A photo by Christian Bardenhorst. unsplash.com/photos/8lMhzUjD1Wk

The ugly duckling of health and social reform

Image: Christian Bardenhorst

Over 60s have always made up a significant minority of the prison population, but are now the ‘fastest growing’ demographic in custody, said Nigel Newcomen, Prisons and Probation ombudsman, in his annual report.

The implications of this, for the way health (and social care) is delivered in the prison service, are often slightly overlooked. He went on to add that prisons may have to offer “care home and even hospice” services in the future.

The impact of a greying population has been extensively scrutinised, but usually in terms of the jewel in Britain’s crown, the National Health Service. Media coverage has focused on specific failings to provide a suitable standard of care for elderly patients, and concerns about the added financial burden of looking after a society that is now living 15 years longer on average than when the NHS was conceived.

But in reality, the unique needs of elderly service users pose a challenge across the board for the provision of social services, of which prisons are no exception.

A report by the charity Age UK identified several reasons why the proportion of elderly prisoners is rising, namely due to a “stacking” effect. Prosecution for historic sexual offences may be responsible for a small spike.

But rather than there being a sudden influx of older offenders, the increase is mostly due to people growing old as they carry out their sentences.

Problems begin with the fact that the archetypal prisoner is young and male. Exercise and rehabilitation programmes, amongst other things, may be inaccessible to prisoners over 60. Thus, people are at risk of age discrimination.

Another big problem is responsibility: the same Age UK report went on to say that there is a “lack of any explicit policy or guidance that supports effective commissioning for [elderly peoples’] needs, resulting in confusion across the system as to who is responsible for what.”

In some prisons, staff become primary care workers for elderly patients, which they may be untrained or unwilling to do.

An example of this is the death of a 94-year-old prisoner this year, who was fatally injured after falling out of bed in his cell. He had been taken from a care home to serve out his jail sentence.

The prison in question was commended for their response to the death, and purchased “crash mats and electronic beds to protect against such falls in future.” Nonetheless, specialised provision of care for the elderly in UK prisons must improve.

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