Date of Award


Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)


Occupational Therapy

First Advisor

LaVonne Fox


Aged; Prisoners; Prisons


The current U.S. correctional system is structured for the young, well, able-bodied prisoner and does not take into consideration the extensive needs of elderly inmates. The number of elderly inmate has been steadily increasing and is going to continue to rise with the increase of age expectancy of the average American and changes in in sentencing policies that increase the length of stay in prisons (Potter, Cashin, Chenoweth, Jeon, 2007; The Sentencing Project, 2005). Currently elderly inmates make up 12% of the federal prison population (Mauer, King, Young, 2004, p. 24).

An extensive literature review was conducted to determine the current prison culture, the health status of the elderly inmate, utilization of service, financial cost, best practices within the current prison system and the potential role of the occupational therapist (OT). Professional journals and publications were searched as well as current criminal justice systems websites and the census bureau to identify statistical data. The literature review results indicated that the current prison culture is not suited for the elderly inmate.

Elderly inmates have extensive physical and mental health problems that are exacerbated by the current prison culture. The diminishing health status of the elderly inmate is affected by cognitive and psychosocial factors, environmental factors, and physical factors within the prison system. Exacerbating the inmates diminishing health may result in an increase in dependence which the personnel are not prepared or trained for.

The diminishing health of the elderly and lack of therapeutic environment within the prison system adds to the high cost of housing elderly inmates. The average cost of maintaining an elderly inmate ranges from $65,000 to $69,000 per year, as compared to $22, 650 per year for a younger inmate, (Mauer, King, Young, 2004, p. 25; Gaydon & Miller, 2007, p. 687).

Currently prison systems in the US do recognize the problems associated with the elderly in prison. To try to begin meeting the needs of the elderly prisoners, some prisons have begun developing and implementing various solutions such as: 1) separate geriatric units, 2) specific programming for elderly, 3) better medical care and attention to needs of prisoners, and 4) early release back into the community (compassionate release).

Another proposed solution to the problem is the development and proposed implementation of Elderly in Prison: A Programming Protocol. This protocol is designed for use by occupational therapists and the criminal justice system. The Ecological Model of Occupation forms the theoretical base in the development of the protocol. The protocol presents both evaluations and interventions developed specifically for elderly inmates. It is proposed that this protocol will serve as a guide for use by an OT when working with the elderly in the prison system. It will also serve as an educational resource to teach personnel, in the criminal justice system, about effective programming.