Ageing Prisoners’ Views on Death and Dying: Contemplating End-of-Life in Prison

Abstract

Rising numbers of ageing prisoners and goals on implementing equivalent health care in prison raise issues surrounding end-of-life care for prisoners. The paucity of research on this topic in Europe means that the needs of older prisoners contemplating death in prison have not been established. To investigate elderly prisoners' attitudes towards death and dying, 35 qualitative interviews with inmates aged 51 to 71 years were conducted in 12 Swiss prisons. About half of the prisoners reported having thought about dying in prison, with some mentioning it in relation with suicidal thoughts and others to disease and old age. Themes identified during data analysis included general thoughts about death and dying, accounts of other prisoners' deaths, availability of end-of-life services, contact with social relations, and wishes to die outside of prison. Study findings are discussed using Allmark's concept of "death without indignities," bringing forth two ethical issues: fostering autonomy and removing barriers. Attributing the identified themes to these two ethical actions clarifies the current needs of ageing prisoners in Switzerland and could be a first step towards the implementation of end-of-life services in correctional systems.

Identity as an older prisoner: findings from a qualitative study in Switzerland

“…The goal of the Swiss national project "Agequake in prisons: Reality, policies and practical solutions concerning custody and health care for ageing prisoners in Switzerland" was to examine the health care of older prisoners in Switzerland. During the course of this project, both qualitative interview data (see Handtke and Wangmo 2014;Bretschneider and Elger 2014;Wangmo et al 2017) from older prisoners (50 years and older) and quantitative data from the medical records of older and younger prisoners (see Wangmo et al 2015a, b) were collected. The secondary data analyzed in this study come from the qualitative part of this project, and the analysis was done in light of gaps in research illustrated above and lack of primary data.…”

“…Thus, prisoners are considered old (at least in the scientific literature) when they reach 50 or 55 years, although some recent research considers this an oversimplification (Spaulding et al 2011). Older prisoners were defined as those who are 50 years and older for this project and both qualitative interview data (see Handtke and Wangmo 2014;Bretschneider and Elger 2014;Wangmo et al 2017) from older prisoners (50 years and older) and quantitative data from the medical records of older and younger prisoners were collected (see Wangmo et al 2015a, b).…”

“…Therefore, the aim of this paper is to highlight how older prisoners in Switzerland conceptualize their old age and identity. We nevertheless note that the topic of identity before and during imprisonment had not been a part of the original research project (Handtke and Wangmo 2014;Handtke et al 2017;Wangmo et al 2017); therefore, the question of how identity changes as a consequence of imprisonment cannot be treated in the scope of this paper.…”

The individual experience of ageing prisoners: systematic review and meta‐synthesis through a Good Lives Model framework

“…Some ageing prisoners may come to see death as liberation from misery (Crawley & Sparks, 2006;Aday, 2005). Handtke and Wangmo (2014) report that 50% of ageing prisoners have suicidal thoughts, which are often undisclosed, as being on suicide watch is stigmatising. In addition, suicide assessment is not carried out regularly, making it more difficult to identify at-risk subjects (Barry et al, 2015).…”

“…Given these uncertainties, prison may be seen as a protective environment (Doron, 2007, Aday & Webster, 1979. For example, healthcare provision, although far from being ideal, grants a level of security that could be lacking in the community (Handtke & Wangmo, 2014). This applies especially to the US health care system and to prisoners living in geriatric hospital wings which provide highly specialised treatments (Doron, 2007).…”