The Prison Paradox: Why Inmates Age Faster

The days can seem endless in Canadian prisons — and yet, inside, inmates actually age faster than on the outside. Why? Université de Montréal nursing student Jim A. Johansson explores that question in his doctoral thesis, co-supervised by UdeM Faculty of Nursing professor Étienne Paradis-Gagné and University of Ottawa School of Nursing professor Dave Holmes. Prison accelerates aging beyond the norm in the general population, explained Paradis-Gagné, a researcher at the Philippe-Pinel forensic psychiatric hospital research centre. While people are generally considered “elderly” around age 65 or 70, the threshold drops to 50 behind bars, he said. The rapid decline stems from constant hypervigilance fuelled by fear of aggression or retaliation, an environment of violence and tension that creates chronic stress, and a lack of stimulation that hastens cognitive and physical decline, compounded by inmates’ difficult life journeys, often marred by instability, poverty or substance use. At the same time, accelerated aging is combined with a painfully slow pace of life. “Prison imposes rigid routines, schedules and a daily existence defined by waiting and endless hours of boredom in an under-stimulating environment,” Paradis-Gagné said. “There’s a reason it’s called ‘doing time.’” In a study published last fall, the research team used a theoretical framework drawn from science fiction to illustrate this warped experience of time. They turned to Philip K. Dick’s 1964 novel The Martian Time-Slip, set on a futuristic planet where the days are very long. When the characters return to Earth, they discover they have aged at an alarming rate. “This analogy helps us grasp the complex reality of prison time from a narrative angle,” Paradis-Gagné said. “It also shows how literature can enrich our analysis of health issues—an approach that is uncommon in our field.” Paradis-Gagné believes it is important to understand the inmate experience of time, for it underscores the challenges prisons face in supporting an aging population. Healthcare workers—especially nurses—play a vital role inside correctional facilities, providing daily care to elderly inmates who are often physically frail or nearing the end of life. However, prisons are ill-equipped to meet the needs of aging inmates, the researchers argue: the buildings are obsolete and unsuitable for people with limited mobility, and staffing is inadequate. Transferring an inmate to long-term care or a community facility at the end of life is fraught with obstacles due to the stigma, media scrutiny and a lack of specialized facilities for people with serious criminal histories, the researchers say. “This marginalization creates a blind spot in public policy,” Paradis-Gagné argued. “We need to invest in age-friendly infrastructure, bolster care teams and facilitate transfers to long-term care when necessary.” In short, enhanced support for aging and better end-of-life care is needed in prison settings, the researchers believe.