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Prisons try to adjust as their inmate population grows older

JUANA SUMMERS, HOST:

The number of elderly Americans serving time in prison has skyrocketed in recent decades. In 1991, for example, just 3% of the men and women behind bars in state and federal prisons were 55 or older. Over the course of three decades, that percentage of elderly prisoners has grown to 15%. That's led to climbing costs for prisons as they deal with the more advanced medical needs of the incarcerated. Sarah Lehr of Wisconsin Public Radio reports.

SARAH LEHR, BYLINE: Oakhill Correctional, a minimum-security facility, is surrounded by cornfields just outside the state's Capitol, in Madison, Wis. Most of the inmates there sleep in bunk beds. But at a newly opened unit within Oakhill, all the beds are low to the ground.

RACHEL SNOW: There's many of the guys that are down there that cannot navigate steps.

LEHR: Oakhill's nursing supervisor, Rachel Snow, says the low beds make it accessible for inmates who use walkers or wheelchairs. On this day, more than 20 inmates are in the unit. Some are getting medication through IVs. Another does an arm exercise with a nurse to improve range of motion. Snow says many need help with dressing or eating. Others require extra medical attention.

SNOW: But we have many guys down there with respiratory issues, end-stage COPD, emphysema, cardiac issues.

LEHR: There are more than 20,000 people locked up in Wisconsin prisons, and more than 15% are over age 55. The graying of Wisconsin's prison population mirrors national trends. Mike Wessler with the Prison Policy Initiative says that's partially because the country's population is getting older, but it's also due to longer prison sentences.

MIKE WESSLER: In the '80s and '90s and early 2000s, there was a real focus on tough-on-crime policies that ushered in an era of mass incarceration.

LEHR: Harlan Richards was 30 when he was convicted of murder after stabbing someone in a fight. He served decades behind bars in Wisconsin before he was paroled at age 67. He says prison life is different for older inmates.

HARLAN RICHARDS: I mean, you get aches and pains, and you get medical problems. And a young guy can stand sleeping on a hard bed. He can stand, you know, the substandard food and stuff like that.

LEHR: Bryce Peterson, a scientist with the CNA Center for Justice Research and Innovation, says many people enter prison in worse health than the general public, in part because of poverty. Then, medical problems can get even worse because of the conditions within prison, including violence and poor health care. He says that all has financial consequences.

BRYCE PETERSON: The best estimates are that it's anywhere from 2 to 5 times more to take care of someone who's older than it is to take care of someone who's younger in prison.

LEHR: A 2015 report from the U.S. inspector general found federal prisons with the highest percentage of older inmates spent more than $10,000 annually per inmate on medical care. That compares to less than $2,000 per inmate at prisons with younger populations. At the same time, studies show the chance of people re-offending decreases with age. Every state except for Iowa has what's known as compassionate release policies. Those allow inmates to get out early because of advanced age or serious health problems. But Wessler, the Prison Policy Initiative spokesman, says compassionate release is rarely used.

WESSLER: It's a cumbersome process, requires lots of approvals, lots of documentation.

LEHR: Wessler hopes for a more far-reaching solution.

WESSLER: My hope is that, before prisons consider opening a nursing home behind bars, states will look at revisiting some of these harsh sentencing laws.

LEHR: He and other advocates say the focus should be on reducing the incarcerated population to begin with. For NPR News, I'm Sarah Lehr in Wisconsin.

(SOUNDBITE OF BUN B AND STATIK SELEKTAH SONG, "STILL TRILL (FEAT. METHOD MAN AND GRAFH)") Transcript provided by NPR, Copyright NPR.

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