老病残罪犯

根据我国现行《刑事诉讼法》和《监狱法》等法律法规的规定，暂予监外执行是指被判处拘役、有期徒刑和部分无期徒刑的犯罪分子，因具有严重疾病、怀孕哺乳、生活不能自理的特殊 ...

Rising temperatures and severe heat, as a result of climate change, have led to a significant number of heat-related deaths and injuries among correctional populations in the United States. This article analyzes cases from the U.S. Circuit Courts of Appeals in which inmates challenged the constitutionality of their conditions of confinement in extremely hot facilities pursuant Title 42 U.S. Code Section 1983. An inductive analysis of caselaw revealed two themes: inmates with heat-sensitive health conditions and reasonable staff responses to inmate's heat exposure. The article concludes by offering policy guidance to prison officials based on the themes revealed in the circuit court decisions and by providing recommendations for future research.

Citizens are members of a particular country who, because of birth, registration, or application, are entitled to enjoy certain basic rights and privileges. Discrimination by reason of age, ethnicity, religious background, or liberty of any person should not be entertained at any level; hence, every citizen is to be treated equally in terms of the enjoyment of basic rights and privileges. The most important fundamental right to be enjoyed by a citizen is the right to life, mainly because a person needs to be alive to enjoy other rights and privileges as contained in the constitution. However, the right to life is not limited to the right not to take a person’s life, and rather it expands to the right to enjoy unhindered access to resources that will ensure good physical and mental well–being. Unfortunately, some countries are unable to ensure the enjoyment of these rights by all their citizens. In a bid to manage the limited resources, some persons are being discriminated against, one of which is inmates who are incarcerated and serving an imprisonment term. This act of discrimination was evidenced in 2020 during the COVID–19 pandemic when immediate preventive measures were taken across the country to curb the spread of the virus. It became a cause of concern whether inmates in correctional centres were equally carried along on these measures. This article will discuss the right to life of prisoners in Nigerian correctional centres as it relates to their unhindered right to health. Using the doctrinal and empirical method, this paper will identify the local and international instruments that provide for the enjoyment of the right to health of inmates, and particularly whether inmates were discriminated against in the exercise of the various preventive measures taken during the pandemic.

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Japan’s criminal justice system is undergoing a historic transformation. To address shifts in crime demographics, an aging prison population, and the need to improve judicial efficiency, Japan has implemented several major reforms. Among these, the revision of the Sentence Reduction Act, scheduled for implementation in 2025, combined with the plea-bargaining system introduced in 2018, constitutes the core of Japan’s criminal justice modernization. These reforms not only transform the way sentences are enforced but also redefine the practical logic of criminal prosecution. The context for these reforms is complex and diverse. On the one hand, Japan faces an aging prison population, with many elderly inmates unable to work, making traditional corporal punishment difficult to enforce. On the other hand, high recidivism rates raise public doubts about the effectiveness of rehabilitation. Furthermore, traditional investigative methods are limited in their effectiveness against highly concealed crimes, such as organized and corporate crime, necessitating new judicial tools. These factors are collectively driving changes in Japan’s criminal justice system. This article aims to comprehensively analyze the core elements of the 2025 revision of Japan’s Sentence Reduction Act, including how it will work in conjunction with the judicial bargaining system, the potential social challenges it will bring, and propose corresponding optimization paths. The research not only helps to understand the direction of Japan’s criminal justice reform but also provides a comparative legal reference for similar reforms in other countries.

