Peer caregiving improves inmates’ lives

America’s aging population is growing rapidly—including in prisons. The number of state and federal prisoners age 55 or older rose 250 percent between 1999 and 2014, according to U.S. Department of Justice data. But prison facilities are not designed to accommodate elders’ needs.

“With the natural slowdown of physical mobility and cognitive processes, older prisoners are vulnerable to predation and humiliation,” said Anne Katz, a clinical professor at the USC Suzanne Dworak-Peck School of Social Work and its USC Edward R. Roybal Institute on Aging.

Addressing the health needs of older inmates was the subject of a symposium held at USC and hosted by the USC Roybal Institute in partnership with the Los Angeles-based Center for Health Justice.

In helping to mount the conference, Katz said, “I wanted to promote awareness of people aging in prison and highlight existing model programs.”

She and co-organizer Aileen Hongo, MSW ’13, MAG ’07, a life skills instructor at Five Keys Charter School and a USC Roybal Institute research fellow, worked with former prisoners from a unique program at the California Men’s Colony, a state prison near San Luis Obispo, California. The “Gold Coats” program offers special training for healthy inmates to care for older inmates with dementia and other cognitive impairments. It was named for the distinctive gold smocks worn by the caregiving prisoners.

Regaining humanity

“When the opportunity came for me to become involved, I took that challenge because I wanted to reclaim my humanity,” recalled Samuel Law, one of the first gold coats in the 1990s. “I felt that I had lost my humanity by committing my crime, and I did not want my life to end with that legacy.”

Before being released from prison in 2009, Law assisted ailing inmates with many intimate daily-life activities, including showering and changing diapers. “For them to say thank you—it was like a million dollars for me—and that is what kept me going,” he said. “I saw individuals that needed help, and at that point in my life I was mentally, emotionally and physically able to put myself in a position to help people.”

Hongo, who occasionally visits the Men’s Colony to conduct art expression workshops with gold coats, observed how the program transforms people.

“It changes you when you care for someone who has Alzheimer’s. It humbles you when you’re dealing with people who are dying.”

A gold coat for seven years, Steven Berry is now a certified substance-abuse counselor and a manager at New Directions for Veterans who has had many life-changing experiences while working in the program.

“I can always remember with vivid clarity what is was like when a close friend and confidant reached out his hand to me, which I grasped as he took his last conscious breath, and all while knowing that his last image of the physical world was of me, as he gazed into my eyes in his point of transition to the unseen world,” Berry said.

Not all inmates are eligible to join the program. The prison requires that gold coats have a clean behavior record for five to 10 years.

“The environment is challenging, and we must concede to the schedules and to unusual occurrences as they happen,” notes Marie Mohapp, a Men’s Colony recreational therapist who supervises the Gold Coats program. “There are additional security-based rules that limit the ways in which trainings can be provided, so we are forced to be creative.”

Despite the limitations, Mohapp said one key payoff is how the gold coats provide a vital service by caring for the most vulnerable inmates.

“Gold coats are also advocates for the lower-functioning inmates, ensuring that any needs, as well as any unusual behaviors or potential victimization concerns, are communicated to staff,” she said.

Skills after prison

When gold coats are released from prison, professional licensing laws restrict their ability to secure the types of jobs that the program trained them for. As Hong said, “You can work as a caregiver in prison, but unfortunately you can’t do that outside of prison.”

Still, there are opportunities to apply their skills in other occupations. Barry Hughes, a gold coat for five years who left prison in 2012, is currently a health technician in the mental health department of the federal Veterans Health Administration.

“After being trained, being selected, going through these experiences that meant so much to so many people, I can just tell you that this is why I do my work today,” he said.

For supervisor Mohapp, such stories are inspiring.

“Being a part of this program has given me hope that change is possible: people can learn better coping skills, gain insight into their criminal behavior, pursue redemption and get a chance to reclaim their humanity,” she said.