Older persons with dementia in prison: an integrative review

Abstract

Purpose The number of prisoners over 55 years is increasing and many are at risk of developing dementia. This has generated new responsibilities for prisons to provide health and social care for older persons. The purpose of this paper is to synthesize the existing research literature regarding the phenomenon of the health and social care needs of older persons living with dementia in correctional settings. Design/methodology/approach Using an integrative review method based on Whittemore and Knafl, the inclusion criteria for the review are: articles written in English; a focus on some form of dementia and/or older persons with discussion of dementia; to be set in a correctional context (correctional facility, prison and jail); be derived from a published peer-reviewed journal or unpublished dissertation/thesis; and be a qualitative, quantitative or mixed methods study. Based on those criteria, a search strategy was developed and executed by a health sciences librarian in the following databases: Medline, CINAHL, Embase, PsychINFO, Proquest Nursing and Allied Health and Web of Science; searches were completed up to April 2019. After data were extracted from included studies, synthesis of findings involved an iterative process where thematic analysis was facilitated by Braun and Clarke’s approach. Findings Eight studies met the inclusion criteria. Key findings of the eight studies include recognition of dementia as a concern for correctional populations, dementia-related screening and programming for older persons and recommendations for improved screening and care practices. Most significant is the paucity of research available on this topic. Implications for research are discussed. Originality/value This paper identified and synthesizes the limited existing international research on the health and social care needs of older persons with dementia living in correctional settings. Although existing research is scant, this review highlights the need for increased awareness of dementia as a concern among older persons living in correctional settings. As well, the review findings emphasize that enhanced screening and interventions, particularly tailored approaches, are imperative to support those living with dementia in correctional settings.

Criminal Responsibility in Geropsychiatry: Competence, Culpability, and Care

“…They are known to have relatively greater longevity than men and report worse self-rated health than men, the experience of many culturally diverse groups, and their unique requirements related to living with dementia. 53 Helping develop geriatric housing units to facilitate continuum care for elderly prisoners and linking former inmates to postrelease health care services to older persons is another untapped dimension.…”

“…They are known to have relatively greater longevity than men and report worse self-rated health than men, the experience of many culturally diverse groups, and their unique requirements related to living with dementia. 53 Helping develop geriatric housing units to facilitate continuum care for elderly prisoners and linking former inmates to postrelease health care services to older persons is another untapped dimension. Increasing the research on dementia in prisoners specifically rather than identifying dementia as a secondary outcome of elderly prisoners and appreciating the difference between cognitive decline and dementia is imperative.…”

Older people in custody in a forensic psychiatric facility, prevalence of dementia, and community reintegration needs: an exploratory analysis

“…In general, the increasing number of older people in custody has been linked to population aging, more crimes and arrests later in life, and strict sentencing legislation (see Barry et al, 2017 ; Blowers & Blevins, 2015 ; Luallen & Cutler, 2017 ; Regan et al, 2003 ; Uzoaba, 1998 ). Alongside the trend of an aging correctional population, evidence suggests that a notable proportion of older people in custody are living with one or more psychiatric issues (see Stoliker & Galli, 2019 ) which may include neurocognitive issues, such as dementia (Brooke et al, 2020 ; Maschi et al, 2012 ; Peacock et al, 2019 ). In addition, older people in custody show high rates of physiological issues and complex health needs (see Colsher et al, 1992 ; Fazel et al, 2001 a, 2001 b; Kakoullis et al, 2010 ; Lawson, 2014 ).…”

“…In addition, older people in custody show high rates of physiological issues and complex health needs (see Colsher et al, 1992 ; Fazel et al, 2001 a, 2001 b; Kakoullis et al, 2010 ; Lawson, 2014 ). Despite this understanding, there have been limited empirical investigations into the social, medical and mental health needs of older people in custody in general (Fazel et al, 2001 a, 2001 b, 2004 ; Koenig et al, 1995 ; Stoliker & Galli, 2019 ; see also Michel et al, 2012 ), and specifically within the context of dementia (Brooke et al, 2020 ; Peacock et al, 2019 ), as well as the extent to which these needs are being met.…”

“…While correctional facilities generally have policies and practices in place to assess, diagnose, and treat physical and mental health issues, the correctional setting is hardly conducive to supporting older individuals with increased and complex health issues as many facilities lack geriatric- or dementia-specific health care services (Brooke et al, 2020 ; Maschi et al, 2012 ; Peacock et al, 2019 ). Indeed, research has indicated that older people in custody show high rates of physical and mental health issues, yet a notable proportion do not receive adequate care for these issues during incarceration (see Stoliker & Galli, 2019 ).…”