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Extending Elder Justice and Human Rights to Incarcerated Older Adults, Part II: Promising Programs and Solutions
posted 12.02.2013

By Tina Maschi

In my first AgeBlog post on this topic, I described stories of trauma, abuse and resilience from older adults in the community and in prison. In pursuit of elder justice and human rights, communities and services should promote human agency and holistic well-being across the life course. While prevention of elder abuse and incarceration is a key aspect of creating and sustaining a human rights culture and an aging-friendly global community, we must deal with the current aging-in-prison crisis.

These quotes and photos skim the surface of the health and other traumatic and stressful conditions endured by elders confined in prison: 

Quote from “Mary,” 56-year-old woman in prison; served five years.

Prison is a hard place. Pure hell! As long as you are in Khaki, you are considered non-human. I miss my family and want to go home so bad. I don’t feel there is enough mental health available on a regular basis or the comfortable feeling of just expressing yourself without the fear of being put in lockdown. The elder suffer the most because there isn’t much for them, us. The medical here makes no sense. Until you have an ailment, you are put off and time holds you back. I have the starts of osteoporosis and seeing how some people young and old are treated makes me suffer and deal with it. I look at it that I will deal with it when I get home. In the meantime I hurt and deal with it. Prayer and God is what gets me through every day, moment, second I am here. Overall it’s horrible and wouldn't wish this on my worst enemy.

Quote from “Joseph,” 57-year-old man in prison.

I was assigned to a job in the prison infirmary (E.C.U.) as a porter. The infirmary job was often very depressing. They have a couple of padded cells there and the screams of tormented souls could be heard throughout many shifts. There were also what we called the “death rooms.” These were a row of five or six cells which housed terminally ill inmates. They had been brought in from prisons throughout the state. Many were fairly young. The medical “professionals” working here had minimal interaction with them; they were largely cared for by care inmate volunteers. When one of the terminal cases passed away, an ambulance would eventually arrive to take the body out of the prison. The guards and medical staff would not help “bag and tag” the body, so it was left to us porters to assist in it. The apathy of the guards toward dying inmates was unconscionable. We had one inmate about 30 years old whose wife and two small children were given permission for a special visit because he was near death. As shift change approached, a nurse entered the room and the family had to stand outside of the door. A female guard yelled to the nurse, “Isn't he dead yet? I don't want to have to stay late to do the paperwork.” The two little girls were sobbing in no time. We also had an inmate turn 100 years old there. He was completely bed-ridden. He passed away eventually. I was left wondering how society was being served by that. In the six months that I worked there, six or seven inmates passed away. Hepatitis and diabetes cases abounded, with many amputations.

Quote from “Jesus,” a 72-year-old man in prison.

You don’t need a survey to know you have a lot of men over 50 getting ready to go home, with no money. No place to stay. And no one trying to understand this part of the problem. I earn $15 a month. I go home in 9 months. I have no family to turn to. I don”t want to come back to prison, after doing 7 years. I am trying to stay positive. I pray. I go to see the psych for one on one and I try to look on the bright side. But the reality is, when I hit the street I am on my own.

Despite the majority of society remaining bystanders as this 30-year, human-made disaster has grown, there have been many people and service providers who have become “Upstanders,” and either advocated for or developed and provided services on behalf of incarcerated older adults and their families. Below I highlight just some of the promising programs that promote dignity, respect and overall well-being for elders mired in the justice system. These programs also may give readers ideas for how similar programs might be developed or refined in their own jurisdictions.

Common Characteristics of Promising Upstanding Programs

Whether aging services are offered in prison or in the community after prison release, common characteristics of promising upstanding programs for incarcerated elders include one or more of the following:

  • Has a mission that promotes dignity and respect for all persons and holistic well-being;
  • Offers age- and cognitive capacity–sensitive environmental modifications (proper lighting, common social space, handrails and are ADA-compliant);
  • Offers health literacy, disease prevention and chronic disease–management programming and holistic supportive counseling;
  • Uses trained interdisciplinary staff and peer support models;
  • Incorporates integrative medicine, including incorporating the arts and animal-assisted therapy;
  • Offers specialized services for older adults with dementia or cognitive impairment from early to late stages, including palliative and hospice care; and,
  • Has discharge planning and is engaged in intersectoral cooperation and collaboration.

Innovative Prison Programming

Promising upstanding prison programs for incarcerated older adults include: the True Grit Program, and the California Men’s Colony.

The True Grit Program in Nevada is a structured living program that attempts to deal with the special needs and foster the well-being of the rapidly increasing population of geriatric inmates. Together with Nevada’s Division of Aging Services, the program was designed to enhance physical health (by means of various recreational and physical therapy activities); mental health (using group and individual therapy and self-help modalities); and spiritual health (coordinated with the prison chaplain and volunteers). The program boasts a zero percent recidivism rate.

