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Forty-two years later, he needs a walker to leave his cell in the Nebraska State Penitentiary's skilled nursing facility. He breathes heavily, clear plastic tubes pumping oxygen into his nostrils to compensate for chronic obstructive pulmonary disease, a legacy of a cigarette habit he gave up when tobacco was banned in state prisons eight years ago.

Now known as Wopashitwe Mondo Eyen we Langa, he is among the fastest-growing segment of inmates in federal and state prisons across the nation: the elderly.

A 2012 report released by Human Rights Watch found that from 1995 to 2010, the number of state and federal prisoners 55 or older quadrupled, growing at six times the rate of the overall prison population.

The silver tsunami is one of the results of a national shift during the past 30 years toward a more punitive, get-tough approach to crime.

Prison officials call it aging in place.

In 1990, U.S. prisons held 33,500 inmates 50 and older, about 4 percent of the total population, according to the National Institute of Corrections. By 2002, that number more than tripled to almost 113,400 and grew to include 8 percent of all state and federal inmates.

The same pattern holds true for Nebraska. In 1983, the state had 2,774 prisoners, of which only 5 percent, or 127 inmates, were ages 50 plus. In 2012, the state's prisons housed 8,211 prisoners, of which 14 percent, or 1,150 inmates, were 50 or older.

The American Civil Liberties Union estimates that by 2030, one third of the nation's inmates will be 55 and older.

Adapting to the ills of age

Prisons are built to house the young, and despite their growing numbers, old inmates remain a minority.

But faced with a burgeoning contingent of geriatric prisoners, Nebraska prison officials are working to adapt to the growing needs of people in their final years.

In general, people in prison tend to be sicker and age more quickly than those on the outside. Hard living, addiction and lack of health care take a heavy toll.

About 80 percent of inmates in Nebraska have histories of substance abuse and 30 percent are mentally ill, according to the state Department of Correctional Services.

Physically, the bodies of older inmates show wear and tear about 10 years in advance of people on the outside, studies have shown.

With the exception of his former cigarette habit, we Langa has taken care of himself. He doesn't drink or do drugs. He exercised regularly until he fell ill. He became a vegetarian in the 1970s, and he has a mouth full of teeth.

“We have a very large dental program because of the use of methamphetamine," said Steve Urosevich, chief operating officer of Health Services for the Corrections Department. "It just destroys their teeth. We have a lot higher percentage in our population than the general population does of HIV, hepatitis C, AIDS."

The department has an annual budget of $35 million for inmate health care, including behavioral, mental and substance abuse treatment. About $7 million of that goes toward treatment at community hospitals and specialists. All that money comes directly from the state's coffers. In addition, Medicaid last year paid $579,000 in hospitalization bills for qualifying inmates.

Prisons spend twice as much on older inmates as on their younger counterparts, the ACLU said in 2012: The average inmate younger than 50 cost $34,135 annually while those older than 50 cost $68,270. Other studies have shown medical costs for older prisoners to be three to nine times greater than for younger inmates.

Urosevich did not have a breakdown of costs in Nebraska but said trips for treatment at outside facilities cost double for older inmates — $8,000 versus $4,000 — and older inmates are more likely to need them.

There are exceptions: The annual cost of treatment for one 21-year-old Nebraska inmate with a rare form of hemophilia is $700,000. The man, who Urosevich said he could not identify, is serving 90 to 100 years.

Saving money with prevention

The cliché that an ounce of prevention is worth a pound of cure quickly is becoming the Nebraska prison system's motto.

“Plus, I think just the moral and ethical thing to do is to try to help someone be healthy,� Urosevich said.

In 2012, guards began evaluating inmates 45 and older upon admission using a test developed by the departments of Gerontology and Criminal Justice at the University of Nebraska at Omaha.

The assessment looks at things as simple as whether a person can eat without help, needs a cane, remembers words, can use the toilet.

The Corrections Department also started in-house programs recently for chemotherapy and dialysis — in high demand because drug use can lead to kidney failure. On-site treatment is cheaper and reduces security risks inherent in taking inmates out for treatment.

And the department just completed a pilot program teaching preventive care to inmates with chronic illnesses at the Nebraska State Penitentiary. Urosevich called it a resounding success and said it eventually will be rolled out at all of the state's prisons.

The final release

After more than four decades behind bars and a serious health scare, we Langa still hopes to die a free man.

Last fall, the possibility he would die in a prison cell seemed almost certain. He spent weeks bedridden and stopped breathing three times.

“As far as I'm concerned, it was life or death,� he said in a March 14 interview at the penitentiary. “I don't know, and apparently they (medical staff) don't know what triggered me having these incidents.�

We Langa and Ed Poindexter were convicted of first-degree murder and sentenced to life for the Aug. 17, 1970, bombing death of Omaha Police Officer Larry Minard. They are the state's seventh- and eighth-longest-serving inmates.

