Table 3 Final recommendations in order of importance (median score) and level of agreement (mean absolute deviation)

1

Immediate health needs on release should be taken care of (Uninterrupted access to mobility equipment, sufficient prescription medication to outlast any service delays or public holidays)

9

0.39

2

Introduce health assessments in prison that are aligned with Commonwealth funded aged care services, that also include a risk assessment component

9

0.44

3

Cognitive function and dementia assessment/diagnosis should be available to all older people in prison

9

0.61

4

Clearer responsibilities and roles on the part of community services (e.g., disability, aged care) to remove the risk of this group falling between the gaps

9

0.66

5

Improved systems for information sharing, administration and communication between stakeholders and services

9

0.72

6

Longer and consistent funding to allow programs to be piloted, evaluated and implemented

9

0.76

6

Sustainable funding models for programs that are found to be effective

9

0.76

8

Establishment of an independent reintegration team to liaise with all the different groups and services involved in release planning

9

0.79

9

Transition planning should occur as early as possible during a person’s time in custody (ideally at least 3–6 months prior to release)

9

0.83

9

Fill service gaps for First Nations prison leavers who have unique cultural and health needs

9

0.83

11

Increased housing options specifically for older people who are leaving prison, especially those convicted of sex crimes

9

0.85

12

Seamless transition between state or commonwealth services and in-prison services for people entering and leaving prison (ie going from a Medicare to Justice Health environment, and leaving again)

9

1.05

13

Fill service gaps for women leaving prison in older age

9

1.07

14

Existing transition programs should review their criteria to allow increased eligibility of older people who may not be ‘high risk’

9

1.12

14

Increased cooperation from Local Health Districts for release planning^a

9

1.12

16

Parole boards should reconsider programs that are not suited for older people due to issues such as cognitive ability

9

1.27

17

Preventative functional maintenance programs are needed to prevent deterioration during incarceration

8

0.80

18

Intense, person-centered case management approach developed with the input of the individual

8

0.97

19

Government funded, centralised transition support and advocacy roles that bridge pockets of practice across areas

8

1

20

Increased use of diversion policies for older people who could be better housed/rehabilitated elsewhere

8

1.02

21

Activities in the community to help make new social connections

8

1.05

22

Increased independence and responsibility during incarcerated life to emulate more real-world conditions (e.g., responsibility for meals)

8

1.15

23

Life skills courses to prepare for release that is focused on daily living (e.g., cooking, transport) and accessing services (e.g., going to the bank)

8

1.17

24

Prison leavers should have a physical transition support “package” in hand (including e.g., key contacts for local services, tips, to do lists, medical records and identification)

8

1.17

25

Programs to increase self-efficacy and agency in older people leaving prison

8

1.20

26

Digital literacy/ technology readiness programs (e.g., smartphones, internet, accessing services online) for older people

8

1.22

26

Increased education for nursing homes and aged care staff to reduce stigma and increase confidence

8

1.22

28

A review of medical parole policies and their apparent underutilisation

8

1.27

29

Older people leaving prison should be deemed a priority population for the Commonwealth funded Care Finders initiative to help access aged care services (includes a workforce of First Nations facilitators)^b

8

1.37

30

Release planning should occur regardless of risk level

8

1.41

31

Release ‘practice’ via excursions, or immersive experiences (e.g., videos, role play, virtual reality) to increase familiarity with post-release life

8

1.44

32

A trauma-informed care framework should be adopted by all stakeholders

8

1.46

33

Initiatives to increase public awareness of the existence of this population and the societal economic and human rights implications

8

1.66

34

Initiatives to address stigma in the general public towards prison leavers, especially against those convicted of sex crimes

8

1.95

35

A state/national forum for stakeholders to share experiences and plan to work together better

7

1.47

36

Peer mentoring by someone with lived experience, involving both counselling and moral support

7

1.66

37

Increased involvement from religious groups in the community to meet spiritual and social needs

6

1.95