The California Men’s Colony in San Luis Obispo, Calif., (a medium security facility) has a peer-support dementia unit. The program aides are six volunteer inmates or “social aides.” Their responsibilities include making sure those in the unit receive medical care, and providing social support and protection as prison is often a dangerous environment in which older adults with cognitive disorders are vulnerable to victimization.

Community Reintegration

Three North American programs that are exemplars for community reintegration include the Senior Ex-Offender Program (SEOP), Hocking Correctional Facility (HCF) and Reintegration Effort for Long-term Infirm and Elderly Federal Offenders’ (RELIEF) Program.

Funded by the U.S. Office on Aging, San Francisco’s SEOP is based in a senior center for adults ages 50 and older who are currently incarcerated or about to be released. It provides medical, financial, social, mental health and employment services for ex-offenders. The program hopes to eradicate the problems elders commonly experience when released from prison, such as homelessness, drug addiction, alcoholism, AIDS, untreated diabetes, hypertension and cardiovascular disease, depression and unemployment. And it encourages getting a new start away from the criminal element. Comprehensive wrap-around services include supplying the ex-offenders with clothing and hygiene products, pre- and post-release counseling (including mental health and substance abuse), case management, gender-based transitional support groups and health literacy and counseling.

The Hocking Correctional Facility (HCF) in Nelsonville, Ohio, begins the community reintegration process before older adults exit prison to maximize health and well-being after prison release. Its setting is unique because it offers a one-stop shop of services to help prisoners prepare for community reintegration, including a pre-release program that provides inmates with information on Social Security access, job-seeking skills, housing placement services, employment training, property maintenance, self-care and psycho-educational classes (on topics that address age-related issues such as the physical, psychological and social processes of aging), and general education and literature courses.

The facility also provides its staff with training to deal effectively with geriatric populations, including training on chronic illnesses and death and dying issues. Community reintegration is an active component of services so that older prisoners have the necessary resources, including an approved placement in nursing homes if the older adults’ functional capacities warrant such placement.

The RELIEF Program in the Pacific Region of Correctional Service in Canada was established in 1999 to facilitate the transition of elderly and infirm prisoners into the community. The program addresses the hospice care needs of elderly and infirm ex-prisoners (who are screened and provided hospice care training). The program is designed keeping in mind human rights and the social justice values of dignity and worth of the person and respect to the dying. It uses former prisoners as caregivers in an attempt to provide compassionate peer support to fellow ex-prisoners who are dying.

Next Steps

I implore community service providers to be Upstanders on this moral and economic issue of our time. Adults ages 50 and older have a less than 1 percent recidivism rate regardless of the nature of their crimes. And when provided holistic services, there is a zero percent recidivism rate. Being of minimal risk to society, to continue to deny them access to quality services may be argued to be the equivalent of elder abuse, neglect, mistreatment and discrimination. This blog highlights just a few of the more compassionate and upstanding responses that service providers can offer.

For more information, please feel free to contact Tina Maschi at

Tina Maschi, Ph.D., L.C.S.W., A.C.S.W., is an associate professor at the Fordham University School of Social Service in New York City, and founder and executive director of the Be the Evidence Project.

Photos reprinted by permission from Ron Levine Prisoners of Age

From the editorial committee of ASA’s Network on Multicultural Aging (NOMA)

Help us improve AgeBlog and rate this post by clicking here! 

Further Reading:

“Trauma and Coping among Older Adults in Prison: Linking Empirical Evidence to Practice,” by Tina Maschi, et al. (in press)

Trauma, Stress, Grief, Loss, and Separation Among Older Adults in Prison: The Protective Role of Coping Resources on Physical and Mental Well-Being,” by Tina Maschi, et al.

The Case for Human Agency, Well-Being, and Community Reintegration for People Aging in Prison: A Statewide Case Analysis,” by Tina Maschi, Mary Beth Morrissey and Margaret Leigey

Aging, Mental Health, and the Criminal Justice System,” by Tina Maschi, Samantha Sutfin and Brendan O’Connor

The High Cost of the International Aging Prisoner Crisis: Well-Being as the Common Denominator for Action,” by Tina Maschi,  Deborah Viola and Fei Sun

The Heterogeneity of the World Assumptions of Older Adults in Prison: Do Differing Worldviews Have a Mental Health Effect?” by Tina Maschi and Judith Baer

The Aftermath of Childhood Trauma on Late Life Mental and Physical Health: A Review of the Literature,” by Tina Maschi, et al. 

Forget Me Not: Dementia in Prisons,” by Tina Maschi et al.

 “Trauma and Stress Among Older Adults in the Criminal Justice System: A Review of the Literature with Implications for Social Work,” by Tina Maschi, et al.

 “Trauma and Life Event Stressors Among Young and Older Adult Prisoners,” by Tia Maschi et al.



Excellent information about a often forgotten population

Thank you Tina for this contribution. Your work is certainly interesting.  It's also important for us to remember this population is in great need of services and for opportunities to have a better life than before or during incarceration.  We look forward to hearing more from you as your work continues. 


Anne Ornelas

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