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Introduction
The concern with the elderly, sometimes, stops in the prevention of chronic diseases that usually affects them, to the detriment of the quality of life, which can only be achieved through knowledge about the real needs that they have. It is believed that one way to understand such idiosyncrasies is to seek to understand the meaning of the aging process for these individuals (Freitas, Queiroz, & Souza, 2010).
With the growing increase in the older population segment, the need to deal with the specifics of their health conditions is imperative, whatever the scenario in which they are inserted. In this context, it is necessary to consider the elderly who live under adverse conditions, as is the case of the incarcerated elderly.
1. Literature review
According to the Brasilian Institute of Geography and Statistics (IBGE), the fastest growing population segment in Brasil is the elderly, as projections on aging show that between 2015 and 2030, the number of people aged 60 or over could rise from 23,940,885 to 41,541,763, that is, a 74% growth. For the year 2050, it is estimated that the Brasilian elderly population may reach 66,457,570 individuals (IBGE, 2019).
The aging of people deprived of their liberty is a reality, due to the increase in life expectancy of Brasilians in recent years and within the prison system there is also a considerable increase, although the elderly deprived of their liberty are subject to great difficulties, such as: poor diet, poor health, unhealthy environments - all of these somehow intensify the physiological characteristics of natural aging. The elderly prison population is relatively small compared to the general population. However, data from the National Prison Department show that the incarceration of this portion of the population tripled between the years 2005 and 2010 (National Prison Department, 2015).
The National Survey of Prison Information (INFOPEN) is a system updated by the managers of the prison establishments since 2004, and synthesizes information about the prison establishments and the prison population. In 2014, the National Prison Department (DEPEN) reformulated the methodology used with an intention to modernizing the data collection instrument and expanding the range of information obtained. Thus, for the first time, the survey received the detailed report format. The treatment of the data allowed a wide diagnosis of the studied reality, but which in no way exhausted all the possibilities of analysis (Brasil, 2017).
According to information from INFOPEN, from July to December 2019 there were 748,009 thousand people deprived of their liberty in Brasil. Regarding the capacity, the national capacity is 442,349, with a deficit of 312,925 across the country. Brasil is the third country with the largest number of people incarcerated, behind only the United States and China. The number of people deprived of liberty fluctuates between the different units of the Federation. The state of São Paulo concentrates 30.9% of the country's prison population, with 231,287 individuals deprived of their liberty (Brasil, 2020).
A study on the meaning of the aging process for elderly people deprived of their liberty, in a state in the southeastern region of Brasil, highlighted: feelings of regret, the loss of family life, the family repercussions, the loss of freedom and the feeling of injustice. Considering that the objective of this research was to understand the feelings of the elderly in relation to incarceration, it is possible to identify the different constructions that they used to express their perceptions about these feelings (Lopes et al., 2020).
Adapting to a new reality such as incarceration is sometimes difficult and slow due to the loss of control of the elderly over various aspects of their lives. The elderly, from the moment they are admitted to the prison space, are immediately confronted with significant changes in their moral life, involving the beliefs and values that they have about the other and about themselves. Thus, admission to the prison space will necessarily imply a set of readaptations, both in time management and institutional daily life, as well as in the management of social, professional and family relationships (Freitas, Queiroz, & Souza, 2010).
A study carried out in the state of Paraíba on the meaning of aging for elderly people deprived of their liberty showed that they expressed feelings of melancholy, anguish and constant loss, due to the impossibility of any type of development. The difficulty in doing work activities, the decrease in family life and intergenerational conflicts corroborate the loss of the quality of life of the elderly in prison (Oliveira, Costa, & Medeiros, 2013).
When the family maintains the support bond with the person deprived of liberty, it significantly contributes to their recovery and rehabilitation, as this bond happens in a marked way, leading to a commitment by the person deprived of liberty to their family, which is renewed at each visit (Ghiggi, 2012).
When considering the importance of the family for the elderly deprived of liberty, it is also necessary to pay attention to the fact that this incarceration causes great damage to their family circle, being necessary to invest in more sophisticated penal solutions, such as work and education programs, among others, that promote a real reinsertion of this elderly person into society, in line with their social and family context (Brasil, 2017).