Entering the 21st century, the increase in the number of people with dementia emerged as a major social problem due to the nuclear family and aging population. This also affects prisons, which leads to a surge in dementia inmates, and each country's correction policies are responding to this, Similarly, Korea's corrective policy is being affected. External factors affecting the decision-making process of korean correction policy for dementia inmates include recommendations from authoritative bodies, including recommendations from the National Human Rights Commission and the United Nations and Alzheimer's Council. It is necessary to examine the problems of the recommendation rather than to follow the contents of the recommendation from the so-called Bacon's “idolatry of the theater”. Therefore, it is necessary to approach the recommendations from a critical point of view. For example, the recommendations lack a bureaucratic sociological perspective and overlook the role of mental health nurses and correction nurses, which play an important role in the prevention and treatment of correction policy for dementia inmates. Therefore, it is necessary to approach recommendations from a critical point of view. Recommendations are largely lacking in bureaucratic sociological perspectives and overlook the role of mental health nurses and correction nurses in the prevention and treatment of prison dementia inmates. In this paper, after describing the contents of the recommendations of the organizations that can influence the correction policy, the problem was originally criticized from an interdisciplinary point of view.Furthermore, I have made recommendations for these authoritative organizations in correction policy for dementia inmates. The purpose of this study was to describe the appropriate policy for corrective dementia policy, and the research method was a literature review and the approach was an interdisciplinary approach. The focus was on reviewing and criticizing the NHRC's recommendations, which have a significant impact on corrective dementia policies. In conclusion, the direction of the correction dementia policy was suggested, and the key is the establishment of correction dementia-friendly correction nursing regime.

: The death of a person in custody has always been in the limelight. Some people in custody die because of some form of violence, some due to accidents and some because of natural disease. In this study, we have attempted to identify the various causes of death in a person under custody in the Chhattisgarh region. A single-centre, retrospective study was conducted for all cases (n=35) of custodial death between the years 2018 and 2019. Data collected included age, sex, manner of death, place of death and cause of death. Male inmates have a higher rate of custodial deaths. 100 % of male and 90 % of female deaths in custody are natural deaths. The most affected age group was the 51-60-year age group. The hospital was the place of death for 100 % of males and 90 % of females. Tuberculosis and cirrhosis of the liver were among the common causes of death in a person in custody. Deaths in custody in Chhattisgarh are primarily natural deaths. Regular health screening and proper health care facilities for the prisoners are the need of the hour.

In the context of food in state detention centers or correctional institutions, it is regulated based on Law Number 22 of 2022 concerning Corrections regarding Corrections. The health and nutrition of prisoners must be considered in detail by technical implementers in food violations because in Article 9 letter d of Law Number 22 of 2022 concerning Corrections it is stated that prisoners have the right to receive adequate health and food services in accordance with nutritional needs, this must of course be carried out in accordance with the instructions and orders of the law. In this case, the Ministry of Law and Human Rights together with the Ministry of Health are reviewing further the fulfillment of the recommended RDA (Nutritional Adequacy Rate) according to age groups and nutritional requirements as well as for inmates with special needs. The problem raised in this article is how to fulfill prisoners' rights to receive adequate food in accordance with nutritional needs based on Law Number 22 of 2022 concerning Corrections? And, what are the legal consequences if prisoners' rights to receive adequate food according to nutritional needs are not fulfilled based on Law Number 22 of 2022 concerning Corrections? This type of research is empirical legal research. The data source comes from primary data. The results of this research are, First: Fulfillment of prisoners' rights to receive adequate food in accordance with nutritional needs based on Law Number 22 of 2022 concerning Corrections is stated in Article 9 letter d which confirms that prisoners have the right to receive adequate health services and food in accordance with nutritional needs. , this must of course be carried out in accordance with the instructions and orders of the law. Second, the legal consequences if prisoners do not fulfill their right to receive adequate food in accordance with their nutritional needs can be divided into administrative sanctions in the form of a written warning to employees/officials of the Pekanbaru Class II A Penitentiary who are negligent in fulfilling prisoners' rights to receive adequate and nutritious food, temporary dismissal to Employees/Officials of the Pekanbaru Class II A Penitentiary who are negligent in fulfilling prisoners' rights to receive adequate and nutritious food, and intensive supervision by the Indonesian Ministry of Law and Human Rights. As well as the consequences of criminal law, namely law enforcement of Article 2 paragraph (1) of Law Number 31 of 1999 concerning the Eradication of Corruption Crimes, if it is proven that there has been a deliberate budget cut by Class II A Pekanbaru Correctional Employees/Officials in fulfilling the prisoners' right to receive adequate food and nutritious.

