AGING INMATES PRESENT PRISON CRISIS

States Already Feeling Money Pinch Must Deal With Costs Of Caring For
Elderly Convicts

Death is a little sweeter now for some inmates at the Louisiana State
Prison at Angola, which once was called the "bloodiest prison in America."
In a state where a "life sentence" means just that, officials at Angola are
determined to provide "death with dignity" for inmates. There is a hospice
for the terminally ill. No one dies alone. Since 1998, a glass-enclosed
hearse, made by prisoners and drawn by two horses, carries bodies to the
prison cemetery in handmade coffins. Inmates walk behind, singing Amazing
Grace.

Of the 5,018 inmates at Angola -- 115 miles northwest of New Orleans on the
Mississippi River -- 90% will die in state custody, says Angola's warden,
Burl Cain. That's a result of longer and mandatory sentences in recent
years, with limited parole opportunities.

"Inmates are getting older and more feeble, and the medical costs are going
up," Cain says.

As states try to cope with the growing costs of prisons during tight
financial times, one expensive problem sticks out: older, sick and dying
inmates. And the crisis is only expected to grow.

It is a huge problem for state governments that are cash-strapped, says
Ronald Aday, author of the 2003 book Aging Prisoners: Crisis in American
Corrections. "In addition to health care issues, work assignments,
co-payments, nutritional requirements, concerns for victimization, end of
life issues and appropriate staffing are concerns that will have to be
addressed," he says. "The task is a daunting one."

State Approaches Vary

Prisons have long had elderly inmates, but aging baby boomers behind bars
signal new challenges for states.

In 2002, there were 120,933 prisoners 50 and over in the nation's prisons,
more than double the number in 1992, says the Criminal Justice Institute of
Middleton, Conn. That is 8.6% of inmates, up from 5.7% in 1992.

"When considering dangerous, violent and predatory inmates, one does not
usually envision an elderly man hobbling down a prison corridor with a cane
or walker," a new institute report for the Justice Department says.

"However, in reality, some of the most dangerous and/or persistent
criminals sentenced to life in prison without parole 30 years ago are now
old, debilitated, frail, chronically ill, depressed and no longer
considered a threat to society or the institution," the report says.

States are responding in different ways. Some have wings or units just for
older prisoners. Others have entire geriatric prisons. Many have hospices.
Some make greater use of medical parole and early release, and some are
saving space for more cemeteries.

Each state approaches its elderly inmates differently, says Joann Morton, a
criminologist at the University of South Carolina. Some are careful to
monitor every inmate over age 50. Others provide no special programs or
treatment beyond that available to all inmates.

A 2001 summary in Corrections Compendium, a journal of the American
Corrections Institute, found in a survey of 46 states that:

* Sixteen maintain separate facilities to house older inmates. In 2000,
Florida opened a work camp for 378 able-bodied inmates, mostly older than
50. It is on the grounds of the Florida State Hospital at Chattahoochee. As
of May 31, Florida had 7,636 inmates ages 50 and over, an increase of 12%
from the year before.

* Many states have medical treatment, including annual physicals, special
diets and exercise programs, for older inmates. In Texas, the state
comptroller reported in 2000 that 200 of its 1,159 inmates older than 65
required around-the-clock skilled nursing care. Nebraska offers
nursing-home living for some inmates, the report says, and Oklahoma
considers some of its older inmates open to exploitation and puts them in
single-person cells.

* Forty-one offer some kind of early release for older inmates, depending
on health. Early release, however, remains limited in some states.

* Many states offer hospice care for dying inmates, says Fleet Maull,
founder of the National Prison Hospice Association in Boulder, Colo. He
predicts that every state will offer hospice care within five years.

A report by the non-partisan California Legislative Analyst's Office says
elderly inmates cost two to three times more to care for than do younger
ones. It notes that the National Center of Institutions and Alternatives
estimates incarceration costs for an elderly inmate are $69,000 a year,
compared with a national average of $22,000 for all inmates.

This year, with California facing major financial problems, the analyst's
office recommended releasing more non-violent seniors to parole, but the
Legislature didn't go along.

Dying In Prison

Many older inmates die in prison without any family or friends to pay for a
funeral or burial. As a result, corrections officials often become funeral
directors, cemetery operators and grief counselors in addition to health
care providers.

At Angola, Cain says 34 inmates died there last year, and 10 of them were
buried at the prison cemetery. He has opened a prison hospice that serves
eight to 10 inmates at a time. It gets high marks from hospice experts --
this at a prison that was called "the bloodiest prison in America" in the
early 1970s because of its high number of inmate-on-inmate deaths.

Although groups such as the American Civil Liberties Union have concerns
about the way Angola is run, Warden Cain also gets praise. Al Shapiro,
president of the Louisiana ACLU chapter, says, "We have our differences,
but I don't doubt his compassion for sick and dying inmates."

Cain says, "I always remember the victims, but I can't help the ones that
are in the grave. Maybe I can do something for ones we have here." Aging
population

Inmates ages 50 and over in state and federal prisons (in thousands):

1992 41.6 (rising steadily to)

2002 120.9