Best care options for older prisoners with dementia – a scoping review

Introduction: The prisoner population is ageing and consideration is needed for how to best support those with age-related health conditions in the system. Existing work practices and organisational structures often fail to meet the needs of prisoners with dementia, and prison staff experience high levels of burden due to these prisoners’ increased needs. Little is known about the best method of responding to the needs of this growing sub-population of prisoners. Method: A scoping review was conducted to answer the question: What are the perceived best care options for prisoners with dementia? To be included, publications had to be publicly available, reported on research findings, or viewed opinions and commentaries on care practices relevant to older prisoners with dementia. Searches were conducted in eleven databases to identify relevant publications. Data from the included publications were extracted and summarised into themes. Results: Eight themes were identified that could support better care practices for prisoners with dementia: (1) early and ongoing screening for older prisoners; (2) specialised services; (3) specialised units; (4) programs/activities; (5) adaptations to current contexts; (6) early release or parole for older prisoners with dementia deemed at low risk of re-offending; and (7) training younger prisoners (8) as well as staff to assist older prisoners with dementia. Besides practical strategies improving care practice, costs, prison-specific resources and staff skills were highlighted as care barriers across all themes. A lack of empirical evidence supported these findings. Conclusion: One of the implications of the international ageing prison population is higher numbers of people incarcerated with dementia. Suggestions for best care approaches for prisoners with dementia now need to move from opinion to empirical approaches to guide practice.