Abstract Mr. John is a 60-year-old incarcerated male with advanced stage IV lung cancer that had metastasized. He was admitted to the hospital with significant pain and failure to thrive. Several lines of chemotherapy failed him, and he desired to be at home with his family as he approached the end of life. Unfortunately, he was unable to leave the hospital except to be back to prison. He was continually shackled to bed with 2 police officers in his room. The case highlights the need to advocate for compassionate release, that allows for the early release of terminally ill inmates who are not a danger to society, and offers tools and steps to help release hospitalized inmates to the care of their families. To obtain compassionate release, the first step is to identify eligible inmates with a terminal illness and a life expectancy of less than six months, which must be confirmed by a medical evaluation. The second step involves filing a petition for compassionate release with the appropriate authority, including medical records, a statement from the treating physician, and a plan for the inmate’s release and care in the community. The third step entails advocating for the inmate’s release, which may involve working with advocacy groups, contacting elected officials, and raising public awareness. By granting compassionate release to dying inmates, we can provide them with the opportunity to die with dignity and spend their final moments with their loved ones, which is a fundamental aspect of social justice.

This article examines the various mechanisms by which federal prisoners attempted to avoid death from COVID-19 when the pandemic first appeared in the United States in 2020. The author examines the roles of prison officials and of the federal courts and prosecutors and the difficulty prisoners had in obtaining legal representation, concluding that the compassionate release mechanism allowed too few inmates to protect themselves from the disease. Pronounced regional differences across the United States and the situation of child pornography offenders are also highlighted.

The prison population is aging and health care costs are rising. Compassionate release for the terminally ill and disabled is underutilized, especially in Louisiana, which is the state with the highest incarceration rate. This article evaluates the utilization of community physicians to improve compassionate release rates. Health care providers at a contract hospital for the Louisiana Department of Public Safety and Corrections collaborated with attorneys, the Louisiana Department of Health, and the Louisiana Department of Public Safety and Corrections to facilitate compassionate release for eligible individuals. A retrospective analysis of patients referred for compassionate release between August 01, 2022 and December 31, 2023 was completed. Outcomes included release rates and underlying conditions. During this time, 18 patients were eligible; most were 56 to 75 years of age, consistent with national trends. Of the 18 eligible patients, four were released, eight died while incarcerated, and six remained incarcerated. This retrospective review shows that a coordinated, multidisciplinary approach can have a significant impact.

Abstract The COVID-19 pandemic has posed a significant health threat to people in corrections facilities due to communal living, inability to social distance, and high rates of comorbidity among incarcerated populations. Combined with the First Step Act of 2018, which granted incarcerated individuals seeking compassionate release access to the courts, the pandemic increased the number of people in federal prisons petitioning for early release due to health risk. Analysis of federal compassionate release case law throughout the pandemic reveals inconsistent judicial reasoning related to COVID-19-based requests. Inconsistently interpreted compassionate release factors include vaccination status, COVID-19 reinfection, and the “degree” of extraordinary circumstances considered. Varied application among federal districts produced inequitable access to compassionate release. Therefore, this analysis provides insight into how an unclear policy can create disparate public health outcomes and considerations for compassionate release determinations in future times of uncertainty, such as a pandemic.

As incarcerated individuals age, prison systems often struggle to provide appropriate long-term care. Compassionate release policies can address this gap by allowing seriously ill or aging individuals to transition to community-based care. Many nursing homes, however, are reluctant to admit individuals recently released from prison. This study examined how incarceration status affects nursing home admission decisions. Using a statewide secret shopper methodology, researchers contacted all 74 licensed nursing homes in Rhode Island. Callers first inquired about bed availability for a standardized model patient, then disclosed the patient would be arriving from prison under compassionate release. Responses before and after disclosure were categorized and analyzed using ordinal regression. Of 74 facilities, 61 (82.4%) were reached. Before disclosure, 52.5% reported bed availability within one month; this dropped to 26.2% after incarceration was mentioned. Complete rejections increased from 9.8 to 44.3%. Facilities were 3.41 times more likely to downgrade admission status after disclosure (OR = 3.41; 95% CI: 1.76–6.70; p < 0.001). For patients with serious criminal offenses, the rejection rate reached 70.5%, and the odds of rejection increased to 11.39 (95% CI: 5.48–24.65; p < 0.0001). Facility size was not associated with rejection likelihood. Incarceration and criminal history significantly reduce access to nursing home care, even when medical need and payment ability are constant. These findings highlight the need for policy and system-level interventions to reduce stigma and increase care access for aging individuals eligible for compassionate release.

