Prisoners Who Are Older, Chronically Ill or Disabled

There are now more older prisoners than ever before in England and Wales; precisely ‘four times the number of people aged 60+ than there were in 2002.’ People aged 60 and over are now the fastest growing age group in the prison estate. In 2023, 159 people aged 50 or over died of natural causes whilst in prison – almost three times the number that died twenty years ago. (Prison Reform Trust; Factfile February 2025)

In terms of ability, 36% of all prisoners are estimated to have a medical or mental disability, compared to 19% of the general population: 11% have a physical disability; 18% have a mental disability; 8% have both. Of prisoners screened through educational assessments in England in 2023-24, over half (55%) were identified as having a learning difficulty or disability. 62% of women and 54% of men report having mental health problems. (Prison Reform Trust; Factfile February 2025)

In 2024-25, older prisoners made up 20% of Advice Line callers, 41% of letter-writers and 29% of Outreach Clinic attendees. 55% of Advice Line callers, 72% of letter writers and 55% of those attending Outreach Clinics self-identified as suffering from a disability, a chronic health condition, mental health issues or learning difficulties. Over the course of the year, PAS’ Community Care Caseworker delivered seven Outreach Clinics in two prisons, seeing 56 prisoners one-to-one, and opened 13 new end-to-end legal cases on behalf of older, ill and disabled prisoners.

Unfortunately, it comes as no surprise that older, chronically ill and disabled prisoners have needs and rights that are consistently overlooked by prison officers or delayed by Prison Service bureaucracy. Such is the toll of time in prison, that incarcerated people tend to have a biological age roughly 10 years in advance of their contemporaries in the outside community. (Centre for Policy on Ageing; Growing Old in Prison, 2011).

PAS Caseworkers regularly receive calls and letters from older, chronically ill or disabled prisoners whose conditions of imprisonment severely impact their daily quality of life. Many are unable to use stairs and therefore cannot access basic prison facilities such as the exercise yard, classrooms, library, work stations, healthcare, medication hatch and chapel. In addition, there is currently no legal obligation for prisons to provide optional activities / ‘time out of cell’ for those unable to work due to age or disability. Caseworkers report that many older prisoners who experience chronic pain are therefore confined to their cells for up to 23 hours a day. Isolation is further exacerbated by the fact that many prisons do not provide in-cell phones and older prisoners are typically less likely to have family visits. Needless to say, for elderly prisoners living with dementia, the prison environment is relentlessly gruelling.

PAS is frequently asked for assistance when prisons and probation services fail to meet legal responsibilities towards older, chronically ill and disabled prisoners, both during their time in prison and when they are due for release. Caseworkers help such prisoners obtain appropriate social care assessments (including Occupational Therapy), adaptations to cells (grab rails, adapted showers and toilets), specialist equipment (beds, chairs, mobility aids, wheelchairs, non-slip flooring, level access) and reasonable adjustments to prevent unfavourable treatment compared to other prisoners. This includes facilitating external doctor, hospital or optician appointments for long-term conditions such as arthritis, diabetes, dementia and failing eyesight or hearing.

PAS also helps older, chronically ill and disabled prisoners who feel unsafe in wings occupied by younger prisoners hurling abuse, to move to quieter wings or different prisons. It assists prisoners in obtaining suitable jobs in prison so that they can earn privileges and challenge the perception that they are too old, ill or disabled to work.

PAS can also facilitate extended library book loans for dyslexic prisoners and the provision of large print books for visually impaired prisoners.