By Heather Campbell
This article originally appeared on The Lawyer's Daily website published by LexisNexis Canada Inc.
In October 2009, Ottawa nursing home resident Peter Lee allegedly smothered his bathroom-mate to death. Police believe that the 84-year-old, who had dementia due to Parkinson’s disease, suffocated the victim, who was asleep in bed, and then dragged the body toward the bathroom. Lee was charged with second degree murder.
In recent years, tragedies like this have captivated the public. [In January 2018], a CBC Marketplace investigation reported on the “shocking rise” of abuse in Ontario long-term care homes. The episode begins with security camera footage of two elderly men having a physical confrontation in a nursing home hallway.
“One of these men will soon be dead,” says Marketplace host David Common. The video captures the aggressor punching and then shoving the 84-year-old victim, who falls to the floor. The attacker then smashes the man with a chair. Suffering a broken hip, the victim dies four days later.
Incidents like this are a double tragedy: one senior has lost their life, and another has become a killer. But after the headlines fade, we rarely hear about what happens to the aggressor. Like much coverage, the Marketplace investigation doesn’t mention it. With few exceptions, the killers’ stories remain untold. Yet these men are our husbands, fathers and friends.
Men like Second World War veteran Jack Furman, who at age 94 was charged with second degree murder after he allegedly attacked his care home roommate with a shelf; and 74-year-old Piara Singh Sandhu who was charged with two counts of second degree murder after he allegedly pried the metal base off a bedside table and bludgeoned his two roommates to death; and widower Peter Brooks, who at age 76 was convicted of second degree murder in the death of a fellow long-term care resident and sentenced to life in prison with no parole eligibility for 10 years.
These men are forgotten criminal defendants. Along with other killers with dementia, they are often left languishing in forensic hospitals and prisons, institutions that are generally ill-suited for someone with the disease.
Eight months after his bathroom-mate died, the court found Lee unfit to stand trial. He was sent to a secure forensic unit, where he was detained for over six years.
Lee was stuck in a dilemma. Each year, the Ontario Review Board found him unfit to stand trial and concluded that his detention was necessary because he posed a significant threat to public safety. The board pointed to evidence that Lee was aggressive in hospital; for example, on one occasion, he pushed pizza into a nurse’s face.
Yet as the board acknowledged, many nursing home residents engage in similar behaviours as Lee. But the prospect of finding him a nursing home bed was “extremely limited.” At first, no home was willing to take him. Seven years after the slaying, two homes were prepared to house the 91-year-old, but their wait lists ranged from about eight to 10 years.
Most people with dementia will not commit a crime, let alone murder. However, nursing home violence may be on the rise. As Marketplace reported, resident-to-resident abuse in Ontario doubled in six years, from four per day in 2011 to about nine in 2016. Several factors are likely contributing to this increase, including understaffing and increasing dementia rates among residents. Incident reporting systems have also improved, so some abuse that went unreported in the past is now being counted.
Another factor may be the well-intentioned reduction in anti-psychotic drug use, though the evidence is unclear. On the one hand, the Canadian Foundation for Healthcare Improvement has found that taking residents off the drugs reduced abusive behaviour. On the other hand, Marketplace found that as anti-psychotic use went down, resident-to-resident abuse went up.
Deadly violence by people with dementia is an extreme outcome with no quick fix. Part of the solution is increasing the number of specialized beds for persons with aggressive behaviours. Earlier this month, Ontario made strides on this front, opening a new 20-bed unit for older adults with dementia who present complex behaviours in an acute care hospital.
[Zero violence is] an admirable but likely unattainable goal. Prevention is the first line of defence for keeping persons with dementia out of the criminal justice system. But every incident cannot be reasonably eliminated.
Dementia is a condition whose symptoms can manifest as violence. Sometimes it can be fatal.
The sad reality is that a small number of killers with dementia will enter a criminal justice system that is ill-equipped to manage their needs. To improve this situation, we cannot let these forgotten men fade from public memory. Their stories must be told.
Heather Campbell is a PhD student at Queen’s University and founding director of Dementia Justice. She articled at the Canadian Centre for Elder Law and practised law in British Columbia. You can follow her on Twitter @SeniorsLaw.
The International Society for Frontotemporal Dementias is now accepting abstracts for the 11th International Conference on Frontotemporal Dementias, which will be held at the International Convention Centre in Sydney, Australia from November 11-14, 2018.
ICFTD 2018 invites you to submit abstracts for oral presentations, data blitz presentations, and poster displays in one of the following categories:
Abstract submission guidelines are available on the conference website.
In this post, we share important research by Meagan Strasser on the health experiences of older offenders while they are incarcerated and following their release from prison.
Master of Arts in Criminology
Faculty of Social Sciences
University of Ottawa, 2017
In Canada, the number of adults over the age of 50 incarcerated in federal penitentiaries has doubled over the past ten years, now comprising nearly 25 percent of the federal prison population (Martin, 2017). As this population continues to grow, so too will the demands placed on prison health services. To address this issue, researchers, policymakers, and practitioners suggest creating more accessible bedspace within existing institutions, cordoning off age-segregated prison units, building specialized geriatric prisons, and/or increasing the use of compassionate release. These solutions implicate institutional and community-based corrections, which produce ‘carceral’ and ‘transcarceral’ spaces respectively. These spaces are characterized by the application of social control within, across, and outside of custodial settings, which can have enormous implications for accessing health and healthcare. This research project explores how the health of incarcerated and formerly incarcerated older adults unfolds in the spaces to which they are confined. Semi-structured interviews were conducted with staff (n=4) and older residents (n=5) at halfway houses in Ottawa, Ontario. Drawing upon French Marxist philosopher Henri Lefebvre’s theorization of space, including three ‘moments’ of spatial production, and complementary criminological literature on carceral space, a thematic analysis of interview data revealed several important findings. Ultimately, the present study highlights tensions with respect to how the aging body is negotiated in carceral space, how the everyday practices that shape the lives of incarcerated and formerly incarcerated older adults contribute to the production of space, and what this reveals about the nature of these spaces.
