Congress Workshops Examine a Variety of Topics
Black, White and Gray All Over: New York Cares for its Elderly
Inmates are growing old in our facilities, and it is our duty to find ways to appropriately care for them, said Dr. Lester Wright. The number of elderly inmates in the New York State Department of Correctional Services has been increasing steadily in recent years, and because New York is one of the few states with a declining inmate population, the percentage of elderly inmates--those 55 and older--has been increasing even more rapidly. As deputy commissioner of health services and chief medical officer for the DCS, Wright helped implement a unit within the system to care for inmates with cognitive impairments. The Unit for the Cognitively Impaired (UCI), located within the Fishkill Correctional Facility, has been housing patients with various forms of dementia since it opened in October 2006. The deputy superintendent for health at Fishkill, Elizabeth Williams, RN, helps oversee UCI, and she explained later in the workshop how the unit came to be and some of the services it provides.
Wright opened with some background information on the experience of aging, focusing particularly on some of the difficulties of aging in a correctional environment. Elderly people do not hear, see, walk or digest dinner as well as younger people, and they suffer from such ailments as tooth decay, depression and lethargy. Elderly patients sometimes require wheelchairs and walking devices; often cannot climb to the top bunk; and need warmer uniforms in the winter. Older inmates are often intimidated by younger inmates, he noted, and older inmates can be more vulnerable to attack. So, should they be housed in separate facilities once they reach a certain age? The flip side to that is older inmates can have a calming effect on younger inmates, Wright said, which is one reason he prefers to keep them with the general population.
"Is it a burden or an opportunity to care for inmates?" Wright asked. Because most inmates return back to the community, he views incarceration as a time to improve the health of inmates and send them back to the community in better shape then when they came in. Wright listed the host of services that corrections provides to inmates. Care for the elderly is imperative, Wright said, and because it is more expensive to care for older inmates, we must come up with creative, cost-effective ways to keep them healthy and active. The common age in the community in which a person is designated as elderly is usually 65, Wright said, but because inmates are harder on their bodies than the average person, their physiological ages are often greater than their chronological ages, making elderly an accurate description for 55-and-over inmates.
Services. Williams explained some of the outpatient medical services provided at Fishkill, one of five regional medical units within the DCS. Fishkill contracts with a variety of vendors on site, enabling 93 percent of inmates' medical appointments to occur at a secure facility. Inmates from all over the region travel to Fishkill to receive dialysis, dental, phlebotomy, ophthalmology and X-ray services. The facility has a contract with Erie County Medical Center, whereby staff dial into Erie's emergency room, and doctors at that facility assess Fishkill patients via telemedicine equipment. Williams said it is very popular with the medical staff who like having another set of eyes to help diagnose patients, and it has proved cost effective. Wright chimed in that it prevents 20 percent of patients from going out to receive services unnecessarily, and when a patient does need to be transferred to a hospital, the Erie County doctors will call the nearest hospital to prep its staff on the inmate they are about to receive. At Fishkill's 20-bed infirmary and 30-bed long-term unit, a multitude of in-patient services are provided to inmates. The long-care unit admits patients with chronic, terminal diseases, and as such, provides a hospice program for dying inmates. …