The two consider themselves political prisoners singled out by the FBI and Douglas County officials for their leadership roles in the National Committee to Combat Fascism, an offshoot of the Black Panthers. Poindexter was head of the committee, we Langa its deputy minister of information. They allege authorities planted evidence, coerced witnesses and withheld the recording of the 911 call that lured eight officers to a North Omaha house. Minard died after a booby-trapped briefcase packed with dynamite exploded.

Omaha Sen. Ernie Chambers, who helped facilitate we Langa's surrender to police, considers their convictions “a gross miscarriage of justice� and said authorities feared loaded mouths more than they feared loaded guns.

"I brought Mondo in because I didn't want anything to happen to him," Chambers said recently. "... They felt Ed and David were like the head of a beast and if you killed the head, the body died. So they couldn't kill them literally because generally they were around other people. So the next best thing was to let the system take care of them, and they locked them away."

Amnesty International has taken up the case, and political activists including Angela Davis and actor Danny Glover have spoken on their behalf. All appeals and requests for commutation have been rejected.

When they come up for parole in January, supporters plan to add a new twist — a request for compassionate release because neither man poses a threat to society, said Mary Dickinson, vice president of Nebraskans for Justice.

Statistically, the argument bears out. Arrest rates for serious crimes drop precipitously by age 50, according to studies by the U.S. Department of Justice.

But the argument has failed in the past. Jerry Hansen, 77, the state's longest-serving prisoner, has been eligible for parole since 1977. He is serving two sentences of 20 years to life for killing his wife's parents, Howard and Gertrude Soderling, at their Cedar Bluffs home Jan. 22, 1965, plus 20 years for shooting his wife, Sandra, who survived.

Hansen was described as a model prisoner until 1973, when he was taken to speak at an Alcoholics Anonymous meeting as part of an exchange program. He was allowed to stop to see his ex-wife, and while there, he tied up his guard and shot Sandra Hansen several times. She was paralyzed; he picked up another one to 20 years.

In 2009, Hansen filed a civil petition saying he was in ill health and “no threat to society whatsoever.� He asked the judge to intervene with the state Board of Parole and argued that public policy when he was sentenced recognized inmate reformation and rewarded it with parole but that now, the board “requires a maximum service of imprisonment in retaliation.�

Lancaster County District Judge Karen Flowers dismissed the suit, saying it is up to the board to decide what is best.

And not everyone thinks compassion is appropriate.

“That is what life in prison means,� said one of Larry Minard's children, Larry Jr., who was 9 when his father died.  

A helping hand

Hearing loss, bad vision and dementia — typical ailments of the elderly — can cause friction in prison, and guards generally don't approach their jobs with the mind-set of nursing home aides, said UNO Gerontology Professor Julie Masters.

"It may not be, 'I'm being obstinate,'" she said. "It may just be, 'I didn’t hear the command.' If I have cognitive issues like dementia and Alzheimer's disease, I might have a pretty tough time finding my cell."

Some need help with the simplest acts such as dressing, bathing, eating.

Enter the porter program.

“We wanted to offer the inmate health porter program so that inmates can help us care for the increasing patient load we're experiencing because we're not authorized any more staff,� Urosevich said.

Officials in charge of the program use psychological testing and interviews to filter out applicants who may have predatory natures, he said. Starting pay is 38 cents per hour and can go as high as $1.08.

“Which is good pay for an inmate,� Urosevich said.

Joleet Poole sees the porter program as a chance to practice Christian values in prison.

“I took this job because, being a Christian, I believe in the Bible," he said. "The Bible says that anyone who wants to be a leader must first learn to be a servant.

“It's just like any other job. Some days you leave with a really fulfilled feeling and other days you leave wondering, ‘What have I gotten myself into?’�

The hard part, he said, is watching them die.

Poole, who works with almost a dozen men including we Langa, has one criticism of the program: Even at the end of their lives, he said, inmates are treated as prisoners first and patients second. 

We Langa lives in the penitentiary's skilled nursing facility but eats lunch each day with the general population.

On his way to the chow hall, as many as 30 guys will stop to wish him well, give him a fist bump.

Poole said we Langa transcends generations. He's respected by young and old, prisoners and guards.

“The entire time he is eating, the poor guy's food ends up getting cold because so many people are well-wishing him,� Poole said.

“I have been in here 42 years, and I haven't so much as had a fight," we Langa said. "I had to tell a person one time, ‘I'm almost 65. And I've gotten to this age partially because I give people their respect. You're not 30 yet, and you've lived as long as you have out of pure luck.’�

He has written multiple books and countless articles, and before he got sick, he played guitar, wrote a prison newsletter and gave history lectures to fellow inmates.

