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 Arriola is one of about 18,400 inmates over the age of 55 in
California prisons, according to the California Department of
Corrections and Rehabilitation.
It is a swelling population that has led authorities to take the
first steps toward creating a dementia unit at the state's main
prison medical facility in the San Joaquin Valley city of Stockton,
Reuters has learned.
"We have identified a specific need for a specialized unit for our
dementia population and are in the very early phases of concept
development," said Elizabeth Gransee, spokeswoman for California
Correctional Health Care Services.
The wing would mark a shift from California's earlier efforts to
treat prisoners with cognitive decline, relying on inmate volunteers
and a modest staff to help them rather than a more expensive medical
unit.
Reuters visited two California prisons recently to look at the
challenges states face, as improved medical care, long sentences
from tougher crime laws, and a steady increase of older adults
entering prison has contributed to an extraordinary rise of elderly
inmates.
In California, seven percent of the state's 130,000 prisoners were
over the age of 60 in 2016, the most recent year for which data is
available, compared to just 1 percent 20 years earlier, according to
a report by the California Department of Corrections and
Rehabilitation.
"We and all of the jails and prisons around the country need to be
able to do a better job with individuals who have cognitive
impairment," said Dr. Joseph Bick, chief medical executive at the
California Medical Facility in Vacaville.
Throughout the United States, states are grappling with similar
challenges as prisoners age. Inmate medical costs amount to about $3
billion per year nationwide, according to a recent report by the
state of Georgia, where medical care for inmates over the age of 65
costs $8,500 per year, compared to $950 for those who are younger,
the report showed.
Nationwide, 44 percent of inmates over the age of 50 have
disabilities, compared to 27 percent of prisoners overall, a 2015
report by the Department of Justice shows. About 20 percent have
cognitive disabilities, the report showed.
ROUND-THE-CLOCK CARE
Prisoners with cognitive decline can require round-the-clock care
and help with dressing themselves, brushing teeth and going to the
restroom. Because prison life - and for many, life on the streets
before prison - is so difficult, inmates are considered geriatric
after the age of 55 in California and many other states.
Arriola, who is housed with about 2,600 prisoners with chronic
conditions at the California Health Care Facility in Stockton, came
on a Thursday morning in May for a follow-up visit with a
gastroenterologist. But he talked distractedly to the doctor, and
said he did not recall having stomach problems.
It is not an uncommon situation at the Stockton facility, where
physicians and nurses are trained to work with an increasing number
of patients experiencing cognitive decline, said Dr. Anise Adams,
the chief medical officer.
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About 500 prisoners are being treated for dementia or Parkinson's
Disease in California prisons, including 200 at Stockton, officials
said.
"It's hard for them to explain to the nurses what they want or how
they feel," said inmate Scottie Glenn, 47, who participates in a
program in which able-bodied inmates help those who are ill.
On a recent May morning, Glenn, who is serving 25 years to life for
murder, was assisting a wheelchair-bound inmate who needed to see a
doctor. Sometimes, he writes letters for inmates, or helps them to
communicate.
HOSPICE CARE
Older inmates' needs have led the state to build a large dialysis
center, stock hundreds of wheelchairs and offer assistance with
hearing and declining vision. Stockton's medical facility has a
physical therapy center, and a palliative care unit is set to open
in the next few weeks.
The California Medical Facility in Vacaville set up a hospice
decades ago during the AIDS crisis, which now houses more inmates
dying of old age diseases, officials said. The state expects to
spend about $26,000 per inmate on health care next year.
Once a dementia unit is set up, California would follow New York,
which opened one for its much smaller prison population in 2006. New
York spends about $2.7 million annually to care for 29 patients in
the unit, the state corrections department said.
California officials say it is too soon to know how much the unit
they hope to create will cost, but it would not be difficult to
re-purpose an existing ward for use by dementia patients.
Such patients wake up in the middle of the night not knowing where
they are, requiring trained staff to comfort them. Others behave in
ways that normally get an inmate in trouble, such as batting away a
doctor's hand during an injection.
In a normal prison ward, that is considered assault, said Captain
Paul Vasquez, whose job includes reviewing behavioral issues at the
Stockton facility.
Inmates can be handcuffed, lose privileges and even be sent to the
Security Housing Unit, where prisoners are kept in near-isolation,
he said.
"We need to learn to respond to them a different way - and not in a
regular mainline type of prison," Vasquez said.
For photo essay please click on: https://reut.rs/2lhHvs5
(For a graphic on 'At the end of the sentence' click https://tmsnrt.rs/2JY2D1d)
(Reporting by Sharon Bernstein; Additional reporting by Jane Ross;
Editing by Bill Tarrant and Diane Craft)
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