Prison Grays

By Lara Bricker

Hampton Union, Sunday, April 4, 2004

[The following article is courtesy of the Hampton Union and Seacoast Online.]

HAMPTON -- If 74-year-old Helen Garland is found guilty of assaulting her older sister Alice Keyho, she could face 10 to 30 years in prison - which could equate to a possible life sentence.

Garland, of 10 Philbrook Terrace, Hampton, has been in jail since her arrest March 26 on three counts of first-degree assault for allegedly beating Keyho repeatedly before the 85-year-old woman's death.

She was transferred to the Hillsborough County Jail from the Rockingham County Jail this past Monday because that jail is better equipped to handle female inmates.

Prosecutors say age does not affect a decision of whether or not to charge a person they believe has committed a crime. Age usually becomes an issue during the sentencing portion of a case.

"Usually you start a case when you look at it, you immediately think, 'Where do I want to end up in this case, what's the point of prosecution?" Rockingham County Attorney Jim Reams said. "When you have someone who's older, it becomes more pressing to decide where you want to end up with this case."

Defense attorneys with older clients usually ask the court to consider a person's age in sentencing, Reams said.

Senior Assistant Attorney General Michael Delaney, who is prosecuting the Garland case, declined to comment on how, or if, age played a role in the pending charges against Garland.

Older inmates

A prisoner of Garland's age is not as unusual as some might expect, according to state jail officials. A 78-year-old woman is currently serving a 10- to 20-year sentence in the state women's prison in Goffstown, state prison spokesperson Jeff Lyons said.

For statistical purposes, anyone over 50 years old is considered an elderly inmate, Lyons said.

"Fifty is an age in general when certain issues start happening no matter who you are," he said.

Of the 2,475 total inmates now in the state prison system, 13 percent are over the age of 50.

"We don't really treat them a lot differently than the general population inmates," he said. "Someone with a cane may be on the lower level."

Dr. Robert MacLeod, administrative director of medicine and forensic services for the state Department of Corrections, said the age demographics of the prison system are changing. Inmates who have been in jail on lengthy sentences are aging and younger inmates are getting longer sentences.

"The stereotypical young inmate is becoming someone who's middle-aged or older than that," MacLeod said. "If we were to talk five years from now, we would even be talking about this to a greater extent."

The population of older women in the state prison system is growing more than the population of men, he said.

Rockingham County Jail Superintendent Gene Charron said the county jail also has its share of older inmates.

"We've had folks come in here after they're sentenced in walkers and wheelchairs," he said.

MacLeod said he doesn't know what to attribute the older population to, but added it is a societal issue.

"Society is getting older, so you're apt to get those individuals that are going to land in the prison or have been in the prison for a number of years," he said.

Helen Garland, 74, of Hampton, is facing charges in connection with the death of her sister. New Hampshire prison and jail officials say the state is seeing a graying of its inmates. Staff photo by Sarah Zenewicz/

Medical facilities

Along with the climbing age of the prison population comes associated medical issues. The state prison system has a budget of $7.5 million for medical costs, Lyons said. The average annual cost of incarcerating an inmate is $25,341, but medical issues can drive that number up dramatically. For example, the cost of dialysis for a handful of inmates who need the treatment is more than $200,000 per year alone.

The average daily cost of providing medical coverage per inmate is $8.70, MacLeod said.

The state prison system is equipped to deal with older or ill inmates and has two, 24-hour infirmaries throughout the state.

"We are able to accommodate acute-care illnesses to those that require a much longer stay," MacLeod said. "We're able to accommodate those needs."

The prison medical ward is staffed with registered nurses, nurse practitioners and physicians. While they are able to deal with inmates who have issues requiring longer infirmary stays, many seriously ill inmates are transported outside for treatment.

For example, there are inmates who leave the prison for chemotherapy, radiation or dialysis treatment. Five inmates are currently going through chemotherapy. The top two medical issues facing inmates are cardiac and oncology. Of the inmates in treatment, 97 require observation on a regular basis through the chronic-care clinic.

Those with respiratory illnesses number 318, high blood pressure comes in at 216, while 135 are listed with cardiac issues. A number of inmates - 56 - have seizure problems, which could be attributed to past drug use or other issues. One hundred ninety-nine inmates have Hepatitis C, while 12 have been diagnosed with HIV or AIDS.

The Rockingham County Jail budget for medical expenses is about $1 million, Charron said. Regardless of age or social status, their medical tab is paid through the county budget once they enter the jail. For example, Social Security benefits, Medicare or veterans benefits are not paid while the person is in jail.

Charron has observed a number of older inmates arriving in worse health than in previous years.

"Your drug culture is getting older and a lot of these individuals who had used and abused, it's now caught up to them," he said. "But they're still coming to jail and now they're coming to us sicker. It's a cycle, except that each time they come here, they're a little bit older and a little bit sicker."

County jails do receive a discount from hospitals, which they previously were not given, Charron said.


Jail officials do not see an end in sight when it comes to issues of housing elderly inmates. They do believe the system will have to change to meet the needs of that population.

"I think we're going to have to think of new and different ways to try and render the services inside the prison," MacLeod said. "That may mean we have more specialized housing down the road. We're talking about that sort of thing today."

In some cases, jails are not able to accommodate older inmates. The case against Lewis Merchant, 76, who was arrested on Aug. 8, 2003, on assault charges, became a high-profile example. Merchant, who had been a resident at Haven Healthcare of the Seacoast in Hampton before his arrest, could not be accommodated in the county jail. He had a number of age-related illnesses, and was eventually transferred to the state hospital in Concord after Charron and Assistant Superintendent Al Wright spoke up.

"The intent and purpose of a jail is changing. We're becoming more and more of a social-service agency," Charron said. "And we can't provide the care an individual needs."

Charron said he doesn't know how the issue will be addressed.

"What do we see as a ray of hope? I don't know what the answer is. Is there an answer? You're going to own this no matter what," Charron said, referring to the cost of providing state services to uninsured older people or the mentally ill. "There's no one that's unscathed here."