The full thesis is available here.
On February 22, 2018, the Citizens Advisory Committee, Correctional Service Canada, Peterborough Reintegration Services (formerly Peterborough Community Chaplaincy), Trent Centre for Aging & Society, and the Trent Forensic Science, Nursing, Social Work, and Sociology programs are joining together to explore the pressing issue of how we reintegrate senior parolees into our communities and long-term care facilities.
To order tickets
To join in the employer village (one ticket is included in the registration fee)
By Kelvin Robbins
This post is adapted from a November 2017 postgraduate student paper. It was originally published on the Canterbury Christ Church University Policing and Criminal Justice blog.
There is little consensus on what constitutes an elderly prisoner. The definition of “elderly” in prison research literature ranges from 50 to 65 and older. This lack of clarity in defining "elderly" is an issue. Whilst age provides a simple measure of chronological progress since birth, it is a poor measure of life stage and ability. Therefore, allocating resources on the basis of chronological age could give unnecessary benefit to some and disadvantage others, and it makes meaningful comparison difficult for researchers as well as for policy makers.
Matters are further complicated in that there is some evidence that physiological deterioration is more advanced in an inmate compared to a person based out in the community, and this is put forward as an argument that incarceration accelerates the ageing process. However, this can’t apply to an elderly person committed to prison for the first time.
Overall, there is no clear chronological point a person becomes “elderly” in the criminal justice system. Perhaps it is unsurprising that defining the elderly in a prison context was identified as a top priority in developing national US policy in 2012.
Reviewing the literature relating to the imprisonment of the elderly reveals a number of clear themes. Firstly, society predominantly associates criminal behaviour with youth. It is described as a young man’s game, with prisons designed around fit young men, not for those with deteriorating health and physical ability. Prisons are institutionally geared towards smooth running and self-maintenance. This lack of consideration, or “institutional thoughtlessness” results in elderly prisoners being invisible in policy.
Expecting elderly prisoners to follow the same rules as younger prisoners could even be described as discrimination. For example, withdrawing access to media has been found to be more impactive on the elderly. Elderly female prisoners, as a minority within a minority, suffer more from this institutional thoughtlessness. Elderly female prisoners are described as forgotten, but some go further in describing a “pattern of malign neglect” in programmes and policies.
Another key theme is dementia. Prison systems are unprepared to handle this condition, as are earlier stages of the criminal justice system. Research indicates dementia can be devastating if undiagnosed in a correctional setting, but there is a lack of data about its prevalence in prison. Evidence shows younger adult prisoners are more likely to have chronic illnesses and psychiatric illness, so elderly prison populations may be more likely to suffer dementia. Certainly, healthcare planning for elderly prisoners cannot be extrapolated from estimates based on elderly based out in the community.
A third theme is the cost of elderly prisoners, disproportionately higher for elderly prisoners compared to their younger inmates. Financial issues seem to feature more in American literature, as responsibility to provide healthcare for inmates moves from the individual to the state for incarcerated persons in the USA, but there is also increased financial burden associated with elderly inmates in the UK.
Elderly prison populations are rising. Prison populations globally have grown, and within this there is a sustained surge of elderly prisoners, who are the fastest growing subgroup of prisoners. However, there is no clear consensus as to why. Some academics argue it is simply reflective of the increasing proportion of the elderly in wider populations, but this is dismissed by others. A potential reason may be the increasing length of sentences, yet as long ago as 1984 41% of prisoners were over 55 at their first committal to prison, and other schools of thought consider sentence length as a marginal contributor to increasing elderly prison populations.
UK courts have become increasingly preoccupied with retribution and risk, and there may be a societal shift to incapacitation models of crime control rather than rehabilitative approaches. There is also a greater readiness to prosecute historic offences, particularly sexual offences. This rise in elderly prisoners has led to established criminological theory of criminal involvement declining with age being questioned and re-examined.
In response to the rise in elderly prisoners, there are calls for sentencing reform. The established rationales for imprisonment are stretched to breaking point with the elderly. Sentencing guidelines underestimate the impact of imprisonment upon the elderly, and evidence suggests they are much less likely to reoffend. A key call is for Alzheimer’s screening or functionality tests for prisoners, but prison environment based functionality assessments must be developed as existing community based ones cannot easily translate into prison settings.
Whilst there has been good work by non-governmental organisations responding to elderly prisoners, action by responsible authorities lacks consistency with only pockets of good practice. Most positive approaches identified are due to individual improvisations by prison staff. The Prison Ombudsman has called for a national elderly prisoner strategy in 2017, repeating the little heard concern of the HM Chief Inspector of Prisons in 2008.
To conclude, elderly prisoners are a global, cross-discipline issue. Research and concern spans legal, nursing, geriatric, mental health, sociological, and criminal justice literature. National level responses are beginning to emerge, but a clear consistent theme across all the research disciplines is that research is too sparse, and whilst pockets of good practice exist, national policy is inadequate, if it exists at all.