Belgium’s Prisons Face a Growing Elderly Inmate Crisis

The number of prisoners aged 60 and over in Belgium has risen almost 31 percent in seven years, from 550 in 2019 to 719 on 1 June 2026, according to VRT NWS. In a new report published this week, the Centrale Toezichtsraad voor het Gevangeniswezen (CTRG), Belgium’s central prison oversight council, concludes that the country’s prisons were built around security rather than care and that policy has failed to keep pace with an aging inmate population.

A System Built for the Young and Fit

The CTRG reached its conclusions after visiting the dedicated elderly wards of Merksplas prison in Antwerp province and Saint-Hubert prison in Luxembourg province. The full report on older persons in detention, published as a 2026 visit report, sets out how the infrastructure and staffing of Belgian prisons are poorly suited to the needs of the people now living in them.

“The existing infrastructure is built for younger and physically fit prisoners,” Pieter Houbey, vice-chair of the CTRG, told VRT NWS. “Heavy doors, long walking distances and stairs can be a real obstacle for older people. Some prisoners therefore give up on a visit or a doctor’s appointment, simply because they have difficulty getting there.”

The council notes that many older prisoners age faster than people outside prison — a phenomenon it calls “early aging” — driven by difficult life trajectories, health problems, addictions and the impact of long-term detention. As a result, they often face mobility problems or chronic conditions at a relatively young age.

At Merksplas, 22 highly care-dependent elderly prisoners are housed together in a shared dormitory known as Salle 1, with 11 hospital beds lined up along each wall. The CTRG found that the most dependent residents are frequently bedridden by paralysis, severely mobility-limited, severely demented, incontinent or confused.

Individual Cells, Not Dormitories

The council’s central recommendation is a shift away from shared dormitories toward individual cells as the norm for older prisoners.

“With a view to privacy, safety and care provision, we must evolve towards individual accommodation,” Houbey said. “The current dormitory formula is hitting its limits.”

The CTRG also flagged inadequate care staffing in both Merksplas and Saint-Hubert, noting that available care personnel are insufficiently matched to the higher care needs of an aging prison population. According to the Belga wire service, as reported by Medi-Sfeer, the shortage means medical procedures outside the prison often have to be postponed because otherwise day-to-day care cannot continue.

Belgian law is explicit on the standard. Article 88 of the 2005 Basic Law on Prisons requires that prisoners receive healthcare equal to that available in free society, adapted to their specific needs, and that prison healthcare promote, maintain or restore a prisoner’s physical, mental and social wellbeing. The CTRG states that neither condition is met for many elderly prisoners.

A Documented Reality

The report coincides with the broadcast of Achter de tralies van de tijd (Behind the Bars of Time), a documentary by filmmaker Stijn Geenen filmed over a year inside the Merksplas elderly ward. In a companion feature, VRT NWS described scenes of a man lifted by a bed hoist, a nurse showering a man in a wheelchair, and a third shuffling in his underwear with a walking frame between the beds of a dormitory. Behind the windows: bars.

Care worker Koen, who features in the documentary, described the ward in blunt terms. “Actually we are an emergency department for elderly people in prison,” he said. “Older prisoners from all over the country are referred to us. We can only pick out those with the greatest need.”

“The men die here alone in a little hovel. You can’t call it a cell,” he added. “The rust is peeling off the radiator, the sockets have been pulled out of the walls, and no one is allowed near them.”

The documentary also lays bare the thin margins of care. At weekends, a single nurse is responsible for both the 22 highly care-dependent elderly prisoners and the other 430 inmates at Merksplas. The budget allows for only one incontinence diaper per prisoner per day.

Reliance on Fellow Prisoners

With staffing stretched, the ward leans heavily on a so-called fatik — a fellow prisoner who acts as an informal carer. The CTRG noted that such helpers rarely have sufficient medical training. In the documentary, prisoner Michel is described by nurse Anneke as “a hinge: not a saint, but he is there”, carrying food from morning to night, helping people who have fallen and mediating in fights — for 82 cents an hour.

When Michel is released, he enters the outside world without work or benefits. “I can’t go to the social welfare centre, so I have to get money in an unofficial way: repairing things, selling drugs, asking family or old friends,” he said. His warning is stark: “My sentence only begins when I get out.”

’Not the Way We Do It Here’

The most pointed criticism has come from inside the system. Serge Rooman, director of Merksplas prison, set up the elderly ward on his own initiative and has publicly questioned its adequacy. In an in-depth interview with Sociaal.Net, he was asked directly whether it is humane to keep these men locked up.

“No. Not the way we do it here,” he replied. “Some people no longer even know they are serving a sentence. How can it still be meaningful?”

Rooman rejected the idea that officials should settle for incremental improvement. “The bottom line is equivalence,” he said. “As a civil servant you must never settle for ‘it can’t be better’. If you do, you admit there are second-class citizens. That is where dehumanisation begins.”

The CTRG’s visits found that Merksplas and Saint-Hubert established their elderly wards largely on their own initiative, out of necessity, in the absence of any central, integrated policy. Houbey framed the policy gap in a single question: “When does a prisoner become a patient?”

“That is mainly because prisons are organised around a security principle, not a care principle,” he said. “The question is no longer whether the prison system must be revised, but how.”

Beyond the Walls

The report’s recommendations extend past the prison gate. The CTRG calls for better reintegration support on release — housing, care and finances — noting that nursing homes are often reluctant to admit former prisoners. It also wants a clearer framework for palliative care and dying in detention, an issue that becomes more pressing as more people reach old age behind bars.

On the care itself, the council recommends an integrated geriatric model that goes beyond medical treatment to include daily-living support, social contact and activities, and it wants elderly wards recognised as full care units. Houbey’s ideal is a dedicated ward within the prison, with space for specialised care and staff trained in geriatric and palliative care — or alternatively a small, specially designed detention house or a secure unit in a nursing home.

Filmmaker Geenen framed the documentary as a question of dignity rather than sympathy. “The punishment we as a society agreed on is deprivation of liberty. Not deprivation of liberty and neglect,” he said.

What to Watch

The report arrives against a backdrop of persistent overcrowding in Belgian prisons, where Rooman noted that 784 prisoners were sleeping on the floor in a single week earlier this year. Political attention has largely focused on capacity, with Justice Minister Annelies Verlinden pursuing a plan for 2,037 new prison places by 2030.

The CTRG’s findings suggest that capacity alone will not resolve the care problem. With more than 1,300 prisoners already over 55 — and Medi-Sfeer reporting 140 prisoners aged 70 or older — the demand for geriatric and palliative provision inside Belgian prisons will only grow. Whether the report’s call for individual cells, geriatric care units and a palliative framework translates into policy, or joins the previous recommendations that Rooman says have gone unanswered, is the question the coming months will answer.