Skip to main content

Aging in Angola Prison

Our society is faced with the dilemma of aging prisoners, and some predict this will become one of the most important factors in managing the criminal justice system. Elderly inmates represent the fastest growing segment of federal and state prisons, a trend which is expected to continue. Hospice programs are growing in American correctional facilities, with access to health care professionals and efforts to provide a dignified death. In 2010 I took a road trip to photograph aging prisoners in one of America’s most notorious prisons, Louisiana State Penitentiary, also known as Angola Prison. 



I heard about the penitentiary’s special programs for the elderly including a treatment center and hospice, and received permission from Warden Burl Cain to tour the facility with my camera. It was a 150 mile drive from New Orleans through Mississippi Delta wetlands to get to the place that was surrounded by razor-topped chain link fences and sentry towers. Before passing through the gates, armed guards searched my car and confiscated my maps. At 18,000 acres, the prison is the largest in the nation, housing over 5,000 inmates. It is roughly the size of Manhattan Island and surrounded by woods, swampland, and the Mississippi River. Nearly 74% of Angola’s prisoners are serving life without parole.

To accommodate its aging demographic, the Louisiana State Penitentiary implemented special programs to house and care for the frail and sick, and accommodate those who are dying. Inmates volunteer in the hospice unit, build coffins, and even provide burial services. The R. E. Barrow Treatment Center is the medical unit of the penitentiary, with an open ward of twenty-four beds which includes those assigned to hospice, plus special rooms reserved for prisoners who are dying. There are two LPNs and one RN available around the clock. When I visited, the census included prisoners with cancer, degenerative neurological illness such as ALS and stroke, and end-stage COPD. 


The Center maintains a volunteer program where inmates have the opportunity to feed and assist those who are dying or physically impaired. I spoke to Scotty, a volunteer serving two life sentences for double murder. He says the experience working with the aged and dying has humbled him and brought him closer to religion. I had a chat with an elderly inmate who couldn’t walk. He told me how in his youth he stabbed someone to death in a bar with a knife he kept in his boot. 

After visiting the Treatment Center we drove past fields with prisoners tending crops, with armed guards on horseback watching over the workers. My guide brought me to the unit which housed older and physically dependent prisoners. This unit had double bunks, with physically impaired prisoners and those needing adaptive devices assigned to lower beds. This is where I met Mr. Bourgeois, a ninety-two year old sex offender who was in for life plus thirty-five years, and the oldest prisoner in the penitentiary.


Mr. Bourgeois had a quick smile and seemed kindly and gentle, but a closer look revealed numerous scars etched on his scalp from fights during many years in prison. Mr. Bourgeois told me his biggest fear was being beaten up by younger inmates. The National Institute of Corrections has cited vulnerability of abuse and predation as one of the many challenges of a graying prisoner population, contributing to emotional stress and physical deterioration, and an observed phenomenon of accelerated aging.


Experts say that as a person ages they become less likely to commit crimes. Some criminologists refer to a “criminal menopause,” arguing for early release of older inmates citing potential cost-saving by allowing them to serve the remainder of their sentences in the community. However, the value of geriatric release programs must be weighed against public safety and costs related to other programs for their care. Because elderly criminals may be unable to care for themselves in the community, society would still be burdened by the cost of care even though they may no longer pose a threat.

Although he appeared frail, Mr. Bourgeois had surprising strength – perhaps nurtured by a life of crime and incarceration. As I left we shook hands, and I was startled as he nearly crushed my fingers, his face betraying a pleasured grin. As I looked into those eyes of stone I felt reassured that two very large uniformed officers were at my side.


* * * * * * * * * * * * * *

Follow me on Instagram @jlevinemd

Dr. Jeff Levine’s photography exhibit entitled “An International Celebration of Aging” will be at the University of Michigan Medical Center from June to August, 2015 as part of their Gifts of Art program.

References for this post include:

Aday, RH. Aging Prisoners: Crisis in American Corrections. Praeger Publishers, 2003.

End of Life in Corrections
http://www.nhpco.org/sites/default/files/public/Access/Corrections/Corrections_The_Facts.pdf




Comments

Niki Sidle said…
What a thought provoking read this morning. I am a geriatric and medical social worker, currently serving in hospice, so I have to give thought to how they provide hospice care and the elements surrounding. Thank you for the look inside the system.

Popular posts from this blog

Practical Advice for the End of Life: A Podcast with BJ Miller

This week we talk with BJ Miller, hospice and palliative care physician, public speaker, and now author with Shoshana Berger of the book "A Beginner's Guide to the End."

As we note on the podcast, BJ is about as close as we get to a celebrity in Hospice and Palliative Care.  His TED Talk "What Really Matters at the End of Life" has been viewed more than 9 million times.  As we discuss on the Podcast, this has changed BJ's life, and he spends most of his working time engaged in public speaking, being the public "face" of the hospice and palliative care movement.

The book he and Berger wrote is filled to the brim with practical advice.  I mean, nuts and bolts practical advice.  Things like:
How to clean out not only your emotional house but your physical house (turns out there are services for that!)Posting about your illness on social media (should you post to Facebook)What is the difference between a funeral home and mortuaryCan I afford to die?  …

Improving Advance Care Planning for Latinos with Cancer: A Podcast with Fischer and Fink

In this week's GeriPal podcast we talk with Stacy Fischer, MD and Regina Fink, RN, PhD, both from the University of Colorado, about a lay health navigator intervention to improve advance care planning with Latinos with advanced cancer.  The issue of lay health navigators raises several issues that we discuss, including:
What is a lay health navigator?What do they do?  How are they trained?What do lay health navigators offer that specialized palliative care doesn't?  Are they replacing us?What makes the health navigator intervention particularly appropriate for Latinos and rural individuals?  For advance care planning? Eric and I had fun singing in French (yes French, not Spanish, listen to the podcast to learn why).
Enjoy! -@AlexSmithMD




You can also find us onYoutube!



Listen to GeriPal Podcasts on:
iTunes Google Play MusicSoundcloudStitcher

Transcript

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: And Alex, I'm really excited about toda…

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …