The Vanishing Mind: Life, With Dementia

Unfortunately with dementia often comes inappropriate sexual acts and further prosecution for those acts. Long term, prisons may become a major factor in the growth of sex offender registries nationally. There has to be another way to deal with sexual acts of folks with dementia, but what is it? These acts are the Romeo & Juliet crimes of elderly.

2-27-2012 National:

SAN LUIS OBISPO, Calif. — Secel Montgomery Sr. stabbed a woman in the stomach, chest and throat so fiercely that he lost count of the wounds he inflicted. In the nearly 25 years he has been serving a life sentence, he has gotten into fights, threatened a prison official and been caught with marijuana.

Despite that, he has recently been entrusted with an extraordinary responsibility. He and other convicted killers at the California Men’s Colony help care for prisoners with Alzheimer’s disease and other types of dementia, assisting ailing inmates with the most intimate tasks: showering, shaving, applying deodorant, even changing adult diapers.

Their growing roster of patients includes Joaquin Cruz, a convicted killer who is now so addled that he thinks he sees his brother in the water of a toilet, and Walter Gregory, whose short-term memory is ebbing even as he vividly recalls his crime: stabbing and mutilating his girlfriend with a switchblade.

“I cut her eyes out, too,” Mr. Gregory declared recently.

Dementia in prison is an underreported but fast-growing phenomenon, one that many prisons are desperately unprepared to handle. It is an unforeseen consequence of get-tough-on-crime policies — long sentences that have created a large population of aging prisoners. About 10 percent of the 1.6 million inmates in America’s prisons are serving life sentences; another 11 percent are serving over 20 years.

And more older people are being sent to prison. In 2010, 9,560 people 55 and older were sentenced, more than twice as many as in 1995. In that same period, inmates 55 and older almost quadrupled, to nearly 125,000, a Human Rights Watch report found.

While no one has counted cognitively impaired inmates, experts say that prisoners appear more prone to dementia than the general population because they often have more risk factors: limited education, hypertension, diabetes, smoking, depression, substance abuse, even head injuries from fights and other violence.

Many states consider over-50 prisoners elderly, saying they age up to 15 years faster.

With many prisons already overcrowded and understaffed, inmates with dementia present an especially difficult challenge. They are expensive — medical costs for older inmates range from three to nine times as much as those for younger inmates. They must be protected from predatory prisoners. And because dementia makes them paranoid or confused, feelings exacerbated by the confines of prison, some attack staff members or other inmates, or unwittingly provoke fights by wandering into someone else’s cell.

“The dementia population is going to grow tremendously,” says Ronald H. Aday, a sociologist and the author of “Aging Prisoners: Crisis in American Corrections.” “How are we going to take care of them?”

Some prison systems are confronting that now. Many would like to transfer demented inmates to nursing homes, but their often-violent crimes make states reluctant to parole them and nursing homes reluctant to take them.

New York has taken the top-dollar route, establishing a separate unit for cognitively impaired inmates and using professional caregivers, at a cost of about $93,000 per bed annually, compared with $41,000 in the general prison population. Pennsylvania and other states are giving mental health workers special dementia training.

But some struggling prison systems, including those in Louisiana and California, are taking a less expensive but potentially riskier approach. They are training prisoners to handle many of the demented inmates’ daily needs.

“Yeah, they did something horrible to end up here,” said Cheryl Steed, a psychologist at the California Men’s Colony, where prisoners who help inmates with dementia are called Gold Coats because their yellow jackets contrast with the standard-issue blue. But without them, she said, “we wouldn’t be able to care for our dementia patients very well.”

After escorting Joaquin Cruz to an appointment, James Evers, a Gold Coat, was returning him to their adobe-colored cellblock when they encountered corrections officers strip-searching inmates for missing tools.

Mr. Cruz, 60, who barely recalls that he is in prison for killing someone who sold him fake cocaine, grew confused and resistant when guards tried searching him. “He has Alzheimer’s,” Mr. Evers managed to explain. “It’s not that he’s refusing to do what you’re asking.”

At the prison, shadowed by seacoast mountains, Gold Coats are paid $50 a month and have better knowledge of impaired prisoners’ conditions than many prison guards. Gold Coats, trained by the Alzheimer’s Association and given thick manuals on dementia, were the first to notice when Mr. Cruz began putting his boots on the wrong feet and “started pulling down his pants and going to the bathroom wherever he was,” said Phillip Burdick, a Gold Coat who is serving a life sentence for beating a man to death with a hammer.

