Bleak picture of ageing in prison

A SPECIALISED aged care prison is needed in the Sydney metropolitan area to cater for a rapidly ageing inmate population whose needs are not met by the existing outdated infrastructure.

NSW Inspector of Custodial Services John Paget's final report, Old and Inside, paints a bleak picture of ageing in the state's prison system, including tales of inmates reporting incontinence who were unable to access continence aid, and younger cell mates taking on caring roles.

In one case a frail older man, aged 85 who was medically blind, reliant on a cane and had serious cognitive and memory impairment was unable to access a specialist aged care bed for more than six weeks, during which time he was reliant on a younger cellmate for support.

Dr Paget said in March this year there were 1098 aged inmates in NSW prisons, with the majority being in mainstream correctional centres, however there were only 42 specialised aged care beds within the system.

He was so concerned with some issues, including food quality and hygiene, that on receiving the inspection reports he immediately rang the Commissioner for Corrective Services Peter Severin seeking urgent action.

Across Australian jurisdictions the number of prisoners over 64 grew by more than 130 per cent from 2010-2015, and 225 per cent in NSW.

Older inmates are most likely to have been sentenced for sexual offences (31.9 per cent) or drug offences (20 per cent), and the Royal Commission into Institutional Child Abuse is expected to significantly add to the growth in the aged inmate population.

"Fear dominates the lives of many aged inmates," Mr Paget said.

"These stressors accelerate the ageing process of these inmates.

"The current level of service provision to aged inmates across the prison estate means that it is increasingly difficult for aged inmates to live and function with dignity in the correctional setting.

"This is not acceptable now, nor is it an adequate model into the future."

Difficulties for older prisoners included bunk beds with no ladders or railings at the Metropolitan Special Programs Centre, a lack of shade and seating in communal areas and steps, uneven surfaces and narrow doorways.

Facilities built more than 100 years ago meant trip hazards and inadequate space for mobility aids.

Food safety was a major area of concern for older prisoners, with evening meals at Long Bay Hospital and the Kevin Waller Unit a particular concern.

The report said evening meals were sent at 2.30pm, before lockdown, and inmates were left to keep them warm as best they could in their cell until dinner time.

Some wrapped the meal in a towel or reheated it in a sandwich toaster, however this meant in many cases meals were consumed after they had been left sitting for several hours at unsafe temperatures or reheated multiple times.

The inspector said he had "significant concerns" about the quality and quantity of meals, and timing was a particular concern to older inmates on a number of medications which needed to be taken with food.

Other health needs were also being inadequately addressed, with older prisoners most commonly suffering from frailty, reduced mobility, incontinence and sensory impairment.

Younger inmates and "sweepers" helped ageing prisoners who had dementia, incontinence and mobility issues, and officers sometimes woke up other prisoners to help deal with late night emergency situations such as a need to change bedding.

At the Metropolitan Special Programs Centre almost 50 per cent of inmates had waited more than 100 days to see an optometrist.

On discharge it was difficult to find placements for some inmates, particularly those who had been convicted for sexual offences.

"It is also difficult to find a home that can hold a bed space vacant for up to three months, which is the average time it takes to process discharge arrangements," the report said.

Dr Paget said a larger, specialised aged care prison was needed in the Metropolitan area, ideally through the acquisition of an existing aged care facility.

He also made recommendations including the provision of extra clothing, linen and incontinence products to inmates with continence problems and that meal quality be reviewed and distribution times altered to meet community standards and ensure food was available to manage medication requirements.