Housing

Nebraska prisons have skilled nursing areas at Tecumseh State Correctional Institution, the penitentiary and Diagnostic and Evaluation Center in Lincoln, plus a mental health unit with 70 beds for men with major mental illness and severe impairments including advanced dementia and Alzheimer's.

The skilled nursing areas hold a total of 31 beds and have become the prison system's de facto nursing homes for inmates too sick to be in general population but not sick enough for full-time hospital care.

No female inmates have health problems severe enough to need advanced care right now, but it's only a matter of time, Urosevich said. When they do, he said, they'll have to be sent to outside facilities.

He would like to see medical services consolidated into a single facility with space for old and young alike, and he hopes a planned study of housing needs will address the issue of aging inmates. The study is required by law to look at alternatives before the department can seek funding to build a new prison to address overcrowding. As of March, state prisons were about 1,400 inmates above capacity.

Chambers, who firmly opposes building new ones, said society's dehumanization of prisoners makes them easy to ignore.

“Since you don't care anymore to look at this person as a human being, there is no concern about what happens to him or her once the door closes and they are behind bars," he said. "So it is extremely difficult to get the Legislature to look at programming, to consider the likelihood that practically everybody who is put in prison is going to come out.

"In many cases it turns into a death watch just waiting for them to kick the bucket. Then you dispose of their corpse and another one bites the dust.�

A 2008 proposal by Omaha Sen. Brad Ashford to create a task force to study the graying prison population died in committee.

Gov. Dave Heineman's spokeswoman Jen Rae Hein said the governor is aware of the issue but she declined to comment further, other than to say that the governor, as a member of the state Board of Pardons, doesn't prejudge cases.

When death means freedom

Noel Heathman knows he will die in prison.

The 66-year-old known as Nose speaks in a barely audible rasp punctuated by the sound of breath whistling through a hole in his neck. He has emphysema and is a throat cancer survivor.

It took years for the Tecumseh inmate to come to the conclusion he would die behind a concrete wall.

When an Omaha judge sentenced him to life in prison 33 years ago for kidnapping and raping a 19-year-old Omaha woman, he considered it his duty to escape.

Heathman said he feels bad about what he did and wishes it had never happened. Loaded on meth and booze, he said, he snapped.

Four years after he was sentenced, Heathman became the first inmate since 1951 — and the last — to go over the penitentiary's wall.

Heathman and inmate Roger Weikle fashioned a grappling hook, and in broad daylight Sept. 9, 1984, scaled the prison wall bordering U.S. 77 just south of Nebraska 2. Weikle's leg snapped when he dropped from the 30-foot wall to the ground and he soon found himself back in a cell.

Heathman hid near the prison until 2 in the morning, brushed leaves and mud from his clothing and walked to a hotel across the street for a pack of smokes and a pop.

“I looked like the wrath of God,� he said in a 1985 interview.

Heathman spent three months on the run, stopping in Spencer, Iowa, to have dinner with his parents and then going to Kansas City, Arizona, Wisconsin and California. The law finally caught up with him in Santa Cruz, Calif.

After being recaptured, Heathman vowed to escape again. He thought his chance finally had come when he went to Oregon as part of a prisoner exchange.

"That was my goal, to escape out of Oregon," he said during an interview in 2010. "I figured out a way of doing it, too. ... I was thinking on it and discussing it with a few brothers and then — I got sick."

Throat cancer led to a permanent tracheotomy, and Oregon traded him back to Nebraska. He nearly died in 2009 when a drug-resistant staph infection started in the trache and spread down his back.

That was before the health porter program, but Heathman said fellow inmates and caseworkers in his housing unit offered what help they could while he was recovering, cleaning his cell or carrying groceries for him from the prison commissary.

He doesn't even think about escape anymore.

“I'm too old for that,� he said during a recent interview. “There is no light at the end of my tunnel … I'll die at home (in a cell.) You got to accept it.�

Twelve inmates died in Nebraska prisons last year: Two were suicides, 10 died of natural causes, Urosevich said. When they reach the end, the state offers hospice from a cell with the help of AseraCare.

“They (inmates) have committed a crime. They have had some bad judgments. But they're still human beings,� Urosevich said.

As part of hospice, prison officials allow family members to visit. But for Heathman, when the time comes, the men on his cell block likely will be his only visitors. His parents are dead. His sister and daughter don't speak to him.

Heathman said his few belongings will go to a close friend. When he escapes prison for the last time, he wants his ashes scattered in the Rocky Mountains at Evergreen, Colo.

“It's beautiful there."