Gold Coats report these changes, often at weekly support group meetings with Dr. Steed. They identify “different tricks and strategies to get guys to do what they need to do,” she said.

Before the program was started in 2009, demented inmates frequently caused fights, hitting those they considered threatening or disturbing other prisoners by encroaching on their turf. “The whole atmosphere was hostile,” said Bettina Hodel, a psychologist who started the program and once narrowly avoided being struck herself. Now, Gold Coats absorb much of that behavior. ..For the next three pages of this NY Times special: by PAM BELLUCK

Read More of Article...

Article Summary only...

Family members of sex offenders organize lawsuit against Colorado's indeterminate sentences

8-14-2011 Colorado:

Paul Allen, his parents and his attorney thought he'd serve his probation and move on once he pleaded guilty in 1999 to bouncing a child relative on his knee while sexually aroused.

But after his attempts to recant and withdraw that plea got him booted out of therapy, a judge resentenced him to two years to life in state prison.

A decade later, he's still there.

Allen, 40, was one of the first men sentenced under a 1998 law designed to give mid- to high-level sex offenders a choice: Get treatment behind bars or stay there for life.

Years later, a lack of therapy resources and a parole board reluctant to release even treated sex offenders has blocked the exit out of prison for hundreds of inmates on so-called indeterminate sentences.

Defense attorneys, offenders and their families say the state has broken its promise to treat and release these inmates. Family members are organizing a class-action lawsuit against the Department of Corrections.

Sixty-six of 1,659 sex offenders in custody on indeterminate sentences had eventually been paroled as of June 30, 2010, according to the department's most recent annual report on the program.

Nearly as many inmates are waiting for sex-offender treatment — 300 — as the 345 who are currently receiving it, corrections officials report.

After watching fellow inmates try and try again at therapy, only to be denied parole anyway, Allen waited until 2009 to ask for treatment.

He's halfway through the first phase.

"This wasn't meant to be a life sentence. This was supposed to be an education thing," Allen said.

In 1998 some Colorado lawmakers wanted to institutionalize sex offenders once they served their criminal sentences. Then-state Sen. Majority Leader Norma Anderson wanted something less costly and more fair, she said.

The Lifetime Supervision Act was born.

Judges now pick a minimum sentence for people convicted of certain sex offenses, which ranges from probation to time in prison. The maximum is automatically set at life in prison.

Before locked-up offenders can be recommended for parole, they must complete two phases of therapy.

Then, Colorado Parole Board members decide whether those inmates can re-enter the community on specialized and lengthy probation.

The law applies to Class 4 felony sex offenses — adults having sex with an older but still underage teen or the luring of a child over the Internet — and up through Class 2 felonies such as rape causing serious injury.

Sentencing mid-level offenders

The highest-level offenders have much longer minimum sentences, so those now caught in the DOC backlog are mostly the mid-level offenders.

Anderson said the intent of the law is good.

"Instead of keeping someone in prison for life to protect the public from a sex offender, you give them treatment and have them out and controlled . . . and a productive member of society. That's the whole idea," Anderson said.

But that's not the way it has worked. Recently, sex offenders have had to turn to the courts to even get access to treatment.

In the first decision of its kind in the state, a district court judge in Colorado Springs in June ordered the DOC to treat a sex offender who waited five years to start therapy.

Thomas Spitz, 51, got a minimum two years to life in 2001, after he admitted to touching a 15-year-old relative sexually in a hot tub.

Judge David Gilbert in his order said prison officials "simply failed to process (Spitz's) application or respond to it in any way" and criticized their "abject failure to work with (Spitz), communicate with (Spitz), and to deal fairly with him."

Peggy Heil, who oversees therapeutic programs for DOC, said she could not comment on Spitz's case. She lamented resources that have lagged behind program demands.

Lack of treatment resources

In 2002, for every sex offender treatment program employee, there were 73 inmates who needed therapy. By 2010, that ratio was one to 108.

Likewise, department figures show the number of inmates DOC says need therapy has jumped 47 percent since indeterminate sentencing started, while the budget has increased 20 percent to $3.2 million.

"We're really doing everything we can with those resources. We would love to be able to treat everybody, but the resources aren't there," Heil said.

Prison officials have started taking steps to more quickly process sex offenders with indeterminate sentences.

In March 2009, for example, indeterminate sentence offenders within four years of their minimum started getting pushed to the front of the treatment line, boosting the numbers of inmates DOC could recommend to parole.

