Sunday, February 26, 2012

Life, With Dementia

The Vanishing Mind Behind Bars:

Dementia in prison is an underreported but fast-growing phenomenon, one that many prisons are desperately unprepared to handle. It is an unforeseen consequence of get-tough-on-crime policies — long sentences that have created a large population of aging prisoners. About 10 percent of the 1.6 million inmates in America’s prisons are serving life sentences; another 11 percent are serving over 20 years.

And more older people are being sent to prison. In 2010, 9,560 people 55 and older were sentenced, more than twice as many as in 1995. In that same period, inmates 55 and older almost quadrupled, to nearly 125,000, a Human Rights Watch report found.

California, broke, stubborn and stupid, has nowhere to put their rapidly aging demented inmates, so they are pressing many of the lifers to take care of them.

Struggling prison systems, including those in Louisiana and California, are taking a less expensive but potentially riskier approach. They are training prisoners to handle many of the demented inmates’ daily needs.

Realizing that California, with nearly 13,000 inmates 55 and older, could not adequately care for demented prisoners, the Gold Coat program was started, [and staff] asked the regional chapter of the Alzheimer’s Association to train inmates to help.

“Yeah, they did something horrible to end up here,” said Cheryl Steed, a psychologist at the California Men’s Colony, where prisoners who help inmates with dementia are called Gold Coats because their yellow jackets contrast with the standard-issue blue. But without them, she said, “we wouldn’t be able to care for our dementia patients very well.”

On the one hand, it would obviously be better for these inmates to be transferred to nursing homes where memory-impaired persons can receive normal, professional care. But on the other hand, many of these inmates have a violent past which precludes private care facilities from taking them.

And while putting inmates in charge of their care strikes many as risky, it seems to be teaching the inmate caregivers, many of whom are killers, a lesson in compassion and humility. Not only are they doing the grunt work of orderlies (from bathing inmates to changing adult diapers), but they also help protect the senile inmates from other "predators" in the general population who would rob and steal from them.

Gold Coats also protect demented inmates from prisoners who try assaulting, abusing or robbing them. They also get harassed and called snitches for seeming to side with prison officials and because of the perks they receive.

Gold Coats [also] conduct exercise classes and run meetings designed to stimulate memory and lessen disorientation. They escort inmates to doctors, acting as their intermediaries.

And they act as intermediaries between the demented inmate and staff, many of whom are improperly trained to differentiate malingerers from the mentally ill (or demented).

More inmates have dementia than prison officials realize, experts say. Prison routines can mask symptoms like forgetfulness. Corrections officers are used to punishing aggressive inmates, not evaluating them for Alzheimer’s.

“Not responding to questions appropriately, being belligerent — it’s just considered bad behavior,” said Sharen Barboza, director of clinical operations for MHM Services, a prison mental health provider that trains prison officials.

And like the other mentally ill, the inmates are punished and sent to isolation, which is probably the worst thing you can do to a patient in the throes of dementia.

Nonetheless, the New York Times has done a fantastic job of reporting on this issue and you should read the entire article. We have tried for 30 years to extinguish "these people" from our midst, but the video below is a powerful testament to the humanity that still exists behind bars.

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