The UK has only one specialist unit for the elderly like this US one
Prison bosses in England and Wales have failed to respond to a call to introduce special policies for elderly inmates, the prisons inspector says.
Anne Owers said the response to her 2004 call had been disappointing.
The number of inmates aged over 60 has been rising, but Ms Owers said their treatment was at odds with policies for the elderly in normal society.
The National Offender Management Service said a national strategy for older inmates would not be appropriate.
The prisons watchdog first called for changes in how English and Welsh jails managed elderly prisoners in 2004.
The Scottish Prison Service is in a similar position, with no specific strategy.
Since then, the number of male and female prisoners classed as elderly has risen.
Figures for August 2007 show that the oldest man in jail was 92 and the oldest women 78. The only dedicated elderly unit is at Norwich Prison, in Norfolk.
The number of people coming before the courts has remained largely stable, but more people are being sent to jail and for longer sentences, including more lifers.
In the report reviewing progress since 2004, Ms Owers said there had been some positive developments, but mostly thanks to charities and the work of individual prison staff.
Projects run by Age Concern, the Prison Reform Trust and Nacro, a charity that specialises in resettling offenders, were praised, along with NHS-backed policies in south-west England and the West Midlands.
The report said only three prisons had policies for elderly inmates and there were "numerous examples" of staff being unaware of who would need help in an emergency.
A key recurring problem was a lack of adaptive equipment for the infirm.
Inspectors cited one incident at HMP Ranby, near Retford, Nottinghamshire, where an inmate needed to use a crutch but had been taken from a van in handcuffs.
Ms Owers said the response from the National Offender Management Service had been disappointing as eight key recommendations had not been implemented.
The problems were likely to become more acute amid overcrowding and an ageing jail population, she said.
"Apart from short sections in the Prison Service orders on disability and women, there remains no national strategy for older prisoners," said Ms Owers.
"There is still far too much reliance on the unsupported initiative of particularly committed officers, and too great an assumption that the care of older prisoners, including their social care, is a matter for health services and not for the whole prison."
Juliet Lyon, director of the Prison Reform Trust, commenting on Ms Owers' report, said the fact jails did not take account of older prisoners' needs meant they were facing a "double punishment".
"An ageing prison population is being squeezed into overcrowded jails designed and run for young men," she said.
"As well greater use of community punishments for older offenders, ministers should also consider developing specialist secure accommodation for the elderly in cases where a custodial sentence is necessary."
Prisons Minister David Hanson said policy on older inmates was evolving, with a considerable amount of work under way, including local strategies in some jails.
He added: "The National Offender Management Service has felt to date that a national strategy for older prisoners was not appropriate.
"This position will be kept under review given the increasingly older population in prison, and the work being done between NOMS and the Department of Health aims to address many of the issues raised in this report."