Compassionate release has long been an evolving legal issue in the United States. This evolution is particularly salient today as federal courts struggle to decide whether non-retroactive changes in sentencing laws qualify as extraordinary and compelling reasons for a sentence reduction. This Note explores the development of compassionate release through the Sentencing Reform Act, the First Step Act of 2018, and the resulting surge in motions for compassionate release, especially in response to the COVID-19 pandemic. Additionally, this Note argues that non-retroactive changes in sentencing laws should be considered when deciding whether a defendant’s circumstances meet the threshold for extraordinary and compelling reasons to reduce a sentence. Excluding such changes from consideration perpetuates inequities in the criminal justice system, particularly for individuals sentenced under laws that have since been reformed. Failure to recognize the impact of non-retroactive law changes also undermines the legitimacy of the U.S. Sentencing Commission and the integrity of compassionate release as a tool for justice.

This Viewpoint proposes reform of the medical parole system, suggesting compassionate release applications of terminally ill incarcerated individuals be reviewed by an external medical board.

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An increase in the number of older people incarcerated in prisons has given rise to increased costs of correctional health care. Despite the many benefits of compassionate release, it is rarely used. Citing barriers at the micro, mezzo, and macro levels, we contend that social workers are uniquely suited to increase the number of people released through this mechanism owing to a unique knowledge and skill set. We offer eight specific strategies for how social workers can increase the use of compassionate release by working with individuals, conducting and disseminating research, and engaging in advocacy as shaped by core professional principles and values and related curricula.

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Purpose The purpose of this paper is to provide a historical overview of compassionate release policies in the USA and describe how these policies have been used during the COVID-19 pandemic. The authors then describe how these programs have been shaped by COVID-19 and could be reimagined to address the structural conditions that make prisons potentially life limiting for older adults and those with chronic illness. Design/methodology/approach This paper is primarily descriptive, offering an overview of the history of compassionate release policies before and during the COVID-19 pandemic. The authors augmented this description by surveying state Departments of Corrections about their utilization of compassionate release during 2019 and 2020. The findings from this survey were combined with data collected via Freedom of Information Act Requests sent to state Departments of Corrections about the same topic. Findings The findings demonstrate that while the US federal prison system saw a multifold increase in the number of individuals released under compassionate release policies in 2020 compared to 2019, most US states had modest change, with many states maintaining the same number, or even fewer, releases in 2020 compared with 2019. Originality/value This paper provides both new data and new insight into compassionate release utilization during the COVID-19 pandemic and offers new possibilities for how compassionate release might be considered in the future.

PURPOSE Compassionate release is a process that allows for the early release or parole of some incarcerated people of advanced age, with life-limiting illness, complex medical care needs or significant functional decline. Despite the expansion of State and Federal compassionate release programs, this mechanism for release remains underutilized. Health-care professionals are central to the process of recommending compassionate release, but few resources exist to support these efforts. The purpose of this paper is to provide a guide for health-care professionals requesting compassionate release for patients who are incarcerated. DESIGN/METHODOLOGY/APPROACH This study is stepwise guide for health-care professionals requesting compassionate release for patients who are incarcerated. FINDINGS This study describes the role of the health-care professional in requesting compassionate release and offers guidance to help them navigate the process of preparing a medical declaration or request for compassionate release. ORIGINALITY/VALUE No prior publications have created a step-wise guide of this nature to aid health-care professionals through the compassionate release process.

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Abstract As the U.S. carceral system faces an unprecedented aging crisis, policies such as compassionate release, geriatric parole, and end-of-life care have emerged as critical yet underutilized mechanisms. This symposium explores how these policies profoundly influence the experiences of aging incarcerated individuals and those navigating reentry. Presentations will examine the systemic barriers to geriatric release and reentry, the ethical complexities of medical decision-making for incapacitated older adults in prison, and the privatization of prison hospice care. Additionally, this session will explore social vulnerability post-incarceration, analyzing how aging individuals experience social networks, social integration, and loneliness after release. By incorporating policy analysis, legal archival research, and a review of existing geriatric parole programs, this session highlights the urgent need for reform, advocacy, and interdisciplinary collaboration to address the health and social inequities faced by older adults in the carceral system.

