Growing Older behind Bars: A Systematic Review of Accelerated Inmate Aging and Compassionate Release from U.S. Prisons

Background and Purpose: “Tough on crime” policies put in place from the 1970s-1990s, in parallel with an aging baby boomer generation, have produced a proportion of older inmates who are the largest and fastest-growing segment of the American criminal justice system. By 2030, one third of the prison population will be made up of men over the age of 55, who because of the hardships of prison life are physiologically older (by approximately 11.5 years) than their chronological age suggests. The prison system is not designed to support the structural or programmatic needs of aging men with growing mental and physical vulnerabilities. The purpose of this comprehensive literature review was to analyze existing evidence on the quality of care available to aging, incarcerated men and how increasing utilization of compassionate release policies may impact community-based transitions for elderly inmates.

Methods: Databases such as Google Scholar, Psych Info, PubMed and others were searched, and reference lists mined, for peer-reviewed articles published from 2005-2017 that capture outcomes related to prison-based elderly care and compassionate release of male inmates.

Results: The initial search yielded 73 articles. Initial findings reveal a growing trend of in-prison hospice programs staffed by younger inmates, and policies by the Bureau of Prisons that block the majority of compassionate release applicants, despite Congressional approval to release them.

Conclusions and Implications: Without significant changes in sentencing and release policies, the aging prison population will continue to grow, requiring renewed and diligent thinking about how to protect the rights of the elderly while in prison.