Elder Care: Louisiana Initiates Program to Meet Needs of Aging Inmate Population

Article excerpt

In Louisiana, an inmate sentenced to life in prison is likely to die there, unless a court intervenes or the sentence is commuted by joint action of the board of pardons and the governor. There are 3,014 inmates with life sentences and approximately 1,850 more who have "practical life" - mandatory sentences so long as to effectively preclude release. These inmates represent the future of the already growing population of older inmates, a population that brings with it an increased potential for medical problems and emergencies, circumstances that often develop sooner in prison populations.

In 1980, 281 inmates (4.5 percent of the institutional population) were 50 years of age or older. In 1990, there were 857 (4.6 percent), and at the end of January 1998, there were 1,275 (7.4 percent). Truth-in-sentencing laws will push these numbers higher. More inmates will remain in prison for longer periods of time. And more inmates will grow old in prison.

Current Circumstances

In 1992, the Louisiana Legislature created a crime victims' "bill of rights," which, among other provisions, gave victims more say in probation and parole proceedings. Victim advocates argued that issues other than cost and risk must be considered when weighing the release of inmates from prison, regardless of age. In 1993, the state legislature passed a law excluding inmates sentenced for first- and second-degree murder from medical parole, even if they are terminally ill or permanently incapacitated.

After Congress enacted the Violent Crime Control and Law Enforcement Act of 1994, which offered construction grants and other incentives to states that ensure violent offenders remain incarcerated for substantial periods of time, the Louisiana Legislature passed a law requiring inmates who commit a crime of violence on or after Jan. 1, 1997, to serve 85 percent of the time imposed before qualifying for release. The state's first comprehensive felony sentencing guidelines, implemented in January 1992, were repealed, effective August 1995, amid insistent claims that they existed to shorten sentence lengths.

An Approach to the Challenge

Inmates in Louisiana state institutions live in dormitories in the general population - unless their behavior or assessed physical, mental or emotional needs indicate that cell block housing is required. This is true of geriatric inmates (the term used here to mean "aging" rather than "of advanced age"), just as it is of teen-age newcomers to the system, HIV-positive inmates, inmates with mental retardation and/or mental illness, and others. In that sense, older inmates are just one of various groups of special needs inmates within the state correctional system. Like the others, the elderly live in the general population as long as they can do so safely. For those who cannot live in the general population, the department has concentrated on upgrading medical and mental health services at the Louisiana State Penitentiary (LSP) at Angola in order to satisfy the needs of the department's most seriously medically and mentally ill offenders.

Intent on overcoming the constant shortage of doctors and nurses at LSP, the administration increased salaries for doctors and registered nurses, offered remodeled and modernized housing on the grounds to medical staff, and increased the hours of contract physicians.

Angola is in a rural area, and the prison is surrounded on three sides by the Mississippi River and bordered on the fourth side by the ravine-laced Tunica Hills. It is 59 miles from Baton Rouge and about 140 miles from New Orleans. The isolation that once made it the perfect place for a prison also made it a challenging location to maintain a full complement of necessary medical and mental health personnel. Once these limitations were acknowledged, other sites were examined for development of specialized units and services.

Special Needs Facilities

One special needs facility is being developed near Shreveport as a satellite of the David Wade Correctional Center (DWCC). …