This policy analysis examines whether compassionate release statutes in the Southwestern United States reflect neuropsychological standards of care for incarcerated individuals experiencing cognitive decline. With increasing rates of dementia and related conditions among aging prison populations, alignment with best practices from the American Psychological Association (APA), American Medical Association (AMA), and National Institute on Aging (NIA) was evaluated. Correctional policies from eight states (Arizona, California, Colorado, Nevada, New Mexico, Oklahoma, Texas, and Utah) were reviewed using a structured classification rubric grounded in national clinical and ethical guidelines. Policies were assessed across domains including eligibility criteria, procedural clarity, consideration of mental and cognitive health, and alignment with evidence-based screening practices. Independent raters applied the rubric to classify each state’s approach as Progressive, In-Between, or Restrictive. Interrater reliability calculations are currently in progress. California, Colorado, and Texas were classified as Progressive, with statutes that define eligibility criteria, include provisions for medical or mental health conditions, and outline structured application processes. Nevada, Oklahoma, and Utah were categorized as In-Between due to vague definitions or inconsistent implementation. Arizona and New Mexico were classified as Restrictive, lacking formal compassionate release statutes and relying instead on commutation or temporary leave mechanisms. Cognitive impairment and dementia were rarely named explicitly as qualifying conditions, and none of the policies required routine cognitive screening. Most Southwestern state policies do not meet established neuropsychological standards of care. Reforms are needed to incorporate cognitive screening protocols, capacity evaluations, and dementia-specific eligibility criteria to ensure ethical, clinically appropriate release practices.

One of the protective measures prescribed by public health officials to contain the spread of the highly contagious Corona virus was social distancing. And implementing such social distancing measures was even more challenging in prisons. The prisons around the world had been a thriving breeding ground for Covid-19. The prisoners, whose right to health, sanitation, and other human rights are often overlooked during the usual times, were at a heightened risk from Covid-19 outbreaks. Disregarding the safety of the prisons during the pandemic resulted in human rights violations and also significantly impaired the overall containment plans. Courts worldwide resorted to the mass release of inmates either on bail, early release due to shortened sentences, or opting for house arrest/detention to reduce the prison population to allow proper prison administration during the pandemic. Therefore, it is imperative to analyze the policy of inmates' early and mass release during the Covid-19 pandemic as a solution to containing Covid-19 transmission in the prisons and look into how such policy may help in the future in combating public health emergencies. A special emphasis will be given on the measures taken in the prisons of Bangladesh.

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Legal protection of hospitals and health workers in carrying out medical acts in the service of prisoners, among others, the legal foundations that provide legal protection to doctors in the exercise of their profession and dealing with the law due to allegations of malpractice contained in Article 50 of Law No. 29 of 2004 on medical practice and Article 27 paragraph (1) of Law No. 36 of 2009 on health. And receive protection in implementing health care in Article 45 of the Hospital Act, Paragraph (2), and Article 8 of Law No. 36 of 2009 on health. The legal form for patients of prisoners who damage health facilities includes: the types of sanctions applied to prisoners and prisoners who violate the rules and damage health facilities or damage public facilities are as follows: a) there is a warning or reprimand for prisoners who make a light mess. b) put him in a solitary confinement cell of a convict of violation of the heavy category. C) the loss of the granting of remission or parole to the offending prisoner. And face legal sanctions following Article 406 of the Criminal Code and Article 521 of Law 1/2023.  

This research paper conducts a comparative analysis of prisoner health rights under Pakistan's colonial-era prison laws and contemporary international human rights instruments. The study examines the Pakistan Prisons Act 1894 and the Pakistan Prison Rules 1978, tracing their origins to British colonial policies that considered inmates primarily as economic assets and sources of labor rather than individuals entitled to dignity and healthcare. Through a detailed doctrinal analysis of specific provisions, the paper demonstrates how these laws relegate medical officers to subordinate administrative roles, enforce archaic health assessments based on body weight and labor capacity, and provide mechanical rather than ethical healthcare protocols. These provisions are critically evaluated against the United Nations Nelson Mandela Rules 2015, the United Kingdom Prison Rules 1999, the European Prison Rules 2006, and correctional legislation from New Zealand and South Africa. The comparative framework reveals fundamental philosophical differences: while international instruments mandate the equivalence of care, clinical independence for medical officers, strict confidentiality, and comprehensive health assessments, Pakistan's framework perpetuates a custodial, labor-oriented approach. Ultimately, the paper argues that this system retains a colonial legacy of exploitation, denying prisoners fundamental health rights, and concludes with recommendations for legislative reforms aligned with modern human rights standards.

