These seniors face the same mental and physical health care needs as people on the outside, experts say, but they’re growing old in a system already strained by the sheer numbers of prisoners, to say nothing of the pressure created by the COVID-19 pandemic. Their plight is the focus of Aging Behind Prison Walls: Studies in Trauma and Resilience (Columbia University Press, 2020), a new book co-authored by Professor of Social Work Tina Maschi, Ph.D., and Keith Morgen, Ph.D., associate professor of psychology at Centenary University.

From Isolation to Solitude

Maschi noted that although the book focuses on aging in prison, it is also a story of humanity. Its data-driven analysis—both quantitative and qualitative—reveals that the men and women behind bars have mustered a resilience that could teach those of us on the outside a thing or two, said Maschi, particularly when most Americans are coping with pandemic isolation.

“Now we’re all in a metaphorical prison, so why don’t we ask the wisdom keepers in prison, what does it mean to take social isolation and view it as solitude?” asked Maschi.

Maschi said the coping strategies used by incarcerated elders include finding meaning in their lives from before, during, and after imprisonment. But society undervalues incarcerated people, so their wealth of knowledge falls mostly on deaf ears. Over the years, Maschi said, she’s come to appreciate older incarcerated people for their unique and informed perspectives.

“One of the elders once said to me, ‘You may have a Ph.D., but I have a direct line to the wisdom only others can read about in your research,’ and I realized he was right,” said Maschi.

Trauma Begets Trauma

Over the course of 10 years, Maschi interviewed 677 incarcerated people for the Hartford Prison Study under the jurisdiction of the New Jersey Department of Corrections. The research produced multiple journal articles, including a study of some frequently overlooked communities, such as LGBT incarcerated elders. But perhaps her most significant finding was that 70% of the participants experienced three or more traumatic experiences in their lives, including physical and sexual abuse. The ill effects from these experiences linger for many years later, she said. And yet, her research also found that older incarcerated adults who had spent years working through the trauma lived healthier lives into their senior years. They, in turn, passed on the knowledge to younger men and women in prison, of which many were able to make positive changes in their lives.

One young man she calls Joseph credits a prison elder with helping him turn his life around. Joseph had been abused by his parents and a coach. With the help of an elder he was able to gain insight into “what happened to me and what I had to do to get ahold of the monster in control of me,” he tells her in the book. Before that he experienced “a world locked away from all caring feelings and [he]put on a tough exterior.”

Based on the data, Maschi said, “If we give them love instead of suppressing love we know that people have better results.”

Prison as a Metaphor

Maschi worked in prisons for 15 years before finding her way to the older adults there. Initially, she researched young prisoners and wanted to understand trauma in their past that paved the way to incarceration. But she also wanted to examine outcomes of being incarcerated over several years, which led her to the older population. In time, she said, she has come to view America’s mass incarceration crisis as analogous to society’s greatest ills.

“The prisons are a metaphor, these are stories of humanity and we need to understand how we got to this point because if don’t want to look at how we got here, we’ll never get out of it,” she said. “And if we don’t do something, we’ll be looking at thousands of people dying, including many chained to beds, and that problem is only going to get bigger and bigger.”

Maschi said that most Americans’ personal and collective beliefs don’t align with the brutality of mass incarceration. She said much of the problem springs from a “fear-based mentality” fostered by the media that distracts people from focusing on the positives that incarcerated people may have to offer.

Caring Justice

Maschi and Morgen offer concrete proposals—at the community and national policy levels—to address the pressing issues of incarcerated elders. The authors document multiple examples of compassionate programs and interventions that incorporate what they refer to as “caring justice” principles. The approach provides a formalized framework for professionals that integrates “caring” by emphasizing equality, compassion, and authenticity, and “justice” by emphasizing truth, integrity, balance, and ethics. can help everyone examine “how we value, treat, and care for each other.” But the principles are specifically intended to help marginalized individuals and groups, like those with a criminal past, heal and grow. In essence, their recommendations spring from the care that incarcerated elders are already providing in an informal way to younger imprisoned adults

“Caring justice is not coming, it is already here. If you open your eyes you will see it.  While the rational view is respected, it should be tempered by the heart and expressed through compassion,” she said.  “There’s science behind this; we know from our other research that oppression and hatred often are associated with health and justice disparities. In comparison, a compassionate and authentic approach is most often associated with better health, well-being, and an increased sense of belonging.”

Caring justice is a “heart and head integration” method that Maschi says is best expressed in the spiritual creative writing of an incarcerated older adult known as Mr. J’s Unchained Mind, who is briefly mentioned in the book. Maschi writes that Mr. J’s Unchained Mind enables him to be fully aware of his inner landscape and his relationship to the world.  In one paragraph introducing a poem by Mr. J, the authors reference 15 empirical studies that support the importance of “biopsychosocial spiritual medicine” to promote resilience, transcendence, and well-being. That is to say, Mr. J’s faith. He writes:

I was once a Fool but now I’m Wise!
I was once Blind but now I See!
I was once Deaf but now I Hear!
I was once Ignorant but now I use Intelligence!
YOU have your Ph.D., but I have Knowledge and Inspiration that comes from a Higher Power, the one and only True GOD!
A Mind is a terrible thing to waste, so is the Soul!

Tina Maschi, PhD, associate professor at the Graduate School of Social Service, studies both aging and criminal justice, and she found that a subsection of this graying prison population has long been overlooked: lesbian, gay, bisexual, and transgender elders.

To better understand the distinct experiences and needs of this population, Maschi conducted a qualitative study that allowed formerly incarcerated LGBT elders to tell their own stories. Through focus groups and one-on-one interviews with 10 volunteer participants, both male and female, Maschi gathered data from the narratives they told about their lives before, during, and after prison.

What she learned is that violence, often sexual violence, is a tragic fact of life for LGBT inmates, and that many times it is witnessed, overlooked, or perpetuated by both inmates and correctional officers.

“A lot of times, they couldn’t walk from place to place because of the fear of getting attacked, even going from their cell to an education class, or to go to the shower. So they are always on high alert,” Maschi said.

She also reported that sometimes LGBT inmates are put in solitary confinement, not due to their own behavior but for their own safety.

Troubles often continue for LGBT people returning to their communities after prison. Many face service providers who are not sensitive to their unique needs as well as difficulties finding housing where they feel safe revealing their sexual orientation.

Maschi found that a core theme of the participants’ stories was “self and the social mirror.” That is, the participants often managed multiple stigmatized identities, such as being LGBT, elderly, a racial or ethnic minority, being HIV positive, or having a mental illness or substance dependency.

At the same time, however, Maschi saw resilience in the participants that enabled them to continue a coming out process of “learning to accept themselves despite the fact that other people did not.”

“Despite everything that could knock them down, they stood tall and strong and sensitive,” she said.

For Maschi, factors that played a role in this self-acceptance were being accountable for the crimes they had committed, helping others, and finding social support.

Her study also drew upon the participants’ own recommendations for helping LGBT people in the criminal justice system. From these, Maschi concluded that a holistic approach was needed in providing vocational, educational, and clinical services to formerly incarcerated LGBT elders.

“We’re more than the sum of our parts,” she said.

Though an individual may be LGBT, elderly, a racial or ethnic minority, HIV positive, formerly incarcerated, “it’s just a piece of who they are,” she said.

“I think the common denominator is that we’re all human and we all deserve love.”

Maschi’s article on her study findings, “‘Coming Out’ of Prison: An Exploratory Study of LGBT Elders in the Criminal Justice System,” was published in May in the Journal of Homosexuality.

—Nina Heidig