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doi:10.1080/03124070902803475 Ageing Prisoners: Issues for Social Work* John Dawes Flinders University, Adelaide, South Australia, Australia Abstract The growing numbers and increasing proportion of aged prisoners in Australia is an issue causing some concern, but it has received little public or academic attention here. This article, an outcome of an extensive literature review and a small research study into some individual prisoners’ experience of ageing in South Australian prisons, aims to draw attention to the current situation and what it means to these particular prisoners. Participants shared thoughts, feelings, and reflections about their lives, life-long losses and, for some, the meaning of dying in prison. Analysis revealed themes whose consistency with existing literature suggests they are valid areas meriting timely policy and practice concern and development: prison regimes, housing, health care, and imprisonment or release. The issues raised are discussed in the context of the available literature. This problematic area merits attention from the social work profession and further research. Keywords: Corrections; Aged; Bereavement Yesterday in the morning, I reckon, I looked in the mirror. Me say how come I look like this? I was young before . . . (Prisoner (P) 2). Australia’s Ageing Population There is considerable concern about the ramifications of Australia’s ageing population. During the 100 years to 2001, the percentage of Australia’s general population over 65 increased from 4% to 12.5%; life expectancy increased to 80 years for women and 79 years for men, a trend that is expected to continue this century. Correspondence to: Dr John Dawes, Flinders University, Law School, GPO Box 2100, Adelaide, SA 5001, Australia. E-mail: jdawes@chariot.net.au Accepted 6 February 2009 *The views expressed in this article are not necessarily those of the Department for Correctional Services, South Australia. ISSN 0312-407X (print)/ISSN 1447-0748 (online) # 2009 Australian Association of Social Workers DOI: 10.1080/03124070902803475 Australian Social Work Vol. 62, No. 2, June 2009, pp. 258�271 A notable exception to this is Australia’s Indigenous population, which has a reported life expectancy that is approximately 17 years less for both men and women. In 2021, Australia’s median population is expected to be aged between 39.9 and 41.7 years, increasing to 44.6�48.2 years in 2051 (Australian Bureau of Statistics (ABS), 2006). South Australia has the highest median age of 37 years in 2002 (ABS, 2004a). Social work has a role in contributing to policy and practice development in this area. Australia’s Changing Prisoner Population Over the past 25�30 years, Australia’s prisoner population has increased markedly, more rapidly than if accounted for by general population growth. Table 1 shows that the number of prisoners almost doubled in the 15 years from 1988�9 (the bicentennial year of Australia’s settlement as a British penal colony) to 2004 and increased to 27,615 in June 2008. This increase is also reflected in the imprisonment rate (i.e., the number of prisoners as a proportion of the general population of imprisonable age), which has risen from 91 per 100,000 in 1976�7, to 169 per 100,000 in June 2008 (ABS, 2009). This measure allows comparisons between Australian jurisdictions and with other countries (Pratt, 2008). At June 2008, the imprisonment rate for women was 24 per 100,000 and, for Aboriginal people, the age standardised rate was 1,769 per 100,000 of the adult Indigenous population (ABS, 2009). Older Prisoners Although the ABS classifies those over 65 years as elderly, the most common definition for an ‘‘elderly inmate’’ is someone aged 50 years and older (Grant, 1999; Howse, 2003). Research has identified an apparent 10-year differential between the overall health of prisoners and that of the general population (Aday, 2003, p. 88; Dawes, 1997, pp. 193�261; Fazel, Hope, O’Donnell, Piper, & Jacoby, 2001, p. 406). This is attributed to the former lifestyles of prisoners, many of whom used drugs and alcohol to excess, had poor eating habits and a stressful life, and commonly Table 1 Australia’s increasing use of imprisonment Period Daily average Imprisonment rate 1976�7 8,743 90.7 1988�9 12,004 96 September quarter, 2004 23,490 153 June quarter, 2008 27,615 169 Sources: Australian Bureau of Statistics (2004b, p. 3; 2008) and Walker (1994, pp. 24�25). Daily average refers to the count of prisoners held each day and then averaged out over the standard period. The imprisonment rate is the ratio of those imprisoned over 100,000 of the population of imprisonable age and is expressed as a number. Australian Social Work 259 experienced economic disadvantage (Aday, 2003; Dawes, 1997; Kratcoski & Pownall, 1989). On 30 June 2008, prisoners aged 50 years and over comprised nearly 11% of the total prison population (ABS, 2009). In 2007, the ABS reported that there were 2,927 male prisoners over 50 years of age, including 443 over 65 (ABS, 2009). Of the daily average for women over 2007 (1,963 prisoners), 175 were over 50 years of age. This compares with a daily average of 6,708 for Aboriginal prisoners, 252 of whom were over 50 years of age (ABS, 2009). Despite growing numbers of these ageing, mainly male, prisoners, they remain surrounded by young adult males who form 68% of the prisoner population (ABS, 2009). On 30 June 2008, the median age of all prisoners in Australia was 33 years. Most of the prisoners in all selected offences/charge categories were aged 25�34 years, except for those incarcerated for