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

  • Sanetta Henrietta Johanna du Toit (a1), Adrienne Withall (a2), Kate O’Loughlin (a1), Nikola Ninaus (a1), Meryl Lovarini (a1), Phillip Snoyman (a3), Tony Butler (a4), Katrina Forsyth (a5) and Claire A. Surr (a6)...



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 organizational structures often fail to meet the needs of prisoners with dementia, and prison staff experience high levels of burden because of the increased needs of these prisoners. Little is known about the best method of responding to the needs of this growing subpopulation of prisoners.


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 11 databases to identify relevant publications. Data from the included publications were extracted and summarized into themes.


Eight themes were identified that could support better care practices for prisoners with dementia: (1) early and ongoing screening for older prisoners; (2) specialized services; (3) specialized units; (4) programs or activities; (5) adaptations to current contexts; (6) early release or parole for older prisoners with dementia deemed at low risk of reoffending; 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.


One of the implications of the international ageing prison population is the higher number of people living with dementia being incarcerated. Suggestions for best care approaches for prisoners with dementia now need to move from opinion to empirical approaches to guide practice.


Corresponding author

Correspondence should be addressed to: Sanetta Henrietta Johanna du Toit, Faculty of Health Sciences, The University of Sydney, Camperdown, New South Wales, Australia. Phone +61 2 9351 9203; Fax +61 2 9351 9197. Email:


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Please note: the star symbol (*) in front of references indicates the 35 papers included in the review.