About 30 people who call themselves Advocates for Change sat in a circle of folding tables in the low-ceilinged basement of a Denver church on a recent Tuesday and took turns voicing concerns about how sex offenders are treated in Colorado's prisons.

These family members of inmates on indeterminate sentences have spent years in limbo and argue prison policies are as much to blame as budget woes.

For one, inmates can't deny their offenses and still get into treatment. Anything they tell a therapist can be used against them, so offenders trying to appeal their conviction are stuck.

Even those who admit their offenses can have problems.

In the 13 years the lifetime law has been in place, 159 people had completed treatment as of March.

That number is far too low, according to Boulder defense attorney John Pineau, who is spearheading the lawsuit against the state.

"We are trying to get DOC to comply with Colorado law," said Pineau, who admits that his clients aren't the most sympathetic characters. "No one really gives a damn what we do to sex offenders."

Victim advocates like Erin Jemison worry that the DOC backlog could topple the Lifetime Supervision Act, including parts that allow monitoring offenders for life after their release.

"Everyone's screaming they're getting punished too much," said Jemison, executive director of the Colorado Coalition Against Sexual Assault. "I just don't want people to lose sight of the fact it's so hard to get people to report sex assault . . . and then there's such a minuscule group that ends up in prison."

Before former chemistry teacher Derrick Davies went to prison for having sex with a 16-year-old student, a community corrections program had accepted him for treatment and an assessment showed he was a low risk to re-offend.

Davies, now 36, got two years to life in prison in May 2006.

By 2010 he'd completed treatment, but the Parole Board said he was no longer safe for the community and denied his release. This year, the board told him not to come back until 2013.

"You're thinking 'Here's my shot. Here's my shot.' And then you think, 'OK, there's nothing more I can do,' " Davies said. "They want you to plan ahead, think ahead, but that's really difficult when you don't know when or if you're getting out."

Indeterminate consequences

Before 2009, the board released seven sex offenders with lifetime sentences. As of March, that number had grown to 82.

State Parole Board vice chairman Michael Anderson said that years later, it's easy to forget the sting of a sex offense and its impact on a victim.

"Look at something fresh . . . take a look at the victim," Michael Anderson said. "We get down the road, we start to disregard how all of this started in the first place."

Judicial observers are starting to pay more attention to the unintended consequences of indeterminate sentencing.

Defense attorneys say their clients now plead guilty to lesser sex offenses and avoid a trial they might win just to take the possibility of lifetime sentences off the table.

A judge in Broomfield County sentenced Curtis Jay Hilty, a former Realtor who was found guilty of sexually assaulting his sleeping 20-year-old babysitter, to a 30-day jail sentence and 20 years of highly supervised probation in June.

The concern: Any prison term could become a life sentence.

Boulder County District Attorney Stan Garnett, who did not prosecute Hilty's case, said the judge's decision echoes the growing qualms of some in the legal community about the lack of judicial discretion over sentencing.

"Nobody wants to see the system impose penalties that strike the majority of the community as unfair," Garnett said. "It's important for the system to have credibility. It's important we get these right." ..Source.. by Jessica Fender
The Denver Post

Read More of Article...

Article Summary only...

A glimpse inside a therapy session – and the minds – of sex offenders

8-4-2011 Florida:

The designation immediately triggers fear, hysteria and hostility: sex offender. They bring backgrounds as varied as their crimes: a middle-aged professional who enjoyed flashing adult women, a Vietnam veteran in his 60s who molested young girls, a man in his 20s who suffered brain damage in a car wreck and forced a woman to have sex with him in return for a shopping spree.

Every week, they come to a South Florida counseling center to open up, to confront themselves and their pasts with brutal honesty. But because they are sex offenders, they have to do so clandestinely.

They are told to be inconspicuous, not to draw attention to themselves or loiter outside before the weekly group therapy sessions. The therapist doesn't want trouble with the community, even though the clinic is in an isolated strip mall.

"Ironic that the place we come to figure ourselves out, the place we're trying to get out of our secret life, we have to remain hidden," one offender said in a session last week.

This is the incongruity of life as a sex offender. In the outside world, they try to live under the radar, even though they must register with the state and their crimes trail them for life. When they get to the small room they consider a sanctuary, they can finally talk freely, sharing their thoughts, frustrations and shame.

"I have a hard time forgiving myself, even though it's been all this time," said one offender, who sexually abused his stepdaughter 25 years ago.

