Accessibility of prison healthcare for elderly inmates, a qualitative assessment

Abstract

Aging in custody and the rising population of elderly prisoners are creating compelling challenges for criminal justice, prison and public healthcare systems. Geriatric syndrome and higher prevalence of co-morbidities amongst older inmates result in heightened vulnerability in prison environments. Empirical research addressing older adults' access to medical care in detention is scarce; therefore, this study assessed access to medical care in prison from the perspective of older prisoners in Switzerland. We interviewed a sample of 35 older inmates (average age 61 years) on their experience of healthcare accessibility in prison; data were qualitatively analysed and major themes regarding evaluation of their access to medical services were extracted. Our findings identified three barriers to accessing health services in prison including psychological obstacles, negative consequences of healthcare utilization, and environmental hurdles. We advocate facilitating older inmates' access to medical care in order to relieve the psychological burden of seeking health services in detention and adequately informing them of their right to demand these services, thereby lessening the negative consequences of their requests. We suggest further training of prison and medical staff for better management of age-related issues in prison can ease the environmental obstacles.

Acute care of elderly inmates: A vulnerable patient population in emergency department from Turkey

“…Reportedly, elderly inmates exhibit a high incidence of depression and anxiety because of their sentences and the traumatic living conditions in prisons. This increases their tendency to develop chronic illnesses even beyond the generally-higher rate for the elderly [15,17]. Although we determined a lower rate of psychiatric disorders in this study, anxiety was the main cause of the disorders determined.…”

“…Among the causes of ED admissions, medical emergencies, of which cardiovascular disorders predominate, are the leading etiologies. Reportedly, inmates exhibit a higher rate of chronic disorders, including hypertension, asthma, arthritis, certain can-cer types, and hepatitis because of living conditions and substance abuse both before and during prison life, including smoking, illicit drugs, and alcohol [2,[12][13][14][15]. Prison life is more likely to accelerate aging, and inmates look and feel older than their age-matched free counterparts; for instance, inmates are physiologically 10-15 years older than their chronological age and inmates aged 50-55 years are considered to be elderly [4,16].…”

“…Older inmates have special healthcare requirements that are often considered inappropriate for prisons' higher security standards, and which should be addressed with an evidencebased use of medical resources. Prison rules, which are often inflexible, may prohibit keeping healthcare kits inside cells; this may indicate incompetent prison management [15]. Considering the rates of admission and discharge from the ED (n = 96, (68.5%) and 95 (67.8%,) respectively), enabling this sensitive population to be managed within the prison without referral to the ED is an acceptable suggestion.…”

No Silver Lining: Evaluating the Need for Consistent and Appropriate Functionality Assessments Among the Increasing and Incarcerated Elderly Population

“…Existing assessments also measure social connectedness to family and friends by asking questions about the frequency of contact with others, measured through instruments such as the Forensic Camberwell Assessment of Need (Thomas et al, 2008) Addressing geriatric syndromes. Many of the nuanced difficulties that are common among older inmates are referred to as "geriatric syndromes," impairments that increase the risk of experiencing negative outcomes during their incarceration (Heidari et al, 2017;Williams et al, 2014;Williams et al, 2009). The term is not mutually exclusive from the aforementioned functionality domains; rather, geriatric syndromes encompass a variety of afflictions that occur across, and overlap with, indicators of biological, psychological, and social functionality.…”

The evolution of health care in the Texas correctional system and the impact of COVID-19

“…10 Older prisoners report three barriers to accessing health care in prison: psychological obstacles (reluctance), concern about possible negative consequences associated with health care utilization, and environmental hurdles related to limited onsite facilities. 11 Older prisoners take more medications than younger prisoners and are at increased risk for polypharmacy, defined as 5 medications a day. 12 Older prisoners have mental health disorders more frequently than younger prisoners and also abuse alcohol more frequently.…”