*Angus, C. (2015). Older Prisoners: trends and challenges [e-brief 14/2015]. NSW Parliamentary Research Service.
Arksey, H. and O’Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8, 1932.
*Atabay, T. (2009). Older prisoners. In Handbook on Prisoners with Special Needs (pp. 123143). Criminal Justice Handbook Series. Vienna, Austria: United Nations.
*Baidawi, S., Turner, S., Trotter, C., Browning, C., Collier, P., O’Connor, D. and Sheehan, R. (2011). Older prisoners – a challenge for Australian corrections. Trends and Issues in Crime and Criminal Justice, No. 426, 1.
*Baldwin, J. and Leete, J. (2012). Behind bars: the challenge of an ageing prison population, Australian Journal of Dementia Care, 1, 1619.
*Beckett, J., Peternelj-Taylor, C. and Johnson, R. L. (2003). Growing old in the correctional system. Journal of Psychosocial Nursing & Mental Health Services, 41, 1218.
Brooke, J., Diaz-Gil, A. and Jackson, D. (2018). The impact of dementia in the prison setting: a systematic review. Dementia, (London, England). 1471301218801715-1471301218801715. [online]. Available from:
*Brown, J. (2014). Dementia in prison (Discussion paper no. 9, March), Alzheimer’s Australia, Available at; accessed 21 April 2018.
*Brown, J. (2015, October). Living with Dementia in Prison. Available at; accessed 2 May 2018.
Christodoulou, M. (2012). Locked up and at risk of dementia. The Lancet Neurology, 11, 750751.
Cipriani, G., Danti, S., Carlesi, C. and Di Fiorino, M. (2017). Old and dangerous: prison and dementia. Journal of Forensic & Legal Medicine, 51, 4044. doi: 10.1016/j.jflm.2017.07.004.
*Collins, D. R. and Bird, R. (2007). The Penitentiary visit – a new role for geriatricians? Age and Ageing, 36, 1113. doi: 10.1093/ageing/afl144.
*Combalbert, N. et al. (2018). Cognitive impairment, self-perceived health and quality of life of older prisoners. Criminal Behaviour and Mental Health, 28, 3649. doi:10.1002/cbm.2023.
*Correctional Service of Canada. (2013). Healthcare considerations for older offenders. Newsletter of the Asian and Pacific Conference of Correctional Administrators, 34, 1316.
*Cox, J. F. and Lawrence, J. E. (2010). Planning services for elderly inmates with mental illness. Corrections Today, 72, 5257.
*Curtice, M., Parker, J., Wismayer, F. S. and Tomison, A. (2003). The elderly offender: an 11-year survey of referrals to a regional forensic psychiatric service. Journal of Forensic Psychiatry and Psychology, 14, 253265. doi: 10.1080/1478994031000077989.
Das, K., Murray, K., Driscoll, R. and Nimmagadda, S. R. (2012). Assessment of healthcare and placement needs in an older forensic psychiatric population in comparison to a younger forensic psychiatric population. International Psychogeriatrics, 24, 11881190. doi: 10.1017/S1041610212000130
*Dopson, L. (2005). No bars to better care. Nursing Older People, 17, 4747.
*Du Toit, S. H. J. and McGrath, M. (2018). Dementia in prisons: enabling better care for ageing prisoners. British Journal of Occupational Therapy, 81(8): 460462. doi: 10.1177/0308022617744509.
*Duffin, C. (2010). Doing time: health care in the criminal justice system. Nursing Older People, 22, 1418.
Fazel, S., McMillan, J. and O’Donnell, I. (2002). Dementia in prison: ethical and legal implications. Journal of Medical Ethics, 28, 156159.
Feczko, A. (2014). Dementia in the incarcerated elderly adult: innovative solutions to promote quality care. Journal of the American Association of Nurse Practitioners, 26, 640648. doi: 10.1002/2327-6924.12189.
Forrest, G., Baidawi, S, Atkinson, T., Small, H. and Bernoth, M. (2017). Previously unrecognised issues: managing the health of an ageing prison and homeless population. In: Bernoth, M. and Winkler (Eds.), D. Healthy Ageing and Aged Care. (pp 221231). Melbourne: Oxford University Press
*Gaston, S. (2017). Vulnerable prisoners: dementia and the impact on prisoners, staff and the correctional setting. Collegian. 25, 241246. doi:10.1016/j.colegn.2017.05.004.
Ginnivan, N. A., Butler, T. G. and Withall, A. N. (2018). The rising health, social and economic costs of Australia’s ageing prisoner population. The Medical Journal of Australia, 209, 422424.
*Gross, B. (2007). Elderly offenders: implications for Corrections Personnel, Forensic Examiner, 16, 5661.
Hayes, A. J., Burns, A., Turnbull, P. and Shaw, J. J. (2012). The health and social needs of older male prisoners. International Journal of Geriatric Psychiatry, 27, 11551162. doi: 10.1002/gps.3761.
*Hodel, B. and Sánchez, H. G. (2013). The Special Needs Program for Inmate-Patients with Dementia (SNPID): a psychosocial program provided in the prison system. Dementia, 12, 654660. doi: 10.1177/1471301211432952.
Howse, K. (2003). Growing Old in Prison: A scoping study on older prisoners. U.K.:Centre for Policy on Ageing and Prison Reform Trust.
Jeon, Y. H., Potter, E., Cashin, A. and Chenoweth, L. (2007). An innovative model of an aged care hostel in the prison setting: process of benchmarking and evaluation. Geriaction, 25, 1217.
Kakoullis, A., Le Mesurier, N. and Kingston, P. (2010). The mental health of older prisoners. International Psychogeriatrics, 22, 693701. doi: 10.1017/S1041610210000359.
Kingston, P., Le Mesurier, N., Yorston, G., Wardle, S. and Heath, L. (2011). Psychiatric morbidity in older prisoners: unrecognized and undertreated. International Psychogeriatrics, 23, 13541360. doi: 10.1017/S1041610211000378.
