prevention, assessment and intervention responses to elder abuse.

A recent report issued by the United Nations High Commissioner for Human Rights has urged that special consideration be given to older adults in prison due to the accumulated or aggravated disadvantages inherent in their carceral status and grave human rights conditions. Fundamental to human rights values are dignity and respect for all persons, and the indivisible and interlocking holistic relationship of all human rights in civil, political, economic, social and cultural domains. In the Convention on the Rights of Older Persons, rights are framed by conceptions of equality, respect, autonomy and dignity.

Areas of protection of older persons that are underscored for those in prison include age discrimination, legal capacity and equal recognition before the law, conditions of institutional and home-based long-term care, violence and abuse, access to productive resources, work, food and housing, social protection and the right to social security, right to health and palliative and end-of-life care, disabilities in old age, access to justice and legal rights. The United Nations classifies “older prisoners” as a special needs population – along with racial/ethnic minorities, persons with disabilities or terminal illnesses, GLBT prisoners and death row prisoners – with specific, non-binding guidelines for their treatment that include care transitions.

Existing United Nations documents, such as the Standard Minimum Rules for the Treatment of Prisoners and the Handbook on Prisoners with Special Needs, set forth non-enforceable guidelines that address the rights and needs of incarcerated older adults, including access to prison rehabilitation, physical and mental health care, geriatric-specific care, and family programming and linkages to community services. The community reintegration or resettlement of older prisoners with their families is a critical issue that requires attention from corrections officials and others involved in reentry. The collateral consequences of incarceration, such as lack of access to housing, healthcare, employment and social security and benefits, make it challenging for older adults to readjust following their release from custody – especially those who have served lengthy prison terms.

Tina Maschi, Ph.D., LCSW, ACSW is an associate professor at Fordham University Graduate School of Social Service and recipient of the 2010 Geriatric Social Work Faculty Scholars Award funded by the John A. Hartford Foundation and the Gerontological Society of America. She has over 25 years of experience working with diverse age groups of survivors of trauma in correctional and community settings. She is the President of the National Organization of Forensic Social Work and the Executive Director of the Be the Evidence Project at Fordham University, which brings light to pressing human rights and social justice issues of our times, such as Aging in the Criminal Justice System. Read more about her research, community outreach and advocacy efforts at www.fordham.edu/btep. She provided this article exclusively for Prison Legal News.