The Vietnam vet, who molested three girls in the 1980s, said, "I can't have contact with my victims, but I wonder, 'Did I screw them up for life?' "

After my recent columns about sex offenders and the strict residency restrictions that make it nearly impossible for them to live anywhere in South Florida, I was invited to sit in on two group therapy sessions last week, provided I didn't reveal identities of the offenders, therapist or clinic.

Here's what the offenders want you to know: Yes, they have done bad things, illegal things, deviant things. But they are still human beings, not animals or monsters. They want to make good choices, and have a chance at redemption. But faced with so many restrictions, they say it feels as though society just wants never-ending retribution.

"A friend of mine asked, 'How come a murderer or someone who sold drugs to kids can move right next to a school after they get out and we're not told, but it's totally different for you guys?' " said one offender, who had sex with several 14-year-old boys when he was in his early 20s. "I can understand wanting to protect kids, but it's very inconsistent."

As the father of a young girl, I'd rather some of these offenders not live anywhere near me. But they need to live somewhere, and they need some stability in order to hold jobs, rebuild their lives and be monitored by probation officers. So how does society strike the right balance?

Here's what the therapist wants the public to know: Treatment can be effective. "The belief is that sex offenders can't be helped and everybody re-offends, but that's just not true … A lot of people think therapy is coddling but we don't do that. We don't accept excuses. We stress accountability. We want them to understand the development of their behavior, and learn to manage it."

Nobody, not even the offenders, says pedophilia or other deviant thoughts can be "cured," but they say therapy gives them tools to change their patterns and cope with stresses that could lead to re-offending. Studies about sex-offender recidivism paint an unclear picture and are hotly disputed, but some recent long-term studies show re-offense rates in the 8-to-24 percent range.

Most of the 25 offenders at the sessions I attended were there by court order, paying $30 for the hour. Some had just been released from prison, and wore electronic monitoring devices. Others have "graduated" from the program — after giving presentations about what they've learned — and keep attending for free.

Nearly all had been abused — either sexually, physically or emotionally — when they were kids.

You don't have to have sympathy for what they did, but it helps having some empathy for what they face.

The man who sexually abused his stepdaughter spent 17 years in prison, and has been in treatment for nine years. "My offense was a long time ago and I've never re-offended," he said. When he returned to his apartment three months ago, he found an unflattering name scrawled on his door. He has since been evicted and is now homeless.

"I want people to know two things," said another offender, who has bi-polar disorder and molested a minor in 1997. "Treatment provides an arena, if you're honest with yourself, to change. And even though what I did 14 years ago was illegal and deviant, I am not my crime. I did a lot of good things in my life — I've been an advocate for mental illness — and I can do a lot of good things again." ..Source.. by Michael Mayo Sun Sentinel Columnist

Read More of Article...

Article Summary only...

State senator’s plan requires sex offenders to undergo treatment.

3-27-2011 Missouri:

Jefferson City, Mo. — The Missouri House of Representatives will consider a local legislator’s plan to make convicted sex offenders undergo treatment while they serve time in prison. State Sen. Mike Kehoe, R-Jefferson City, sailed a plan through the Missouri Senate that will stop sex offenders who haven’t been in treatment programs from being paroled early.

“If they haven’t completed this program, the probation and parole board can suggest that they stay and complete it but they don’t have enough teeth to make them stay and complete it,” Kehoe explained.

“By implementing this fix it will require those people to immediately go out and take and complete this if they are going to be eligible for early parole.”

SB 250 would stop offenders incarcerated on sex crimes from opting out of in-prison treatment programs. If an offender has not successfully completed a program, SB 250 would block them from parole consideration.

“The modeling would suggest that if they go through this program it may make a difference such that they’re not return offenders for this possible crime as well, so I think there is some different that it makes as the offender moves forward,” Kehoe said.


SB 250 passed its third and final reading in the Senate by a 32-0 vote. It has since gone to the Missouri House and undergone two readings.

The bill became bipartisan when Kehoe allowed an amendement from Sen. Victor Callahan, D-Independence. Callahan’s amendment widens the legal language that prohibits registered sex offenders from living within 1,000 feet of schools and childcare facilities.

Current law only protects licensed daycare centers. Callahan wants to widen the law to include non-profit groups, churches, or businesses with childcare facilities on site.

“For obviously logical reasons, you’ve got to empower neighborhoods to protect children and be aware,” Callahan said.

The Missouri legislature has been out of session for its spring break this week. The break signifies the halfway point in the 2011 legislative session. ..Source.. lakenewsonline.com

Read More of Article...

Article Summary only...