Search results

The purpose of this study was to explore the social needs and experiences of older prisoners who were attending one of two social initiatives in a prison in England.

This paper is based on an interpretative phenomenological study, conducted in a prison in the South West of England. Older prisoners attending an initiative implemented for those over 55, a purposive activity or a social task group, participated in focus groups, which were audio recorded and thematically analysed.

Two overarching themes were identified. Firstly, the need to feel safe: prisoners felt attending an initiative provided them with a safe haven away from noisy and boisterous younger prisoners, who they perceived as different from them and who received preferential treatment. Secondly, being provided with a purpose: prisoners felt they belonged among their peers, which motivated them to attend and support group activities.

This study was completed in one prison. However, both initiatives supported the social needs of older prisoners and enabled them to leave their cells, although they felt unsafe when not attending an initiative.

There remains a need to support the process of integrating younger and older prisoners, by the provision of both integrated and separate initiatives, with the aim of developing cross-generational and bi-directional peer support.

The fastest growing sector of the prison population is older people. Although the numbers are still relatively small (just under 2,500 in 2007), it would seem that the ‘sameness’ principle within prisons renders older prisoners invisible. The health of older prisoners is a matter of concern ‐ research indicates that you age 10 years faster in prison (Uzoaba, 1998) which can compound the problems that may be associated with ageing. The provision of health and social care do not match those for older people outside of the prison system. This article considers the legal issues surrounding the treatment of older prisoners. It recognises that restrictions on liberty are a component of the prison system; however, it questions whether the consequences of ‘sameness’ infringe the legal rights of older prisons. It recommends a statutory presumption of equivalence of care, which can only be rebutted expressly or by necessary implication.

The purpose of this paper is to determine the prevalence of polypharmacy and drug–drug interactions (DDIs) in older and younger prisoners, and compared if age group is associated with risks of polypharmacy and DDIs.

For 380 prisoners from Switzerland (190 were 49 years and younger; 190 were 50 years and older), data concerning their medication use were gathered. MediQ identified if interactions of two or more substances could lead to potentially adverse DDI. Data were analysed using descriptive statistics and generalised linear mixed models.

On average, older prisoners took 3.8 medications, while younger prisoners took 2.1 medications. Number of medications taken on one reference day was higher by a factor of 2.4 for older prisoners when compared to younger prisoners (p = 0.002). The odds of polypharmacy was significantly higher for older than for younger prisoners (>=5 medications: odds ratio = 5.52, p = 0.035). Age group analysis indicated that for potentially adverse DDI there was no significant difference (odds ratio = 0.94; p = 0.879). However, when controlling for the number of medication, the risk of adverse DDI was higher in younger than older prisoners, but the result was not significant.

Older prisoners are at a higher risk of polypharmacy but their risk for potentially adverse DDI is not significantly different from that of younger prisoners. Special clinical attention must be given to older prisoners who are at risk for polypharmacy. Careful medication management is also important for younger prisoners who are at risk of very complex drug therapies.

The social care needs of older prisoners is a neglected area. Social care policy and guidance does not exclude them but rarely mentions them explicitly; consequently their needs may be unmet. At the same time, more people are being sentenced and prisoners aged over 60 are the fastest growing group. Equally, older prisoners are rarely subject to the same safeguarding processes that take place in the community. This paper considers both issues and suggests some ways forward.

The purpose of this paper is to review and understand what the existing evidence base concludes about the needs of this population. The older prisoner population is growing faster than the older general population and placing a strain on prisons. Much of the existing literature focusses on the health-care needs of, or in-prison initiatives for, older prisoners. Typically, these are responsive and lacking an evidence-based understanding of the characteristics and needs of this group.

This paper presents a systematic review of the existing literature on the needs and characteristics of older people in contact with the criminal justice system. After a thorough search and selection process, 21 papers, from 2002 onwards, were included in the final analysis. The review process was structured through (People, Intervention/Exposure, Comparison, Outcome) and reported using (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).

