Delivering better dementia care to ageing prisoners

The paper, Dementia in Prison, finds corrective service authorities across Australia need to respond to the ageing population in the country’s correctional facilities as it increases at a higher rate than the general population.

It points to work being done by the NSW government as a model of good practice for others to follow.

The Hon. John Watkins, Alzheimer’s Australia NSW chief executive, claims prison authorities need to act now to ensure appropriate care for people in prison with dementia.

“Just as people in prison are treated for health conditions such as cancer, hypertension and diabetes, so too are they entitled to be granted access to appropriate medical treatment if they have a diagnosis of dementia,” Mr Watkins says.

The Justice Health & Forensic Mental Health Network (JH&FMHN) in NSW is leading the way with a range of initiatives for prisoners with dementia, including providing appropriate health care from allied health professionals and an inpatient facility in Long Bay Hospital for older offenders requiring long term supported care.

While some in the community may question the need to invest in custodial health services, Julie Babineau, JH&FMHN chief executive, claims those in custody are an incredibly vulnerable patient population whose health needs are commonly greater and more complex than those in the wider community.

“For custodial dementia patients, the Network has established strong care pathways from the moment individuals enter custody and are identified as aged and frail,” Ms Babineau says.

JH&FMHN works in partnership with Corrective Services NSW and other health providers to ensure appropriate care and support for custodial patients as they age and their health needs increase.

The health status of custodial patients is marked by higher levels of chronic disease, drug and alcohol issues, mental illness, and cognitive impairment.

According to the discussion paper, the population of people aged over 50 in Australia’s prisons has grown at a rate faster than the general population and, with age being the biggest risk factor for developing dementia, there is the potential for a rise in the number of people with dementia living in a prison setting.

Between 2000 and 2012 the number of older prisoners in Australia grew by about 95%, with the over 65 age group growing by 166%.

The discussion paper makes a number of recommendations to correctional authorities across Australia, including:

• Assessment for cognitive impairment is included in health checks for prisoners aged over 50 years and ensure prisoners diagnosed with dementia are given adequate support to contribute to their advance care plan while they still have capacity;
• Provide dementia specific staff training across all aspects of the corrections system, including health professionals and wardens, to increase knowledge of symptoms of dementia and appropriate dementia care in the prison environment;
• Collaborate with a cross section of allied health, aged care and specialist services to provide dementia specific advice, training and support to meet the complex needs of inmates with dementia, and
• Develop referral pathways to the Alzheimer’s Australia Younger Onset Dementia Key Worker Program to support parolees in accessing the supports they need to live independently.

Read the discussion paper, Dementia in Prison.