Aging Behind Prison Walls: Studies in Trauma and Resilience

Authors: Tina Maschi and Keith Morgen
Publisher: Columbia University Press, 2021. 296 pages
Reviewer Name: Angela S. Murolo ǀ November 2021

As the prison population turns gray and correctional institutions are slow to react to this burgeoning crisis, Aging Behind Prison Walls seeks to bridge the divide between policy, practice and understanding of the aging prison population. The book is a two-part journey that defines how we have arrived at the problem of aging in prison, and tools to solve this problem through the caring justice framework. The book is overarching, all-encompassing and peppered with individuals’ narratives on aging in prison. Qualitative data collected though the Co-Constructed Community Project, Coming Out of Prison Study and the Hartford Prison Study have people sharing their experiences of trauma, coping strategies and the ability to be resilient even in the most adverse of conditions.

Part one of Aging Behind Prison Walls serves as a point of reference in understanding who is older and incarcerated. This is not simply a discussion of demographics, but rather a discussion of cumulative harm and trauma which impact one’s life-course trajectory, as seen through the eyes of justice-involved older adults. Individual level factors such as age, race, gender and mental or physical disabilities are compounded by social or structural factors such as poverty and homelessness. These factors or variables are discussed as cumulative determinates that have been shown to increase the likelihood of incarceration, and ultimately determine the level of care in prison. While many people think of older prisoners as simply growing old in prison, data from the National Corrections Reporting Program show that new prison admissions of people over the age of 55 have increased between 2005-2016. As the American population ages, so too will people who commit crimes, and thus come under the control of the criminal justice system.

Maschi and Morgen discuss aging in prison using an intersectional lens and life course perspective in order to understand the differences among these older adults. Intersectionality influences the level of justice, care or access to services that people receive. For example, older adults in prison may suffer histories of homelessness, trauma through childhood abuse, and have co-occurring disorders while incarcerated. One cannot address one challenge without recognizing the impact of others. Perspectives of older incarcerated LGBTQ adults are also presented. Challenges are discussed from intersectional and oppression theory perspectives where cumulative harms place older justice-involved adults at greater risk of criminalization, victimization, and abuse. Older incarcerated LGBTQ members are also at greater risk of sexual victimization and related prison trauma. The life-course perspective and power analysis serve here as tools to provide multilevel interventions, prevention and assessments to benefit older adults. By understanding the experiences people bring to incarceration, service providers can aid in healing and thus improve outcomes when older adults return to the community.

Incarceration is difficult under any circumstances, but as Aging Behind Prison Walls indicates, aging in place as an older adult has particular challenges. Simply put, prisons are not really designed for older people, which makes the activities of daily living challenging. Correctional facilities are not designed for older people who need walkers or canes, or wheelchairs. Nor are they designed for older adults who may have to sleep in a top bunk or have issues just performing the activities of daily living. Correctional administrators do often understand the financial costs of having to care for an older person, however, they may be ill prepared to meet that challenge. The authors here outline medical conditions that are common among older offenders, including heart and lung diseases and diabetes, which add to the pains of imprisonment for older adults.

In addition to the physical health challenges, Aging Behind Prison Walls describes the prevalence of mental health issues in this particular population. The authors provide an in-depth explanation of the long-term effects of prolonged trauma and stress, including its negative effects on behavioral, mental, and physical health outcomes. There is also an extensive discussion of the neurobiological effects on the brain, including how the limbic system processes emotion and trauma including the storage of sensory stimuli around a traumatic event. This is relevant because, after traumatic experiences, sensory stimuli (sights, smells) may trigger a negative reaction to otherwise neutral stimuli. For example, someone may act aggressively if the smell of something triggers a traumatic memory. Additionally, post-traumatic stress disorder (PTSD) is prevalent in the incarcerated population. PTSD is related to traumatic brain injuries, trauma, poor physical or declining health, and co-occurring psychological disorders. Addiction is also related to co-occurring psychological disorders. Incarceration alone is known to exacerbate mental health issues, especially among the elderly in prison. Loneliness and fear of death and dying in prison are common.

Of particular interest in the book are the descriptions of conversations about coping, adaptation and resilience among these subjects. Through personal narratives collected through the Hartford Prison Study, we understand how older adults cope with incarceration, histories of trauma, and loss of family members. The authors discuss how coping strategies, including cognitive, emotional, spiritual, social, philosophical, and physical are used singly or in tandem to recover from trauma and build resilience. LGBTQ older adults cope though gaining insight and self-acceptance as well as taking responsibility for their crimes. Coping strategies include supportive emotional counseling (emotional), interaction with family and friends (social), and church and prayer (spiritual) to name a few. Older incarcerated adults utilize at least two forms of coping techniques, which help improve health and mental well-being. According to results from the Hartford Prison Study, older incarcerated adults who practiced three or more coping techniques reported greater levels of physical and mental wellness. This shift from “dis”ease to ease helps older adults cope with imprisonment, recover from trauma, and to have a more positive world view.

Aging Behind Prison Walls also recounts the difficulties people encounter upon release. Using data from the Co-constructing Community Project, service providers, key stakeholders, family members and formerly incarcerated people devised ways to reunite people with their families and to facilitate smoother transitions into the community. This is no small feat; aged-based services for people leaving prison are few and far between. As the book describes, respondents attempting re-entry reported social and structural barriers including housing, employment, lack of family and shortage of social supports. Other barriers to success included addiction, discrimination, and homelessness. Although older adults are comparatively the least likely to reoffend, their challenges are nevertheless vast and complex.

Aging Behind Prison Walls draws from various disciplines to provide a solutions-based framework called caring justice. The caring justice framework presents a new way to look at the same old problems. Considering public safety, health and well-being for all, the caring justice perspective advocates for individual, social and structural change from the inside out. Change comes from caring and justice, not just for self, but for others. Part two of Aging Behind Prison Walls provides a framework for change with the caring justice partnership paradigm and recommends emerging programs both inside and outside prison walls to support older adults.

The authors conclude with a number of salient points, e.g., how older people in prison can teach us how to live stronger, happier lives. They also provide recommendations on how communities can collaborate to construct a more caring, just world. And finally, they describe the limited resources to support older people both inside and outside prison. Unfortunately, as they note, the latter is a need that is not being adequately served.

Aging Behind Prison Walls is well suited for advanced students in criminology, social work, and psychology. Practitioners in prison systems, community corrections officers and service providers would also benefit from this text. There are clear differences between older and younger incarcerated persons, and Aging Behind Prison Walls provides a guide to facilitate understanding the older justice-involved population. The text is actually written in a “tour guide” tone, that invites readers to follow along on the journey of understanding, caring and seeking justice for the most vulnerable of populations. Most importantly, the text encourages us to see the formerly incarcerated as people who are resilient, redeemable and capable of changing from the inside out.

Angela Silletti Murolo is a Doctoral Candidate at John Jay College of Criminal Justice/ Graduate Center CUNY