Dementia and cognitive impairment in the older prison population of England and Wales: identifying individual need and developing a skilled, multi-agency workforce to deliver targeted and responsive services

Forsyth K, Heathcote L, Senior J, Malik B, Meacock R, Perryman K, Tucker S, Domone R, Carr M, Hayes H, Webb R, Archer-Power L, Dawson A, Leonard S, Challis D, Ware S, Emsley R, Sanders C, Karim S, Fazel S, Hayes A, Burns A, Piper M, Shaw J
Record ID 32016000883
Authors' objectives: We aim to develop better care for older prisoners with confusion and dementia by identifying their care needs and designing a training package for prison officers and healthcare staff which will help them meet those needs. The number of people in England and Wales with dementia is increasing. There has also been a big rise in the number of older prisoners and so prisons are dealing with more people with confusion and dementia than ever before and this is likely to worsen further. Government policy is that prisoners should receive the same quality and range of health services as people in the community but presently, anecdotal evidence suggests that prisoners who are confused are often reliant on the support of other prisoners because of a lack of specialist services and, furthermore, they struggle with resettlement into the community. In Part 1 of our study, we will screen 269 female and 591 male prisoners aged 50+ for dementia/confusion using two different tools, one long and one short. We will determine if the shorter screen is as effective as a longer screen for picking up people who need help; if so, this will make it easier and quicker to screen everyone more effectively. Those who test positive on initial screening will be interviewed again using a more detailed assessment process covering individuals risk of violence; security needs; activities of daily living needs; mental health needs; and what support they receive from family and friends. This information will be used to estimate current and future levels of need to guide the planning and costing of services. In Part 2, we will send questionnaires to healthcare managers of all adult prisons in England and Wales (n = 107) to find out how people with confusion/dementia are currently identified and cared for. We will identify what sort of training staff need to help these people more effectively. In Part 3, we will explore the experiences and needs of older prisoners with confusion/dementia by observing their daily routines and talking to staff, other prisoners and their family and friends. This will help us identify the prison-specific needs of this group and how this differs to the community. In Part 4, Data from Part 1 will be categorised into a range of representative case types and case vignettes will be presented to a panel of experts in order to design pathways of care for prisoners with different degrees of severity of confusion/dementia. This will allow us to calculate how much it will cost to provide services now and in the future, based on likely numbers requiring each level of care. We will then create training materials for staff to support them in developing high quality services which meet the full range of needs. Patient and public involvement: The Peer Research Group at the Restore Support Network has been involved in the development of this bid and will continue to support the project by sitting on the management steering committee and expert panel; designing information sheets/consent forms; and advising on issues as they arise. Dissemination: Our comprehensive strategy will include papers in scientific journals; best practice booklets for key organisations; and training materials freely available on the internet. A newsletter style report will also be prepared and disseminated to service users.
Project Status: Completed
Year Published: 2020
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Aging
  • Cognition Disorders
  • Dementia
  • Prisoners
  • Cognitive Dysfunction
  • Prisons
Organisation Name: NIHR Health Services and Delivery Research programme
Contact Address: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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