What to do About the Old Folks' Prisons

A reader commented earlier that the fate of geriatric psych patients is very discouraging. Often, they end up in state mental hospitals. Some have mental illness--and have been ravaged by it for most of their life. Others have dementia and are simply too out of it for most nursing homes to deal with. There are 54,000 patients in state hospitals in America. I don't have a breakdown of how many of those are geriatric cases. Based upon my limited experience looking at state hospital statistics, I'd put their number at 10 to 20 percent, or about 5,000 to 10,000.

I once spent about 20 minutes in the geriatric ward at Western State Hospital here in Washington State. (I was the first reporter allowed to tour the wards in over a decade, the staff told me.) There were all these sweet-looking old people steering about the large day room in specialized wheelchairs. Out the windows, they could see cyclone fencing topped with barbed wire. Some kind heart had attached a few pots of daisies to the fence.

What bothered me deeply about the fact that were there and I was able to walk out the door whenever I pleased was that the business seemed horribly mean. The best we can do for these people is a soft prison? They can be combative, sure. But there's no reason properly equipped nursing homes cannot handle them and offer them a more humane environment. It could also be done at about half the present cost of keeping them in a state hospital. The trouble in Washington State is that nursing homes are almost all privately-owned and the state cannot compel them--at least that's what the state says!--to accept these patients. I'm not so sure that the state is right on that point, but if it is, then perhaps the state ought to build some of these specialized nursing homes and give these poor souls a measure of dignity in the final years of their lives. Other states should do the same thing.