Source — Kaiser Health News

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USA : more prisoners die of old age behind bars

As the number of older prisoners soars, more inmates are dying in prison of diseases that afflict the elderly, new data from the Department of Justice show.
A total of 3,483 inmates died in state prisons and 444 in federal prisons in 2014, the highest numbers on record since the bureau started counting in 2001, according to data issued Thursday by the department’s Bureau of Justice Statistics. In addition, 1,053 inmates died in local jails, where suicide is on the rise.

The U.S. has the world’s largest prison population, with over 2 million people behind bars. While that population has been shrinking in recent years, deaths in custody have climbed steadily.

The deaths reflect a dramatic shift in the prison population: The number of federal and state prisoners age 55 or older reached over 151,000 in 2014, a growth of 250 percent since 1999.

As this population grows, prisons have begun to serve as nursing homes and hospice wards caring for the sickest patients. The majority of state prisoners who died in 2014 were 55 years or older, and 87 percent of state prisoners died of illnesses, according to the report. The most common illnesses were cancer, heart disease and liver failure.

These deaths point to how dramatically prisoners’ health care needs are changing. Older prisoners have complex medical problems, are vulnerable to violence, and may require intensive care at the end of life, said Gabriel Eber, senior staff counsel at the American Civil Liberties Union’s National Prison Project, which files class-action lawsuits on behalf of prisoners seeking better mental health and medical care.

The prisons are not equipped to handle the geriatric population,” he charged.

For instance, Eber recalled one case of a veteran in his 80s who suffered from Alzheimer’s disease and other ailments. Housed with the general inmate population in a large urban jail, the man kept getting into fights and pulling out his catheter. The inmate, who developed an infection and died, should have been kept in a medical unit at the outset, Eber said.

Eber said Thursday’s data raise a question: “Do we need to be keeping all these people behind bars?

In jails, the leading cause of death was suicide, which rose from 328 to 372 from 2013 to 2014. Suicides accounted for over a third of deaths in jails. The suicide rate is now 50 per 100,000 jail inmates. That’s the highest it’s been since the Bureau of Justice Statistics started counting in 2000 — but far lower than in the 1980s, when it ran as high as 129 per 100,000, said statistician Margaret Noonan, who wrote Thursday’s report.

Overall, more than a third of jail deaths happened during an inmate’s first seven days behind bars, according to the report.

Medical care for older prisoners costs three to nine times more than for their younger peers, according to Human Rights Watch.

Williams has been watching the population of older prisoners continue to grow, outpacing the general population of the U.S. As this trend continues, she said, prisons and jails need to catch up.

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