Inmates over the age of 55 more than doubled since 1995

NEW YORK (AP) -- In corrections systems scross the United States, officials are grappling with decisions about geriatric units, hospices and medical parole as elderly inmates -- with their high rates of illness and infirmity -- make up an increasing share of the prison population.

At a time of tight state budgets, it's posing difficult dilemmas for policymakers. They must address soaring medical costs for these older inmates and ponder whether some can be safely released before their sentences expire.

The latest available figures from 2010 show that 8 percent of the prison population -- 124,400 inmates -- was 55 or older, compared to 3 percent in 1995, according to a report being released Friday by Human Rights Watch. This oldest segment grew at six times the rate of the overall prison population between 1995 and 2010, the report says.

"Prisons were never designed to be geriatric facilities," said Jamie Fellner, a Human Rights Watch special adviser who wrote the report. "Yet U.S. corrections officials now operate old age homes behind bars."

The main reasons for the trend, Fellner said, are the long sentences, including life without parole, that have become more common in recent decades, boosting the percentage of inmates unlikely to leave prison before reaching old age, if they leave at all. About one in 10 state inmates is serving a life sentence; an additional 11 percent have sentences longer than 20 years.

The report also notes an increase in the number of offenders entering prison for crimes committed when they were over 50.

Fellner cited the case of Leonard Hudson, who entered a New York prison at age 68 in 2002 on a murder conviction and will be eligible for parole when he's 88. He's housed in a special unit for men with dementia and other cognitive impairments, Fellner said.

A.T. Wall, president of the Association of State Correctional Administrators, said he and his colleagues regularly exchange ideas on how to cope with the surging numbers of older prisoners. "There are no easy solutions."

Wall said prison officials confront such questions as whether to retrofit some cells with grab bars and handicap toilets, how to accommodate inmates' wheelchairs, and how to deal with inmates who no longer understand instructions.

"Dementia can set in, and an inmate who was formerly easy to manage becomes very difficult to manage," he said.

States are trying to meet the needs. Some examples:

--Washington state opened an assisted living facility at its Coyote Ridge prison complex in 2010, with a capacity of 74 inmates. It's reserved for inmates with a disability who are deemed to pose little security risk.

--The Louisiana State Penitentiary has had a hospice program for more than a decade, staffed by fellow prisoners who provide dying inmates with care ranging from changing diapers to saying prayers.

--In Massachusetts, a new corrections master plan proposes one or more new facilities to house aging inmates who need significant help with daily living. Some critics object, saying inmates shouldn't get specialized care that might not be available or affordable for members of the public.

In Texas, legislators have been considering several options for addressing the needs of infirm, elderly inmates. "You can't just generalize about these prisoners," said State Rep. Jerry Madden, chairman of the House Corrections Committee. "Some are still extremely dangerous, some may not be.... Some you wouldn't want in the same assisted living facility with your parents or grandparents."

Fellner, who visited nine states and 20 prisons during her research, said corrections officials often were constrained by tight budgets, lack of support from elected officials, and prison architecture not designed to accommodate the elderly.