Lemieux, C. M., Dyeson, T. B. and Castiglione, B. (2002). Revisiting the literature on prisoners who are older: are we wiser? The Prison Journal, 82, 440458. doi: 10.1177/0032885502238680.
*Maschi, T., Kwak, J., Ko, E. and Morrissey, M. B. (2012). Forget me not: dementia prison. The Gerontologist, 52, 441.
McKinstry, C., Brown, T. and Gustafsson, L. (2014). Scoping reviews in occupational therapy: the what, why, and how to. Australian Occupational Therapy Journal, 61, 5866.
Moll, A. (2013a). Losing Track of Time: Dementia and the Ageing Prison Population: Treatment of Challenges and Examples of Good Practice. London: Mental Health Foundation.
*Moll, A. (2013b). Dementia behind bars: an unexpected yet predictable crisis. Mental Health Today, 24–27.
*Munday, D., Leaman, J. and O’Moore, E. (2017). Health and Social Care Needs Assessments of the Older Prison Population – a Guidance Document, London: Public Health England.
*Norman, A. (2017). Prison – no place for older people. Nursing Standard, 31, 29. doi: 10.7748/ns.31.49.29.s24.
*NSW Justice, Inspector of Custodial Services. (2015). Old and inside: managing aged offenders in custody. Available at; accessed 28 May 2018.
Parliament House of Commons Justice Committee. (2013). Older Prisoners Fifth Report of 2013–2014 HC 89 [Incorporating HC 1100 i–iii]. London: The Stationery Office.
Parliament House of Commons. (2017). U.K. Prison Population Statistics Number SN/SG/04334, 20 April 2017. London: The Stationery Office.
*Patterson, K., Newman, C. and Doona, K. (2016). Improving the care of older persons in Australian prisons using the Policy Delphi method. Dementia, 15, 12191233. doi: 10.1177/1471301214557531.
*Peate, I. (2013). Dementia care and offender populations. British Journal of Community Nursing, 18, 284285.
Pham, M. T. et al. (2014). A scoping review of scoping reviews: advancing the approach and enhancing the consistency. Research Synthesis Methods, 5, 371385. doi:10.1002/jrsm.1123.
*Potter, E., Cashin, A., Chenoweth, L. and Jeon, Y-H. (2007). The healthcare of older inmates in the correctional setting. International Journal of Prisoner Health, 3, 204213.
*Prisons Department of Malaysia. (2013). Elderly offenders in Malaysian prisons. Newsletter of the Asian and Pacific Conference of Correctional Administrators, 34, 712.
Royal College of Occupational Therapy. (2018). Prisons: the value of occupational therapy. Available at:; accessed 31 May 2018.
Shah, H., et al. (2016). Research priorities to reduce the global burden of dementia by 2025. The Lancet Neurology, 15, 12851294.
Sheffrin, M., Ahalt, C., Cenzer, I. S. and Williams, B. (2016). Geriatrics in jail: educating professionals to improve the care of older inmates. Journal of General Internal Medicine, 1, S232.
*Shilling, D. (2012). Senior citizens in prison. Victimization of the Elderly & Disabled, 15, 1728.
Smee, K. (2013). Caring for the ageing prisoner, a new age issue. Newsletter of the Asian and Pacific Conference of Correctional Administrators, 34, 46.
*Stewart, W. and Lovely, R. (2017). Peer social support training in UK prisons. Nursing Standard, 32, 39. doi: 10.7748/ns.2017.e10572.
Stojkovic, S. (2007). Elderly prisoners: a growing and forgotten group within correctional systems vulnerable to elder abuse. Journal of Elder Abuse and Neglect, 19, 97117.
Tricco, A. C., et al. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Annals of Internal Medicine, 169, 467473. doi: 10.7326/M18-0850.
Turner, S. and Trotter, C. (2010). Growing old in prison? A review of national and international research on ageing offenders. Corrections Research Paper Series No. 3, July. Victoria: Department of Justice.
*Vogel, T., Lanquillon, S. and Graf, M. (2013). When and why should mentally ill prisoners be transferred to secure hospitals: a proposed algorithm. International Journal of Law & Psychiatry, 36, 281286. doi: 10.1016/j.ijlp.2013.04.021.
Wahidin, A. (2005). “We are a significant minority”: old women in English prisons. British Society of Criminology Online Journal, 6, 116.
*Wheldon, A. and Williams, R. (2012). Development of a geriatrician led outreach service for older prisoners. Age and Ageing, 2, ii14. doi: 10.1093/ageing/afs112.
*Williams, B. A., Goodwin, J. S., Baillargeon, J., Ahalt, C. and Walter, L. C. (2012). Addressing the aging crisis in U.S. criminal justice health care. Journal of American Geriatric Society, 60, 11501156, doi: 10.1111/j.1532-5415.2012.03962.x.
*Williams, B. A., Stern, M. F., Mellow, J., Safer, M. and Greifinger, R. B. (2012). Aging in correctional custody: setting a policy agenda for older prisoner health care. American Journal of Public Health, 102, 14751481. doi: 10.2105/AJPH.2012.300704.
*Williams, J. (2012). Social care in older prisoners. Journal of Social Work, 13, 471491.
Wilson, J and Barboza, S. (2010). The looming challenge of dementia in prisons. Correct Care, 24, 1032.
Yarnell, S. C., Kirwin, P. D. and Zonana, H. V. (2017). Geriatrics and the legal system. Journal of the American Academy of Psychiatry and the Law, 45, 208217.
*Yorston, G. A. and Taylor, P. J. (2006). Commentary: older offenders – no place to go? Journal of the American Academy of Psychiatry and the Law, 34, 333337.


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

  • Sanetta Henrietta Johanna du Toit (a1), Adrienne Withall (a2), Kate O’Loughlin (a1), Nikola Ninaus (a1), Meryl Lovarini (a1), Phillip Snoyman (a3), Tony Butler (a4), Katrina Forsyth (a5) and Claire A. Surr (a6)...


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