In view of the above scenario, this research emerges from the following concern: what are the expectations regarding the future that the elderly have after their release from the prison system? In this sense, the objective of the research was to understand the expectations of the elderly incarcerated in relation to the future, after serving their sentences.
2. Methods
This is a cross-sectional study, with a qualitative and descriptive approach, which uses the thematic analysis method proposed by Braun and Clarke (2006). This method allows to identify, analyze, report patterns and structure themes based on the collected data, and in addition to organizing and describing the data set in detail, it also allows interpreting the various aspects of the phenomenon. It is a flexible method that can be applied to a variety of theoretical and epistemological approaches. Data collection was carried out from March 10th to June 20th, 2019.
2.1 Sample
The study was carried out in prisons in the Western Region of the State of São Paulo, which has 42 Prison Units, of which 27 are prisons, seven provisional detention centers, three centers for prison progression, four resocialization centers and a differential disciplinary unit. The West region is of great relevance because it houses the only differential disciplinary unit in the State (Brasil, 2017). For the collection of the data, an intentional sample was chosen, and four prison units were selected for easier access to researchers. Such units house a total of 6,168 prisoners, of which 101 (1.63%) are elderly, that is, aged 60 years or more, as shown in Table 1.
Table 1 Distribution of the number of prisoners and the respective number of elderly people in the four prisons, Marília-SP, 2020
Source: Research database (2021)
Elderly people were considered regardless of having completed 60 years in prison or being incarcerated after that age. Those who were outside the prison unit (in transit), fulfilling disciplinary sanctions, judicial presentation, hospitalized and with cognitive deficits that made it impossible to answer the interview were excluded. The participants' cognitive deficit was assessed according to the subjective criteria of the prison unit professionals, since they were asked to bring the elderly with this preserved condition to be interviewed by the researcher.
2.2 Data collection instruments
After approval of the research by the CEP of the Prison Administration Secretariat, a form for obtaining consent was sent by the Secretary for the Coordination of the Western Region of the State of São Paulo, authorizing the beginning of the research data collection. Subsequently, messages were sent to the participating prison units, with information about the research and the researcher, in order to obtain authorization to enter the respective units. With this authorization, the researcher contacted each participating prison unit by phone to check the best date and time for the interviews.
The data were obtained through a face-to-face interview by the main researcher, who had a semi-structured script, containing data on sociodemographic characterization such as: sex, age, marital status, education and skin color. In addition, the following guiding question was asked: how do you imagine your life when you are free? During the interview, questions such as “can you talk more about it?” and “what does this mean for you?” were asked.
The moment before the interviews were conducted, the researcher underwent a routine search carried out by the body scanner of each prison unit. Initially, the objectives of the project were explained and the elderly who agreed to participate in the research were taken to a room indicated by the prison unit. After reading and explaining the free and informed consent term, signed, the interview was conducted, which was audio-recorded in MP3 for later transcription and analysis of the information obtained. All elderly people referred to the researcher agreed to participate in the study, therefore, there were no losses of participants. The interviews were closed when the saturation of the data was observed, understood as the moment of the research in which the collection of new data would not bring more clarifications for the studied object. It is also mentioned that the saturation point, as well as the sample size, is the result of the heterogeneity of the population that is surveyed (Minayo, 2017).
2.3 Data analysis
The data were analyzed through thematic analysis (Braun & Clarke, 2006), according to the following steps: 1) familiarity with the data, which includes immersion through repeated readings of the data in order to approach the depth and breadth of the data contents. During this phase, records were made of the main ideas for subsequent coding. 2) production of initial codes from the data, which represent semantic or latent content that refer to the most basic segment or element of the data. At this stage, the interesting and significant aspects of the text were identified. 3) search for themes, it was developed from the list of codes, which involves sorting the different codes into potential themes. 4) revisiting the themes, which involved its refinement, considering the criteria of internal homogeneity and external heterogeneity, and it is often necessary to resume coding the data. 5) the definition and naming of the themes was carried out, that is, the essence of the subject of each theme was identified. 6) final analysis, that is the writing of the report. In this report, extracts from the speeches of the participants were incorporated into the analytical narrative in order to illustrate the content presented (Braun & Clarke, 2006).