The contradictions within the existing evidence base make it difficult to reach firm conclusions about the needs and characteristics of older prisoners. What is clear from the existing research are the relatively high levels of need. There is also some consensus that where older people commit homicide, the victim is likely to be an intimate partner. Overall, there is a need for consistent recording and reporting of characteristics and demographics and more systematic study design.

This paper has highlighted the key findings and limitations in the existing literature. Future research should make use of secondary official data sources to provide a clearer understanding of the characteristics of this group, their routes to prison, their needs and challenges they present.

The purpose of this paper is to identify primary health concerns prompting older and younger prisoners in Switzerland to consult a nurse or a general practitioner (GP) within the prison healthcare setting, and explores if these reasons for visits differ by age group (49 years and younger vs 50 years and older). The authors used 50 years and older as the benchmark for older prisoners in light of literature indicating accelerated aging among prisoners.

Retrospective information from medical records of 406 prisoners were collected for a period of six months. This study analyzed the reasons for which prisoners visited the nurses and GPs available to them through the prison healthcare service. These reasons were coded using the International Classification of Primary Care-version 2. Data were analyzed descriptively and four generalized linear models were built to examine whether there was an age group difference in reasons for visiting nurses and GPs.

The health reasons for visiting nurses and GPs by 380 male prisoners from 13 Swiss prisons are presented. In the six month period, a total of 3,309 reasons for visiting nurses and 1,648 reasons for visiting GPs were recorded. Prisoner participants’ most common reasons for both visits were for general and unspecified complaints and musculoskeletal problems. Older prisoners sought significantly more consultations for cardiovascular and endocrine problems than younger prisoners.

Nurses play an important role in addressing healthcare demands of prisoners and coordinating care in Swiss prisons. In light of age-related healthcare demands, continuing education and training of both nurses and GPs to adequately and efficiently address the needs of this prisoner group is critical. Allowing prisoners to carry out some care activities for minor self-manageable complaints will reduce the demand for healthcare.

This study presents unique data on healthcare concerns for which prisoners visit prison nurses and GPs. It highlights the varied needs of older prisoners as well as how these needs are addressed based on the availability of the primary healthcare provider within the prison.

The purpose of this study is to collect the first empirical data on the cognitive state of elderly prisoners in Germany and to examine associations between cognitive function and sociodemographic, clinical and incarceration characteristics.

All prisoners aged 60 years and older of five prisons in North Rhine-Westphalia, Germany, were asked to participate. The cognitive screening instruments mini-mental state examination (MMSE) and the DemTect were used to assess global cognition. Executive functions were tested with the trail making test and the frontal-assessment-battery. The Patient Health Questionnaire (PHQ-9) was used to assess participants’ affective state.

The sample of this study consisted of 58 prisoners with a mean age of 65.52 years (standard deviation = 6.03); 82.8% are male. Using the MMSE with age- and education-corrected z-scores, 36.9% of the prisoners showed marginal or impaired global cognition scores. Using the DemTect, 41.4% of the prisoners were classified as being cognitively impaired. Up to 40% of the prisoners showed deficits in executive functioning and around 60% of the prisoners showed depressive symptoms. The correlation analysis revealed significant associations between cognitive scores and age (rho = –0.335, p = 0.014), education (rho = 0.309, p = 0.020), sentence duration (rho = 0.409, p = 0.007) and duration of current incarceration (rho = 0.302, p = 0.043). The DemTect total score was significantly associated with the PHQ-9 (rho = –0.335, p = 0.016).

A large group of the prisoners showed a higher prevalence of cognitive dysfunction than that observed in same-age people who are not incarcerated. Taken together, there is an urgent need for an adequate management of older cognitively impaired prisoners including routine cognitive testing and guidelines-oriented treatment of cognitive symptoms.

