numbers of Older Patients in Prison
Mount, a Cat C training prison, has low numbers of the over 50s, they are
increasing in all prisons. If there is just one patient over 50/55 or a
disabled patient, his needs must be addressed. The Prison Service needs
to follow the NSF for the Elderly which has the following headings:
- Rooting out age discrimination
- Person-centred care
Three - Intermediate care
- General hospital care
Seven - Mental health in older people
Eight - Promotion of health and Active
Service also needs to comply with The Disability Discrimination Act
1995-2005. This affects both staff and prisoners in relation to
buildings, such as access and toilet facilities. The DDA also impacts on
our attitudes towards those with disability.
It may seem
reasonable that there should be a separate prison estate for the elderly.
I would rather not see that develop. The Prison Service had a few
general bedded units where complex problems were kept out of sight. Such
a policy would also discriminate.
In a prison
healthcare setting, the difficulties of disabled people must be
understood. All members of the team should feel empowered to be
responsible for care. Compassion with confidence in aiding the disabled
(e.g. pushing wheelchairs) may need staff training. Prisoners also have a
role in helping each other; that may require a more formalised system. It
could be part of care training for some prisoners, enhancing their life
skills. Healthcare should ensure, within Prison security limits, suitable
supplies of aids for the disabled. The primary care team has a duty to
contact Adult Care Services [Social Services] for assessment of disabled
incontinent patient we simply cannot simply supply the aids – as part of
good medical practice we need to investigate and treat the cause.
In any disabled
patient it is important not to assume that the condition is permanent. The
team must encourage activity and rehabilitation. Healthcare must be on the
lookout for further ailments. Older patients are not stable, and develop
Other issues in
relation to the elderly:
seem to be older than their years in health terms as a whole
more common in elderly prisoners and is often under-treated
disability needs special care in prisoners; but ensuring it is in line
with the DDA
planning is even more complex, with special medical and housing needs.
be missed in prisons, as such patients can function well in an
institution; which increases their problems when they are released
Service does not have a consistent policy on early release of the
terminal patient. Some patients may even wish to die in prison, with
adequate services, or nearby at the new facilities of The Hospice of St.
Francis. Archway has visited there recently and we have discussed these
issues with the Director, Dr Ros Taylor.
can engage the wings to identify these patients and to ensure
patient-centred facilities are provided. To that end, Social Service
assessments can be arranged.
suitable aids for blind and deaf prisoners is required
bedding and other regime issues - are chits needed?
access for bathing arrangements and showers
issues differentiating disabled patients
also prison pay and retirement problems, with different practices in