Table 16 Risk
From: Dementia care pathways in prisons – a comprehensive scoping review
Area | Issues | Recommendations |
|---|---|---|
Assessment | Prison classification systems do not make allowances for the mostly lowered risk of older people, and those LWD (Inspector of Custodial Services, 2015) | Risk assessments should be comprehensive and individualised to consider age and the impact of health on future offending (National Institute for Health and Care Excellence, 2017; Prisons and Probation Ombudsman, 2016; Welsh Government and Ministry of Justice, 2011; Booth, 2016; du Toit & McGrath, 2018; Goulding, 2013) |
There are conflicting recommendations about the use of assessment tools (National Institute for Health and Care Excellence, 2017; Booth, 2016) | Risk assessments should be undertaken by skilled staff (Brooke et al., 2018; Hamada, 2015; National Institute for Health and Care Excellence, 2017; Booth, 2016) | |
Risk assessments should be reviewed regularly (National Institute for Health and Care Excellence, 2017; Prisons and Probation Ombudsman, 2016) | ||
Management | The need to balance safety with the need for risk-taking (Brown, 2016; Murray, 2004) | |
The need for training regarding PLPWD (Brown, 2016; Murray, 2004) | ||
Disciplinary process | Prison policies and procedures regarding disciplinary procedures and the use of restraint and force be modified for older people, the frail, and those LWD (Treacy et al., 2019; Correctional Investigator Canada, 2019; Her Majesty's Prison & Probation Service, 2018; Prisons and Probation Ombudsman, 2016; Welsh Government and Ministry of Justice, 2011; Peacock et al., 2018) | |
Staff training (Treacy et al., 2019; Correctional Investigator Canada, 2019; Her Majesty's Inspectorate of Prisons, 2016) | ||
A balanced approach to disciplinary procedures, with the need to discern between dementia and ‘bad’ behaviour (Dillon et al., 2019; Alzheimer's Society, 2018; Her Majesty's Inspectorate of Prisons, 2016; Her Majesty's Prison & Probation Service, 2018) | ||
The prohibition of the use of solitary confinement or segregation for PLPWD (Ahalt et al., 2017) | ||
Safeguarding | Lack of supervision for PLPWD in prison may leave them at risk (Mackay, 2015) | The need for safeguarding arrangements for older people in prison and those LWD (National Institute for Health and Care Excellence, 2017; Welsh Government and Ministry of Justice, 2011; Welsh Government, 2014; Hodel & Sanchez, 2013; Mackay, 2015) |
Bullying of prisoners with dementia by other prisoners (Brooke & Rybacka, 2020) | Training (Williams, 2014) | |
A means for people to report abuse from both prisoners and staff was suggested (Welsh Government, 2014) | ||
Contacts for legal professionals with safeguarding concerns and training in the area (Soones et al., 2014) |