In the analysis of the interviews, having as object the expectations of the elderly in relation to the future, it was possible to identify the themes: pretension of a new beginning; self-care and health care; from the idealization of freedom to the recognition of difficulties; and focus on religion.
2.4 Ethical aspects
The research was only started after approval by the Ethics Committee about Research with Humans of the Faculty of Medicine of Marília, under number CAAE 94672918.7.0000.5413, as determined by Resolution No. 510 (2016). After institutional approval, the project was sent to the Research Ethics Committee of the São Paulo State Prison Administration for approval under number CAAE 94672918.7.3002.5563. For the presentation of the results, the participants were coded using the letter I, followed by an increasing numerical sequence of I1.... I42.
3. Results
The sociodemographic profile showed a predominance of males (80.2%), white skin color (53.47%), aged between 60 and 65 years (59.41%), married (66.34%) and with an educational level with up to eight years of formal study (66.34%). Such data showed similarity with the national profile of people deprived of liberty, except for the skin color that differs, since the population deprived of liberty, in general, declares themselves to be mixed race/black. (table 2)
Table 2 Sociodemographic data of the elderly deprived of their liberty in prisons in the West of the State of São Paulo, Marília-SP, 2020
Source: Research database (2021).
The interesting and significant aspects of the text and the themes were structured, as shown in Table 3.
From the analysis of the extracts, four analytical axes emerge:
Pretention of a new beginning;
Self and health care;
From the idealization of freedom to the recognition of difficulties;
Focus on religion.
Then, the analytical categories are discussed and compared with the theoretical contributions.
Regarding the thematic “pretension of a new beginning”, it was observed among the interviewees that they have a desire for a new beginning and, for that, they rescue the experiences and accumulations of the past with a view to a new way of living. The incarcerated elderly expressed a desire to take care of themselves and their health, continuing to treat problems that cause suffering or conditions that can become complicated over time, as in the case of heart problems.
The speech of the participants allowed to verify an idealized vision, with regard to their freedom, as they believe that there will be no obstacles with regard to new experiences in the family and social context. They, however, also recognize the possible difficulties after their release, as it is a new beginning covered with obstacles including unemployment and family instability caused by incarceration. The elderly express the desire to advance in religious issues, through the construction of churches, conversion and baptism.
Table 3 Extract of data on elderly people deprived of their liberty in prisons in the West of the State of São Paulo, according to the themes listed. Marília-SP, 2020
Then, the analytical categories are discussed and compared with the theoretical contributions.
Regarding the thematic “pretension of a new beginning”, it was observed among the interviewees that they have a desire for a new beginning and, for that, they rescue the experiences and accumulations of the past with a view to a new way of living. The incarcerated elderly expressed a desire to take care of themselves and their health, continuing to treat problems that cause suffering or conditions that can become complicated over time, as in the case of heart problems.
The speech of the participants allowed to verify an idealized vision, with regard to their freedom, as they believe that there will be no obstacles with regard to new experiences in the family and social context. They, however, also recognize the possible difficulties after their release, as it is a new beginning covered with obstacles including unemployment and family instability caused by incarceration. The elderly express the desire to advance in religious issues, through the construction of churches, conversion and baptism.
4. Discussion
The theme “pretension of a new beginning” after serving the sentence is strongly linked to the family. The family ends up being the axis of reference by which its participants elaborate and determine their social relations, starting to organize themselves around the realization of common projects, built according to the reality in which their components are inserted. In this sense, they have a diversity of structure that emphasizes the place of value that "the family" and family models occupy in a given society (Santos, 2017).
The literature points out that the reinsertion of the individual in the family cycle causes inevitable changes due to the emotional upheaval that both suffered during incarceration, and the process of readaptation was initiated. This process consists of strengthening affective bonds, so that both the family and the ex-convicts are able to overcome all the difficulties imposed during the sentence period, being an extremely important phase so that the individual does not feel helpless and returns to the prison system (Cabral & Medeiros, 2015).
In addition to starting over at home, the elderly also intends to reestablish themselves socially and professionally. When the release date approaches, and one would think that the biggest challenge has already been overcome, these elderly people now have to face the process of reintegration into society as ex-prisoners (Cordeiro, 2018).
