Aging inmates lack health services

As the number of Canadians serving sentences into their senior years continues to rise – with many inmates dying behind bars – prisoner advocates are demanding changes to address age-related health issues, such as dementia.

A recent – though unusual – case has highlighted the issue. Francis McLauglin was convicted of second-degree murder in 1978. He was granted parole in 1989 but in 2016 he was returned to prison after the parole board noticed a change in his behaviour. He spent the last 10 months of his life in prison before dying in January 2017. According to parole board documents, McLauglin was suffering from dementia.

According to 2013 statistics from Correctional Services Canada (CSC), the average age of death for individuals in federal penitentiaries is 60, compared with an average age of around 80 for the general population (78.3 years for males and 83 years for females).

The majority of inmates die of natural causes, with senior inmates contributing to about 87 per cent of those deaths.

Ivan Zinger, the correctional investigator of Canada, says that many individuals lose parole due to age-related health issues.

“Too many offenders die behind bars and there is, in our view, more that must be done in order to transition these aging offenders,” says Zinger.

“If they require end-of-life support that should be provided in the community, and even in cases where they want assisted dying, those decisions should be made in the community not a federal penitentiary.”

The Office of the Correctional Investigator of Canada has been making recommendations on the aging population for over 15 years.

Zinger says that this segment of the population requires altered living situations, increased transition into the community and health care services that reflect end-of-life care.

The longer the sentence, the older the inmate

Federal penitentiaries have a higher number of senior inmates than provincial facilities. This is mainly due to the fact that those convicted of more serious offences, which carry longer sentences, are sent to federal prisons. Provincial institutions are only used for those serving sentences of two years or less.

Seniors end up in federal penitentiaries in one of two ways. First, they may be convicted when they are younger but are sentenced to long prison terms.

Greying prison population seen nation-wide [© Andrew Price]

CSC spokeswoman Esther Mailhot, said via email that 58 per cent of inmates between the ages of 50 and 64 are currently serving life sentences. This contributes to the 22 per cent of inmates who are serving time over the age of 50.

Over the past 15 years, a trend has also emerged of many being admitted at an already advanced age. Since 1998-1999 the number of inmates being admitted at the age of 50 or older has doubled, from eight to 15 per cent.

“The correctional system has not yet switched to answer to the needs of this aging population,” says Adelina Iftene, a research fellow at Osgoode Hall Law School at York University.

“Generally the services, whether medical or programming, are not really responding to the needs of this much weaker population.”

Another issue with an aging prison population is inmates suffering from physical health problems that may require alternative accommodations.

According to Iftene, poor accessibility infrastructure in many federal facilities means inmates with mobility issues have no access to an elevator and are forced to walk up and down stairs.

“If you are thinking of somebody who is terminally ill … you are starting to question why they are in prison in the first place,” says Iftene.

Community Resources

The 7^th Step Society, a group created to help support recidivist offenders, has seen an increased demand for programs to aid older people who have been released from prison and/or are on parole.

Bob Alexander, executive director of the Alberta chapter, says anywhere from three to six people over the age of 60 are living at their halfway houses at one time while on parole.

In most cases Alexander says aging inmates have been in the system for the better part of their lives.

The program he works with in Calgary is generally a work-based initiative. Older inmates choose alternative ways to engage with the community, such as one inmate, 71, who is currently writing a screenplay about his wife.

“When they come to our program their needs are different in the sense that they are typically not employable. Either they have never been employed in their life or they are just getting too old to work,” says Alexander.

Due to their advanced age, inmates unable to get released often face serious health issues inside the correctional system.

According to Mailhot, inmates over the age of 50 are typically serving time for charges such as first and second-degree murder, sexual offences and robbery.

Section 121 of the Corrections and Conditional Release Act states that at any time parole should be granted to an inmate who is terminally ill, suffering from serious mental or physical health issues, or for whom confinement would cause an excessive hardship not foreseeable at the time of their sentencing. This type of release is often called compassionate release or ‘parole by exception’.

Advocates are calling for legislative change to address the aging inmate population. [Photo © Austin Stanton]

According to the 2014-2015 Correctional Investigator Annual Report, in the 55 cases of inmates who were in palliative care, a type of specialized care based on providing relief and increased quality of life for those suffering from serious illnesses, only 14 applications were sent and only four granted.

“There are of course the exceptional cases where offenders who have been incarcerated for many, many years prefer to remain in prison,” says Zinger.

“The way we are currently [housing inmates] is more costly. There is no public safety benefit achieved and frankly it raises some human rights and dignity issues.”

According to Mailhot, CSC is working on a plan to implement some of the recommendations proposed by the Office of the Correctional Investigator of Canada. She stated the development of a strategy addressing the care and custody needs of the aging inmate population and will be completed by the end of the 2017-2018 fiscal year.