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New York prison creates dementia unit

Needs of older inmates treated

FISHKILL, N.Y. -- In the day room, white-haired men in robes watch "The Price is Right." Out on the balcony, another looks through bars as he fidgets from side to side.

Prisons have been dealing with the special needs of older prisoners for years, but the one here in Fishkill state prison is considered unique because it specializes in dementia-related conditions.

The unit -- 30 beds on the third floor of the prison's medical center -- is a first for New York and possibly the nation, though specialists say it likely won't be the last as more people grow old behind bars.

The unit has the clean-white-wall feel of a nursing home -- but for the prison bars. As long as they behave, patients can wander from their rooms to the day room.

William Connolly, Fishkill superintendent, said the men's crimes are not considered in the screening process, though their prison record matters. The idea is to provide proper care and a safe environment.

"A lot of guys, when they were confined to the general population, they stayed in their rooms, they wouldn't come out," said Angela Maume, nursing director.

The average age of patients here is 62, or 26 years above the systemwide average. All have been diagnosed with some level of dementia, which in the case of some patients is related to Alzheimer's or AIDS.

"Some of them don't even remember their crimes," said Dr. Edward Sottile, medical director for the Hudson Valley prison.

The average age of New York's prisoners is climbing. Inmates 50 and over accounted for 3 percent of the prison population two decades ago, compared to 11 percent last year.

Like society as a whole, inmates are getting older as healthcare improves and baby boomers hit retirement age. But researchers also note that inmates are staying behind bars longer thanks to "three strikes" and other tough-on-crime laws.

Nationwide, the number of prisoners over age 50 in state and federal prisons is rising at about 8 percent a year, said sociologist Ronald Aday, author of "Aging Prisoners: Crisis in American Corrections."

Fishkill, a 1,700-inmate, medium-security prison some 70 miles north of New York City, serves as a regional medical hub for the system. Inmates can get everything from throat cultures to long-term nursing care.

The dementia unit opened in October and is still getting up to speed. Twenty inmates from other prisons around the state are now patients.

Neither the American Correctional Association nor several specialists in prison geriatrics were aware of any other prison units for inmates with dementia.

Dr. Robert Greifinger, prison healthcare consultant, said the idea makes sense because staff can be trained to deal with the special cases. All workers on the Fishkill unit -- nurses, corrections officers, housekeepers -- take a 40-hour training course to learn how to work with the cognitively impaired.

The job can be tricky for corrections officers, who usually must fill out a report every time they touch an inmate. Here, contact comes with the territory. Officers are trained to know that, on this ward, an outburst by an inmate could be a symptom of a troubled mind instead of a hostile act.

"A lot of times it would be construed as bad behavior," Sottile said, "but they have no idea what they're doing."