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Research Review

Report: Older Prisoners Need Better Medical Care

Soaring numbers of older, sicker prisoners are causing an unprecedented healthcare challenge for the nation’s criminal justice system, according to a new University of California, San Francisco report.

As the American penal system confronts a costly demographic shift toward older prisoners, the authors call for an overhaul in healthcare practices for older inmates who disproportionately account for escalating medical expenses behind bars. The recommendations include screening for dementia among prisoners, improved palliative care, and standard policies for geriatric housing units for infirm inmates.

The article was published online in the American Journal of Public Health.

The report outlines nine policy recommendations that emerged from a gathering last year of 29 national experts in prison healthcare, academic medicine, nursing, and civil rights.

The recommendations promote cost-effective quality care for older prisoners, says lead author Brie Williams, MD, an associate professor of medicine in the division of geriatrics.

“A first step is to focus on these nine priority areas in order to set the stage for collaboration among the many disciplines involved in older prisoner healthcare,” Williams says.

Prisons are increasingly challenged to provide care to older inmates with a litany of chronic medical conditions. With higher rates of disability in general, older prisoners cost approximately two to three times as much as younger inmates.

The recommendations include the following:

• institute a standard definition of geriatric or older prisoners—the experts suggest age 55 or older;

• improve training of prison staff and healthcare providers;

• provide screening for dementia;

• identify health needs of older women prisoners;

• create national medical eligibility criteria for early prisoner release based on medical needs; and

• establish uniform policies for geriatric housing units.

The report points out that prompt attention to age-related disabilities of older inmates eventually would result in societal benefits outside prison gates. With the vast majority of inmates ultimately released back to the community, “Prison programs that improve health and cognitive skills or that target substance abuse have been associated with decreased recidivism and re-arrest,” the authors wrote. And with better care during incarceration, prisoners when released would make less use of emergency rooms and other community medical resources.

— Source: University of California, San Francisco