SAP counts on the Coordination of Social Reintegration and Citizenship responsible for promoting the re-socialization of prisoners and ex-prisoners from the São Paulo prison system through technical, managerial and political actions that affect the social reintegration and citizenship of people in situations of vulnerability in the face of the penal system. In addition to this coordination, the Social Reintegration Action Group (GARS) is responsible for carrying out re-socialization initiatives with an emphasis on the Prison Units of the State of São Paulo. The programs and projects are promoted according to the reality of the penitentiaries, aiming to contemplate the characteristics of each public (Government of the State of São Paulo, 2020).
The benefits found in the concrete realization of the mechanisms capable of recovering and accrediting prisoners to return to social contact are evident. Decrease in prison recidivism, training for work, as well as a better acceptance by society for participating in this process, as the presence of family, church and society is of great value (Silva & Silva, 2018).
The theme “Self and health care” refers to the view that the prison environment, with the presence of unhealthy conditions, favors the gradual aging of those deprived of liberty, given the evident fragility of the system. In this sense, thinking about health in prison mobilizes concerns about what, in fact, we consider health and how it can and needs to be reframed between the bars. The access of the deprived population to health actions and services is legally defined by the following documents: Federal Constitution of 1988 (1988), Law No. 8,080 (1990) and Criminal Execution Law No. 7,210 (1984).
The National Policy for Comprehensive Health Care for Persons Deprived of Liberty in the Prison System (PNAISP) was born from the evaluation of the ten years of application of the National Health Plan in the Prison System (PNSSP), when it was found that this model was depleted, which he was restricted by not contemplating in his actions, among other things, the totality of the prison itinerary (Brasil, 2014; Melo, Souza, Oliveira, & Coelho, 2016).
It is noteworthy that promoting the health of individuals deprived of liberty not only benefits them, but also improves health and safety conditions in the workplace for professionals in the prison system. Therefore, improving the conditions that negatively affect the health of these people, such as overpopulation, poor food and lack of occupational activities, contributes to the reduction of tensions and violence within the prison (Silva, Filgueiras, & Lobo, 2010).
With regard to religion, the Brasilian Penal Execution Law (LEP) guarantees religious assistance to the prisoner, with freedom of worship and allows the possession of religious instruction books. In the same sense, Law No. 9,982 (2000) also ensures that men and women of all faiths have access to prisons.
In the case of prisons, religion offers support in the experience of adverse situations, interferes positively in the environment and collaborates in the adjustment of prisoners (Ribeiro & Minayo, 2014).
A study carried out with 368 women deprived of their liberty in São Paulo associated a lower frequency of mental disorders with greater personal religiosity. In this way, religion seems to act as a factor of emotional integrity for both men and women, subsidizing assistance in coping with the ailment’s characteristic of the condition of the prison (Ranuzi, 2018).
Conclusion
Considering the objective of this research, it was possible, through the thematic analysis, to understand the expectations that incarcerated elderly people have in relation to their future in freedom after the fulfillment of their sentences.
Among the findings, the hope of starting a new life with family members stands out; the desire for health care to improve the quality of life after release; the recognition of the difficulties they will encounter after the period of imprisonment and for that they hope to count on the support of family members and also the incarcerated elderly believe that they can strengthen themselves emotionally through the religiosity initiated within the prison system and point out that they intend to continue after this period.
The data obtained in this research indicate the importance of dignified treatment for incarcerated elderly people, as well as the relevance of programs that include minorities and their social reintegration, because even in this stage of life and in the conditions they experience deprived of freedom, they still dream and plan the continuity of their projects after incarceration.
During the research, we encountered some difficulties along its path, specifically in relation to the definition of the sample, due to the high turnover; delay in authorization and start of research and adapting to the appropriate days and times of prison units for data collection. In addition, the fact that it was carried out in a single region and limited to the future expectations of the participants can be considered as a limitation of the study, therefore, studies that can reveal the conditions of life and health of these people in a wider sense are needed, with a view to establishing strategies to improve their quality of life, especially with regard to social reintegration.
Even so, it is considered that in the present study important results were obtained that reveal the needs of this portion of the population that are growing fast.
