Doing Time - the experiences and needs of older people in prison

prison cell with bed and a walking stick leaning against a bedside cabinet with a pile of books on it

A report published by the Prison Reform Trust provides evidence that older prisoners face isolation and discrimination because the government is failing to meet their specialist health, social and resettlement needs, with some prisoners who use wheelchairs unable to join in day-to-day prison activities. 

The report, Doing Time: the experiences and needs of older people in prison, supported by the Lloyds TSB Foundation for England and Wales, was launched in July 2008 at Wandsworth prison at an event attended by the Prisons Minister, David Hanson MP and older prisoners.

(to read David Hanson's speech for PRT's launch of Doing Time click here)

The latest official figures show that at the end of March 2008 there were 6,661 men and 316 women over the age of 50 in prison in England and Wales, approximately 8.5% of the prison population. Prisoners over the age 60 are the fastest growing age group in prison, with the number of men more than tripling between 1996 (699) and 2008 (2,242). There were 454 people over the age of 70.

The report reveals that often poor health and social care assessments can lead to loss of dignity and humiliation. Some incontinent prisoners are, for example kept locked in education classes without easy access to toilet facilities. One prisoner interviewed for the report said:

I have bladder trouble especially at night and I often wet my clothes and bedding. I am very embarrassed about this and don't want to be a nuisance. When I mentioned this to my officer he laughed and said that we all have problems like that as we get older. But now I'm wetting myself in the daytime and can't get to the toilet quick enough in education because it is locked. Now some of the younger men and officers are teasing me about my body smell and the stench in my cell.

Although noting the general improvement in prison healthcare since responsibility was transferred to the NHS in 2006, the report finds older prisoners can face difficulties continuing their medication when imprisoned and routinely fail to receive preventative and screening services. Very few social services departments provide support for older people in prison and it can be difficult for prison staff to find out who has the duty to provide services.

Provision for terminally ill prisoners is identified by the report as another area of concern. The current rules for compassionate release for those with terminal illnesses allow release for prisoners expected to live no longer than three months but the report points out that consultants often find it difficult to predict accurately how long someone has left to live. The report also highlights that transfers to hospices are sometimes subject to unnecessary delays.

Based on interviews with 78 men in prison, 18 ex-prisoners and two focus groups with women prisoners, in addition to letters received by the researchers and the Prison Reform Trust's advice and information service, the report makes a number of other practice and policy recommendations. These include:

-          Changing the law to clarify legal responsibilities for social care provision for older prisoners who are frail or unwell and whose needs are largely unmet.

-          The possible establishment of schemes where trained prisoners provide supervised support for older people in prisons where there are significant numbers of prisoners with physical disabilities.

-          Day-to-day prison activities should take into account the needs of older prisoners. As well as making minor adjustments, such as ensuring quick access to toilets at all times for those with bladder problems, separate regimes for older people should be available where possible.

-          Better help and advice should be provided when leaving prison at the end of a sentence. The report states that older prisoners are likely to be the most institutionalised of all those released and finds that over a quarter (28%) of interviewees would be over the age of 70 on release.

-          Older prisoners should be provided with extended visits for elderly visitors who cannot visit often.

The report calls on prison staff to take steps to monitor the involvement of older people in prison life and, in particular, respond quickly and effectively to bullying. The report finds that almost half (48%) of men interviewed had experienced bullying or intimidation. One example cited in the report, is of an older prisoner whose mattress was taken from him by his younger cell mate who also forced him to use the top bunk at night.

Also highlighted by the report is the use of unsuitable prison cells for older people. One interviewee said:

I can't get my wheelchair through the door of my room and I have to try and get from the entrance to my bed. When it's mealtime someone has to collect my food and bring it to me - I've been told that officers are not allowed to push me.

The report calls for cell allocation policies to take account of mobility and other health and social care needs. 

Juliet Lyon, director of the Prison Reform Trust, said:

More and more older people are being locked up in prisons designed and run for young men. Some older prisoners face the double punishment of poor treatment and conditions. The Prison Service is struggling to comply with the Disability Discrimination Act. It would make more sense to develop appropriate secure accommodation for the elderly or to use effective community punishments.