The pandemic has made clear the connections between sites of confinement and incarceration. Personal care homes, prisons, and institutions for disabled people have disproportionately experienced outbreaks, death, and long-term debilitation of incarcerated people. Of the 688 people who have died as a result of COVID-19 in Manitoba, 402 of those died whilst confined in institutions.
Under our current carceral system much of the death and debilitation within these institutions was not preventable, because the carceral structure itself is homicidal. Abolitionist futures are the only path that will prevent the mass debilitation and death brought forth by capitalism-induced crises.
Rapid decarceration now
Early on in the crisis, activists began demanding rapid decarceration of prisons, recognizing that there is no safe way to live in a prison amidst pandemic. Prisons are chronically overcrowded, resulting in double-bunking people in rooms designed for one person, making it physically impossible to safely distance. Further, poor ventilation systems, lack of PPE, lack of access to soap, water and showers, and the ongoing defiance of correction officers wearing PPE have created conditions for outbreaks in prisons. Abolitionists and incarcerated people know that the only way to keep people safe is in community, and this must include people confined in personal care homes.
There has yet to be a mobilization for a decarceration of long-term care. Instead, the focus has been shifted toward a publicization of long-term care in Canada, in contrast to the privatized model under which many long term or personal care homes currently function. But, as incarcerated people and their allies know, state ownership does not promise health, safety nor autonomy. The failures of the long-term care system are not simply about ownership, rather it is the current system of warehousing older and disabled people that creates conditions for such mass tragedy.
It is socially perceived that long-term care is inevitable, not political, and perhaps a natural part of the life cycle. Like prisons, personal care homes have become what abolitionist Angela Davis considers, “an inevitable and permanent feature of our social lives.” But mass confinement is neither natural nor inevitable. However, the warehousing of older and disabled people only became popularized as industrial capitalism and colonialism expanded, displacing traditional community ecosystems of care.
Bonds of solidarity
During COVID-19, the shared experiences of incarcerated people and people confined in institutions have renewed the need for solidarity between disability justice and abolitionist movements. Prisons and personal care homes are both sites of disability confinement—personal care homes are for disabled people, while prisons both create disability (through poor ventilation, lack of safe supply, overcrowding, and trauma) and disproportionately house disabled people. Among COVID-19, the unsanitary conditions, shared refusal to conduct surveillance testing, lack of public communication and large-scale outbreaks serve as a rallying call to unite seniors advocates, disabled people, incarcerated people and their allies.
The immediate suspension of visitations has been particularly problematic, as visitors are critical advocates for institutionalized people. While Manitoba invested millions in creating outdoor shelters for personal care home residents to visit with their families, they have remained closed for the past two months, obfuscating the realities of what is happening inside institutions. These same outdoor visitation efforts could easily have been applied to prisons. Instead there has been a clamp down on almost all communication with the outside. The elimination of visitors amidst outbreaks, despite having safe alternatives, is particularly punitive given the high cost of privatized phone calls.
As long as prisons, personal care homes and institutions have existed, unnecessary death and disease have flourished. The Spanish Flu of 1918, the seasonal flu, death by negligence, death by carceral violence, and now COVID-19 have all brought tragedy to these institutions and the communities with loved ones inside.
Mechanisms of control
Along with the institutional structure, personal care homes rely on carceral responses to manage the needs of residents. In his book Tranquil Prisons, scholar Eric Fabrise refers to the overprescription of sedatives in settings where people do not have autonomy over their medication as “chemical incarceration.” Chemical incarceration is used to control the behavior of people who are often labelled as deviant or resistant. In personal care homes, chemical incarceration is a potentially lethal response to under-staffing caused by austerity budgets.
Quetiapine is a psychotropic medication designated for treatment of psychosis and bipolar with significant side effects, particularly for older people with dementia. However, in 2014 it was found that up to one third of residents in long-term care facilities were prescribed this drug class. A damning report by the correctional watchdog found women’s prisons were serially over-prescribing Quetiapine for off-label usage, with two-thirds of incarcerated women prescribed this same drug class. Amongst COVID-19 there has been an increase in use of psychotropic medication, which has been attributed to the lack of stimulation of institutionalized people as recreation activities have halted.
This method of controlling incarcerated and/or institutionalized people is furthered by policies that mandate surveillance of people who refuse to take their medication. Once labelled as defiant for refusing drugs, people confined in personal care homes can be placed in secure units, with locks on both sides of the door. While both prisons and personal care homes maintain the right to refuse treatment, the ability to refuse psychotropic medications is limited by policy that claims it as life-saving treatment, or as necessary to protect the safety of the institution.
Further mechanisms of control are used by both carceral structures. Designers have highlighted that personal care facilities are designed functionally similar to the panoptic prisons—with a goal to maximize surveillance and minimize the number of workers. These mechanisms of control demonstrate that it is the entire carceral structure that demands abolition, not just the presence of private actors.
Simply reforming institutional spaces will not guarantee safety or autonomy for institutionalized and/or incarcerated people. Abolitionist Liat Ben-Moshe explains that carceral ableist logic hinges on the belief that there is some level of disability that will always require institutionalization. Most people when met with the demand of abolishing institutionalization deny the ability for disabled people to live in community.
However, disabled people, particularly queer, Mad, communities of colour have long challenged this logic, instead building communities of care that protect against institutionalization. Disabled communities are already building abolitionist futures—building ramps, learning how to share meals through feeding tubes, replacing oxygen tanks, administering medication, massaging aching joints, arranging care work, staying up until our kins suicidal thoughts have subsided. We can build communities where disabled people can exist and thrive, and these communities do not have prisons or personal care homes.
If you want to read more about disability justice, crip community, and abolition check out these books:
Decarcerating Disability by Liat Ben-Moshe
Care Work by Leah Lakshmi Piepzna-Samarasinha
Disability Incarcerated edited by Liat Ben-Moshe, Chris Chapman, and Alison Carey