Aged-care interventions for older prisoners should consider their specific needs, existing barriers to their engagement, and the factors affecting program delivery

Stevens BA, Shaw R, Bewert P, Salt M, Alexander R, Loo Gee B.  Systematic review of aged care interventions for older prisoners  Australasian Journal on Ageing. 2018; 37(1): 34-42.

Review question

•      What types of aged-care interventions are available in prisons to support the needs of older prisoners?

Background

•      The number of prisoners over 50 years of age has risen significantly in prisons across Australia, the United States, Canada, the United Kingdom and New Zealand over the past decade. In Australia, for example, the number of prisoners 50 years and over increased by 33% from 2010 to 2015.

•      There are six specific areas of concern regarding care issues in older prisoners: 1) the poor physical environment inside prisons; 2) the increased susceptibility to victimization experienced by older prisoners; 3) the limited access to health education tailored to older prisoners; 4) mental health problems among older prisoners being overlooked; 5) the tendency of older prisoners to experience greater degrees of isolation in prisons; and 6) poor reintegration of older prisoners to healthcare and social supports in the community after their release from prison.

•      This systematic review collected evidence to analyze the types of aged-care interventions available in prisons to support older prisoners.

How the review was done

•      Authors screened the titles and abstracts of 1,186 records after a detailed search of research databases. Qualitative and quantitative studies published from 2006 to 2016 examining aged-care interventions in prisons or correctional facilities were included in the systematic review.

•      A total of seven studies were included in the review after assessing their eligibility. 

•      This study was funded by The Salvation Army Aged Care Plus in Australia. The lead author received funding from J.O. and J.R. Wicking Trust in Australia. The authors declared no conflicts of interest.

What the researchers found

•      Review findings provided insight on two aged-care interventions and qualitative analyses of various aged-care domains.

•      An intervention involving physical-health activities was found not to be effective in reducing distress compared to a control group. Another intervention using psychosocial, physical and spiritual-health activities for veterans was also found not to be effective when compared to a comparison group.

•      Qualitative analyses generated themes relating to promising practices of aged-care interventions. Themes included: the importance of addressing older prisoners’ needs (including health and well-being, loneliness and isolation, anxiety and avoidance); addressing barriers to participation for older prisoners (including prison staff-prisoner relationships, prison physical environment, budget restrictions); facilitating engagement with older prisoners (including older prisoners’ sense of control and independence, creativity, peer support); and improving program delivery (including personnel involved in aged-care programs, supporting evidence for programs, legitimacy of programs).

Conclusion

•      The review found no significant aged-care interventions in prisons. However, qualitative findings were successful in identifying promising practices to guide future work in the field.