homicide and sexual assault, most of whom were aged 35�44 years (ABS, 2009). The data above show that it is likely that all Australian correctional systems will face the challenge of caring for increasing numbers of elderly prisoners in the next few years. Older prisoners present special problems in terms of their health needs, adjustment to prison life, and probable loss of family and community contact (Aday, 2003; Crawley, 2004). Elderly sentenced prisoners are also more likely to be held in lower security prisons (because of their perceived lower risk), which may be beneficial in terms of lifestyle, housing, and regimes, but creates difficulties is accessing services, especially acute medical services, because such prisons tend to be located away from major population centres. Such placement may also contribute to weakening family ties* ‘‘Too long and my people not have much money to spend [on] petrol all the time’’ (P2). Differences Among Elderly Prisoners The following four groups of elderly prisoners have been identified by Aday (2003, p. 18). First Time in Prison/Elderly New Prisoners Prior to imprisonment, such people are often well known because of their offences (fraud, child sexual offences, murder) and subsequent publicity (see, for example, Fewster, 2008; p. 42; Stewart, 2008). Many deny their guilt. Family and friends can be shocked by the alleged offences. A major breach of trust may result, causing damaged or fractured relationships. Their transition to prison is often extremely difficult*‘‘the issues are that you are left without any hope whatsoever’’ (P9)*and they can be at risk of serious self-harm or suicide. Imprisonment can represent the final dramatic change in status for this group and the last step in the series of humiliating experiences (status degradation). Their offences, especially for those convicted of sexual offences, may make them vulnerable in prison to bullying, harassment, or serious violence and even death (Dawes, 1997). They may present with serious health issues, including psychiatric morbidity (Aday, 2003; Fazel et al., 2001; Howse, 2003; McCarthy, 1983; Specter, 1994). 260 J. Dawes Career or Chronic Offenders Career or chronic offenders are prisoners who return to prison regularly because of reoffending. Although some may eventually stop offending and re-establish themselves in the community, many will continue coming into prison until they become elderly. ‘‘Lifers’’ Who Have Grown Old in Prison Lifers who have grown old in prison are serving natural life sentences. Those with parole periods set by the courts may be released, but those serving life without the possibility of release, or with very long periods to be served before parole, may die in prison. Prison is their ‘‘home’’. As they grow old, their care presents many challenges to the authorities because of institutionalisation, loss of social skills, chronic and possibly increasing health issues, and manifestations of ageing, such as loss of mobility and coordination leading to a need for assistance with activities of daily living (Dawes, 2002a). Senility, dementia, and terminal illness may create a need for nursing home or hospice care (Dawes & Dawes, 2004). For these prisoners in particular, family contact usually becomes less frequent or ceases with each passing year, increasing the significance to them of their in-prison network. Thus, possible release becomes problematic. The loss of family, lack of sponsors, and probably cultural shock of returning to the world outside presents additional challenges to those working with such prisoners. Prisoners Given Shorter Sentences Late in Life Prisoners given shorter sentences late in life can be differentiated from the high- profile, first-time older prisoners, but they may also present with serious health problems that require ongoing care. The generally compromised state of prisoner health (see above) places added demands on prison management that create special challenges within the prison context and its place in the community. Rationale for the Study There is a dearth of Australian literature relating to the older prisoner as a demographic group in our prisons that hampers the development of well-founded policies and practices addressing their needs. The present limited exploratory study was undertaken in South Australia as an initial attempt to draw attention to the issues of these older prisoners. In many respects, they are not so dissimilar from other ageing people, but their history and context creates particular difficulties in meeting their needs*‘‘I don’t class myself as a bad person because I’m in here, you know!’’ (P4). Social work has always been concerned with supporting the disadvantaged and marginalised, and ageing prisoners form a growing sector of such clients. It was therefore decided to undertake the present study to highlight the issues involved, using the perspective of the prisoners themselves. What do prisoners think about Australian Social Work 261 becoming old in prison? What issues do they perceive? How do they evaluate their lives? What is it like to face one’s death in prison? Method Prisoners occupy a relatively powerless social position and older prisoners perhaps especially so. Symbolic interactionism, developed by George Herbert Mead (1934), Blumer (1969, 1972), and Goffman (1959) was chosen as an appropriate methodological approach. De Laine (1997, p. 69) has noted Denzin’s (1992) claim about the utilisation of this approach by those who wish to speak for the powerless in society, suggesting its methodological relevance to social work. ‘‘Mead believed that symbolic naming is the