America’s prison population is aging, but care options for older parolees remain limited

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• Judy Woodruff:

  Returning to society after incarceration would, of course, be challenging for anyone, but the difficulties only multiply for older men and women coming out of prison.

  Amna Nawaz reports on the many hurdles these individuals can face after decades behind bars.

• Melvin Malcolm, Patient, Transitions Clinic Network:

  How you doing, Dr. Shavit?

• Dr. Shira Shavit, Transitions Clinic Network:

  Good. How's it going?

  It's part of our ongoing series Searching For Justice.

• Amna Nawaz:

  At the Transitions Clinic Network in San Francisco, Dr. Shira Shavit's first patient of the day is Melvin Malcolm.

• Dr. Shira Shavit, Transitions Clinic Network:

  So how's the fatigue been? Are you still feeling pretty tired?

• Melvin Malcolm:

  Yes, I still am.

• Amna Nawaz:

  Malcolm is 74 years old. He suffers from degenerative rheumatoid arthritis and prostate cancer.

• Dr. Shira Shavit:

  I'm just going to take a quick listen to your heart.

• Amna Nawaz:

  Diseases he developed while serving 38 years in prison for murder and robbery. He was released just three months ago, and, so far, life on the outside hasn't been easy.

  What are some of the challenges that you're facing day to day?

• Melvin Malcolm:

  Handling things on your own.

  Generally, incarcerated, everything is handled for you. Your medication is brought to you. You're told when to eat. You're told when you put a — when to sleep. Things are more or less programmed for you.

  Once you come out, you have to do things on your own. And it's pretty hard. And it's pretty hard to get used to doing that.

• Woman:

  Go head and relax your arm for me, please.

• Amna Nawaz:

  He says the health care he's getting now is much better than what he got in prison, but nearly four decades behind bars has taken a toll.

• Melvin Malcolm:

  I have the degenerative rheumatoid arthritis, as you can see by my hands. And I'm going to have, I think, knee surgery. And my feet are really — are really bad.

• Dr. Shira Shavit:

  Did anything else come up in your visits with him today?

• Amna Nawaz:

  Dr. Shavit says Malcolm is a typical patient here at Transitions, a national network of nearly 50 nonprofit health clinics that serve people post-incarceration.

• Dr. Shira Shavit:

  Our practice here, 66 percent of people have done 30 or more years in the state prison system. And what we know is that people age more quickly when they're incarcerated. And so when we think of older adults, we actually think of people who are 55 and older who have been in the system.

• Amna Nawaz:

  Twenty years ago, people 55 and older made up just 3 percent of the U.S. prison population. Today, that's grown to more than 10 percent. One major reason? Tough-on-crime policies dating back to the 1990s that led to longer prison sentences.

• Dr. Shira Shavit:

  So when people come out of prison or jail, everything's kind of all up in the air at the same time. But it's even more difficult for older adults. People have been apart from the community for longer. They have less connections in the community, less social supports and have more challenges in addressing some of their needs.

• Amna Nawaz:

  The team here at Transitions tries to step in and meet the most pressing needs, not just medical.

• Man:

  That's why you have that little phone icon.

• Amna Nawaz:

  There's technology training.

• Melvin Malcolm:

  How you doing?

• Amna Nawaz:

  Help getting I.D.s and documentation…

• Melvin Malcolm:

  They didn't put my middle name on the I.D. card.

• Amna Nawaz:

  And access to food.

• Ron Sanders, Transitions Clinic Network:

  We also got some chicken too.

• Melvin Malcolm:

  Yes, chicken is OK too.

• Amna Nawaz:

  A key part of this team? People who know what reentry after prison is like, people like 58-year-old Ron Sanders. He battled addiction and was in and out of prison during his 20s on drug charges.

• Ron Sanders:

  So, imagine somebody's been locked up for 20, 30, 40 years. It's good to have somebody to help you guide you along.

  Is this your first time going to Walgreens to get the medications?

• Melvin Malcolm:

  No, this is not the first time, but it's the first time I'm going to get a refill.

