Kelly was a 69-year-old, partially paralyzed amputee when he was wheeled into my prison cell with his oxygen machine in tow.

His hair was long and unkempt, his white medical scrubs stained with blood and urine. A stroke in 1999 left his left arm paralyzed, he recalled. Aggressive diabetes took the leg below at the thigh.

I am not a nurse. My cell at the Idaho State Correctional Institution is the size of a compact parking space. That I was convicted on two counts of arson doesn’t quite qualify me to act as a caretaker. Nonetheless, I soon became Kelly’s.

The share of incarcerated people aged 55 and older has quintupled in the last three decades, and is continuing to rise dramatically, according to the Prison Policy Initiative. This aging population is especially vulnerable, suffering from chronic health conditions and disabilities at a higher rate than their counterparts on the outside. The facilities where they are detained often cannot support their basic needs.

As a result, prison residents like myself are finding themselves in the impossible position of caring for the aging and infirm without adequate training or support — and sometimes, as in my case, without so much as a heads up. 

After Kelly arrived in my cell, the extent of his struggles with mobility and function became clear. I opened his milk cartons and condiment packets during meal times, emptied the plastic jug he was given to urinate in, and helped him put on his coat when he was cold. I refixed his oxygen tube at 2 a.m. after he woke me up in a panic because it had disconnected from the machine. I coaxed him into the shower, alerted staff when he was bleeding from a bad scrape, and relayed his calls for help from the dayroom toilet, which lacked safety bars and was difficult for him to access.

My around-the-clock struggle to treat Kelly with compassion and dignity was made even more difficult by his conviction. (About 10 years ago, Kelly was convicted for the sexual abuse of a child.) His tendency to use obscene gestures and unsavory language, as well as his combative attitude, tested every iota of my patience. Without support from staff or peers, my mental health sharply declined and my personal responsibilities suffered.

A fellow resident was eventually employed to assist Kelly three days a week for roughly half an hour. Another resident pushed Kelly to appointments and the cafeteria to pick up his meals. But during all other times, I was his only support.

Prison residents and employees should be supported in their efforts to care for the elderly in their community. This is especially true in the absence of proper health care infrastructure and crucial accessibility aids, amid a larger epidemic of elderly neglect and abuse.

One California organization, the Humane Prison Hospice Project, is now testing a support model that prison staff, Kelly and I could all have used. The nonprofit trains people to provide emotional support and hands-on care for their aging and dying peers. Should the project successfully refine and scale up its efforts, it could reduce the stress caused by prison staffing shortages and improve the overall health of corrections communities across the nation.

When they are not receiving adequate support at their facility, incarcerated older people like Kelly need to be able to seek help. Because Kelly couldn’t remember how to log in to the prison phone and messaging system, he could not report being exploited, neglected or abused by those handling him without their help. 

My attempts at advocacy were similarly limited. When I tried to seek help from Disability Rights Idaho, an advocacy organization, I learned that we had to call a 1-800 number to receive a consultation, which our prison doesn’t allow. I was unable to get help from Disability Rights Idaho, and did not receive any responses after reaching out to my local Area Agency on Aging or the Idaho Commission on Aging. 

One way to improve conditions for the elderly in prison is by changing the laws that limit their access to courts. The 1995 Prison Litigation Reform Act, in an attempt to cut down on what were seen as frivolous lawsuits, made it more difficult for the incarcerated to file claims by requiring they complete an exhaustive grievance procedure before even filing for legal intervention. The grievance procedure at my facility is a lengthy, bureaucratic back-and-forth. It relies — perhaps a bit ironically — on prison staff compliance at every stage. For a person in cognitive decline, like Kelly, it is an impossible undertaking. 

Another way to improve conditions would be to federally mandate that corrections officers serve as mandatory reporters for Adult Protection Services. Many professionals, including but not limited to doctors, nurses, social workers and teachers, abide by this already. Extending this responsibility to corrections officers may foster a sense of personal accountability, rather than indifference, when something goes wrong.

Eventually, Kelly was moved from my cell. It has been a tumultuous journey for him since — he has been moved in and out of solitary confinement, medical annexes and a maximum security facility. To my knowledge, he is still not receiving the support he needs.