COVID-19 and incarcerated older adults: a commentary on risk, care and early release in Australia

Abstract

Purpose The purpose of this commentary is to draw upon available literature and practices related to COVID-19 and management of older incarcerated adults in Australia to highlight key matters for better risk management and care of this population during this and future infectious disease pan/epidemics. Design/methodology/approach The present commentary draws on current policies, practices and literature regarding the health, needs and management of older incarcerated adults in Australia to discuss risk, care and early release for this population during the COVID-19 pandemic. Findings Incarcerated persons experience poorer health and accelerated age-related decline compared to those in the general community. The present situation offers the opportunity to fill knowledge and practice gaps, including policies for staff training, identification of dementia and cognitive decline, assessment of mobility issues, addressing barriers to health-seeking, possibilities of medical or compassionate release, risk assessment and release protocols and post-release needs. Practical implications While Australian prisons have acknowledged the vulnerability of older persons, more focused adaptation of COVID-19-related policies to consider adults as young as 45 years are needed. Appropriate ethical identification and management of cases in this population is needed, as is discussion on issues of decarceration and medical release. Re-conceptualisation of incarcerated adults as “citizens in need of care”, rather than as “offenders to be secured”, will be beneficial. Robust, local evidence is needed to assist decision-making. Originality/value This is a comprehensive, focused review of relevant evidence, policies and practices for a growing subpopulation of prisoners worldwide with complex needs and particular vulnerability to the COVID-19.

The Risk of COVID-19 Infection in Prisons and Prevention Strategies: A Systematic Review and a New Strategic Protocol of Prevention

“…Third, they created several areas for confirmed cases and suspected COVID-19 cases [ 60 , 61 ]. In Australia, on the other hand, the government adopted several bans against the development of epidemic outbreaks: suspension of visits between prisoners; decrease in transfers between different prisons; temperature control for staff at the entrance; introduction of quarantine periods for new prisoners; and creation of isolation hubs for positive prisons [ 62 , 63 ]. Prisons in the Philippines and Pakistan have a serious problem of prison overcrowding, and it is estimated that only 25% of inmates use face masks as PPE, so the Philippine government arranged to use CTTs as a model to prevent outbreaks within prisons [ 64 , 65 ].…”

Multi-sector stakeholder consensus on tackling the complex health and social needs of the growing population of people leaving prison in older age

“…Most people in prison will be released back into the community, and successful reintegration of this group is a challenge with older people in prison having poorer physical and mental health, and higher unmet health and social needs compared to both younger people in prison, and older people in the community (Australian Institute of Health and Welfare, 2019; Lee et al, 2019;Solares et al, 2020;Stevens et al, 2018). This challenge is exacerbated by prison systems that have been traditionally focused on security rather than care, and the stereotypical 'young' inmate (Davies, 2011;Hwang et al, 2021). These multiple vulnerabilities has resulted in consensus that in the prison context, people over 50 should be considered 'older' (Merkt et al, 2020).…”

“…In Australia, a growing body of literature recognises the rapid ageing of the prisoner population with qualitative studies, economic analyses, examination of offending data and commentaries conducted by academics and various government agencies all acknowledging this issue (Australian Institute of Health and Welfare, 2019; Ginnivan et al, 2021;Hagos et al, 2021;Howard & Corben, 2019;Hwang et al, 2021;Inspector of Custodial Services NSW, 2015; Office of the Inspector of Custodial Services WA, 2021;Simpson et al, 2017;Trotter & Baidawi, 2015). Whilst mostly focused on prisoner population ageing or prisoner health management in general, all emphasise the importance of appropriate post-release support for older prison leavers.…”

Dementia in the incarcerated population: a retrospective study using the South Carolina Alzheimer’s disease registry, USA

“…Malloy et al (2020) suggest that early release has been successfully done in the USA. However, it requires careful consideration of who might be eligible and a strategic plan that includes housing, access to appropriate care and treatment, consideration of stigma and acceptance, economic resources and recidivism risk and transition support (Hwang et al , 2021; Williams et al , 2014; Nielssen et al , 2018).…”