This study has several strengths. To the best of the authors’ knowledge, this is the first study examining the cognitive and affective state in a German prison population. The authors considered female and male prisoners, as well as different prison settings, representing a realistic prison sample. The authors used several neuropsychological instruments to get a more detailed insight into the older prisoners’ cognitive status while trying to consider the economy of time and possible attention deficits to prevent dropouts during testing.

According to the principle of equivalence of care, health care in prison has to be of the same standard and quality as in the general population. This study aims to determine the geographic accessibility of dialysis services for older prisoners and the older general population in Switzerland and whether accessibility and availability of dialysis care are equivalent.

Spatial accessibility analysis incorporated four different data types: population data, administrative data, street network data and addresses of prisons and hemodialysis services.

Analysis revealed that the average travel time to the nearest dialysis service was better for prisoners (11.5 min) than for the general population (14.8 min). However, dialysis service for prisoners is hampered by the necessary lead-time in correctional settings, which, ultimately, leads to longer overall access times (36.5 min). Accordingly, the equivalence of dialysis care for older Swiss prisoners is not entirely respected for availability and accessibility.

The strength of the study lies in the combination of ethical principles and the highly tangible results of a spatial accessibility analysis. The ethics-driven empirical analysis provides arguments for policy-makers to review the current practices.

In the literature, 65 years is commonly used as the age to designate an older person in the community. When studying older prisoners, there is much variation. The purpose of this paper is to investigate how researchers define older offenders and for what reasons.

The authors reviewed articles on health and well-being of older offenders to assess terminology used to describe this age group, the chosen age cut-offs distinguishing younger offenders from older offenders, the arguments provided to support this choice as well as the empirical base cited in this context.

The findings show that the age cut-off of 50 years and the term “older” were most frequently used by researchers in the field. The authors find eight main arguments given to underscore the use of specific age cut-offs delineating older offenders. They outline the reasoning provided for each argument and evaluate it for its use to define older offenders.

With this review, it is hoped to stimulate the much-needed discussion advancing towards a uniform definition of the older offender. Such a uniform definition would make future research more comparable and ensure that there is no ambiguity when researchers state that the study population is “older offenders”.

This study aims to assess the nature and scope of dog-based programmes in prisons, assessing critically the potential opportunities, benefits, challenges and risks of developing innovative dog-based programmes for older prisoners in England and Wales. This paper outlines the potential benefits and challenges of developing dog-based programmes for older prisoners and sets out next steps for future research and practice.

This study is based on a scoping review of published research literature on prison dog programmes (PDPs) in the USA, the UK and other countries, with particular reference to older people in prison, followed by semi-structured interviews with six members of an expert advisory group. The literature review and data from the qualitative interviews were analysed thematically.

There is a substantial body of published research literature which supports PDPs as having identifiable positive impacts for people and also dogs, and also published research which highlights the benefits to older people of dog ownership or participation in dog-based activities. However, much of this research is small-scale and qualitative, and it has been argued that there is a lack of a quantitative evidence base. This research concludes that findings from the literature review and the semi-structured interviews support further research and the creation of pilot projects to develop dog-based projects for older people in prison.

This study was small-scale, and the findings need to be approached with caution. The literature review searched a small number of databases and filtered out articles published in languages other than English, and the review of the grey literature focused on reports from the UK. The number of experts interviewed was small and there was no direct consultation with older people in prison nor with older people with recent personal lived experience of imprisonment and community resettlement. A more extensive future study would benefit from a more extensive literature review, a larger group of participants and the inclusion of service users, prison managers and government policymakers, subject to the appropriate ethical and security approvals. At the time the research took place, ongoing COVID-19 restrictions on prison research meant that research with current prisoners and prison managers would not have been approved by the HMPPS NRC.

This research provides a research-based justification for future dog projects for older prisoners, leading potentially to improved well-being for older people in prison.

This study brings together the published research literature on PDPs with the research literature on the needs and experiences of older people in prison for the first time, and identifies potential directions for future research.