• Ron Sanders:

  Oh.

• Amna Nawaz:

  He's been working at Transitions for 15 years as a community health worker, and spends a lot of time building connections and trust with patients often skeptical of the system.

  Why do you think they trust you?

• Ron Sanders:

  Because they know I came from the same place they came from. I have been in those shoes before. And I know. And, also, I know how scary it is just getting out. And especially when you get out and you don't have any, like, family support or anything, it's really tough.

• Amna Nawaz:

  But for older adults exiting prison, this level of support is rare.

  Few clinics like this exist across the country. And the ones that do are often located in urban areas. For people who need longer-term medical care, the options are even more limited.

  Leticia, Resident, 60 West: Being away for a while, I was really scared.

• Amna Nawaz:

  Leticia is a 67 year-old woman who suffers from mental health disorders and lymphedema, which causes swelling of the arms and legs. She served 17 years in prison for murder. She asked us not to use her last name.

• Leticia:

  I have PTSD, and I had deep depression, and I was very, very disturbed.

• Amna Nawaz:

  In 2019, she was released from prison, and discharged to 60 West, a privately-owned nursing home in Rocky Hill, Connecticut, with 95 beds.

  Opened in 2013, 60 West is funded mainly by the state of Connecticut and its Medicaid system. Many residents here are formerly incarcerated.

  Jessica Dering, Administrator, 60 West: Being able to look anyone up and find out what their history is very easy now in our social world.

• Amna Nawaz:

  Administrator Jessica DeRing says nursing homes are often reluctant to accept residents who've committed serious crimes.

• Jessica Dering:

  Now, certainly, the person could be the picture of nursing home-appropriate. However, traditional nursing homes weren't giving them a chance to be a part of their community. So that's why 60 West was created, so that we could provide an environment of stigma-free living.

• Amna Nawaz:

  If this place wasn't here, where would you have gone? What were your options?

• Leticia:

  I don't know. Probably a shelter.

• Amna Nawaz:

  Leticia's story is not uncommon at 60 West. After 33 years in prison for murder, Mike Jarrett landed here in 2016. He's now 70, battling clinical depression and diabetes. His right leg was amputated from a systemic infection he got while in prison.

  Mike Jarrett, Resident, 60 West: This place is ideal for me because it helps me find — get my Social Security straightened out, find a place to live, get all my medical supplies taken care of. I didn't know how much of benefit this place would be. But it's a fantastic benefit.

• Amna Nawaz:

  People will wonder, why should all these amenities, why should a place as comfortable and as nice as this be made available to people who have committed very serious violent crimes? What would you say to them?

• Mike Jarrett:

  The only alternative to me being here is being left off in the streets. So, I'm kind of blessed that way, but it's not going to last forever. Eventually, this place is going to fill up again.

• Amna Nawaz:

  Jarrett's now navigating his next hurdle.

• Mike Jarrett:

  There's nothing. I'm stuck. My hands are tied.

• Amna Nawaz:

  Where to go now that he no longer needs this level of care. His bed is already in high demand with more older parolees.

• Mike Jarrett:

  The only reason why I am still here for the last three years is because I can't find an apartment. And I can't find an apartment because they apply. And it says that I have a police record, and they won't accept me.

  I am trying hard to get out of here. I certainly don't want to take up anybody else's space.

• Amna Nawaz:

  And Jessica DeRing says, because the cost of care inside prisons is so high, this is a more cost-effective approach for the state of Connecticut.

• Jessica Dering:

  Having us open actually saves the taxpayers of Connecticut annually, because we focus on care. So we can do it in a much more efficient manner. And, ultimately, it costs less money.

• Amna Nawaz:

  60 West says several states are exploring ways to replicate this model as the nation grapples with how to care for this aging population.

  For the "PBS NewsHour," I'm Amna Nawaz in Rocky Hill, Connecticut.

• Judy Woodruff:

  And our Searching For Justice series continues tomorrow with a look at one woman's fight to overcome her past and her background check.