Caring for aging and infirm prison inmates

Inmates age earlier than is common in the community because of inadequate medical care before incarceration and greater use of alcohol and substances of abuse. The number of inmates in New York State prisons who are 55 years or older has more than doubled in the past ten years. This has resulted from longer sentences including life without parole and better health care. The death rate for inmates in this age group has fallen. These inmates require more extensive care for chronic diseases. It is estimated that care of elderly inmates costs up to three times as much as for younger inmates. To provide for health care needs, New York provides age-specific health screening based on national guidelines and has organized primary health care including chronic disease case management clinics. Regional Medical Units provide long term and chronic care. Compassionate release is provided whenever inmates meet the statutory requirements. Hospice services utilizing carefully selected inmate hospice aides are available to who are dying. A Unit for the Cognitively Impaired provides care for inmates with dementia from Alzheimer's disease and other forms of dementia. Planning is underway for assisted living units. Thus a spectrum of age-appropriate care is available to provide essential health care for aging inmates. Although every effort is being made to deliver the care as efficiently as possible, costs will continue to increase as the number of aging inmates increases.