Although the poor health of prisoners poses a serious public health problem, very little is known about the health of specific offender groups. Three waves of an Australian Inmate Health Survey were used to describe the self-reported and objectively tested health of men incarcerated for sexual offences against children only (ISOC), adults only (ISOA), and against both (age-polymorphous; ISOP) compared to men incarcerated without sexual offences. ISOC and ISOP were found to have the poorest self-reported health of all groups, with higher rates of eyesight and cardiovascular problems; however, lower rates of Hepatitis B and Hepatitis C as objectively measured. There are important implications for the correctional and public health systems for addressing the health needs of specific offenders.

India is a nation with the second highest population in the world with a moderate crime rate, thus naturally, overcrowding in prisons in India has been a prevalent issue since long back. Overcrowding in prison is the result of the slow pace of the judiciary in conducting the criminal procedures. It is evident by the fact that the number of under trial prisoners is more than the number of convicted prisoners. In such a scenario it is of massive importance that the rights of the all prisoners are adequately protected. However, in reality, it is far from being the case. The authors have studied and analysed the prominent issues that arise from a lack of competent ground staff and poor infrastructure within prisons, such as poor mental and physical health among prisoners, corruption among prison officials, and arbitrary activities inside prisons across India. The authors have shown in this paper that how poor infrastructure in prison leads to unnatural deaths in prisons, by analysing the statistics provided by the NCRB. After a thorough analysis of the current scenario of prisons in India, the authors have studied the respective current circumstance in reference to international and UN conventions, as well as human rights. We conducted an in-depth psychological research of the inmates' conditions in the prison, as well as the psychological adversities caused by overcrowding, familial deprivation, dread of the unknown, and isolation.

During the first year of the COVID-19 pandemic, governments around the world granted early release to an estimated one million prisoners. While mass prisoner releases are not a new phenomenon — throughout history, governments have freed people in response to health crises, during holidays, or to mark political transitions — the scale, scope and speed of releases during the pandemic were unprecedented. This paper analyzes pandemic prisoner releases, drawing upon qualitative and quantitative data from governments, the United Nations, civil society and legal organizations, and the media.

The purpose of this study is to find out more about how to utilize the assimilation of prisoners in the midst of the Covid-19 pandemic.  The research method used is normative legal research using a statutory approach. The results of the research in this study are that the assimilation of prisoners in the midst of the Covid-19 pandemic is a step by the government in this case the Minister of Law and Human Rights in an effort to prevent the spread of the covid-19 virus in prisons en masse. In addition, it provides utility for prisoners and the government in terms of comfort and security in LAPAS due to the reduction in occupant capacity from 99% overcapacity to 79% so that there are also budget savings from the state in terms of care and health more specifically food ingredients for prisoners.

In custodial contexts, the duty of states to protect the most fundamental right – to life – is heightened. Nevertheless, prisoner deaths are a universal and frequent concern. The mortality rate among the 11.5 million prisoners globally is up to 50% higher than amongst non-imprisoned persons, forming a human rights and health equity concern. It is therefore peculiar that prisoner deaths have attracted only piecemeal scholarly attention. In this article, we problematize epistemologies of prisoner death, highlighting obfuscations and agglomerations in existing datasets based on poor definitions, reductive statistics and constrained medico-legal categorizations. We provide a springboard towards a new epistemological approach that makes the scale and breadth of prisoner deaths and deceased prisoner characteristics more visible to facilitate prevention. We advance three tenets: count prisoners who die rather than deaths in prison, disaggregate prisoner death data through rights-informed dimensions and adopt explicitly defined, mutually exclusive categorizations.

The older incarcerated adult is a vulnerable and overlooked demographic within the U.S. healthcare system, facing high mortality rates due to chronic conditions and age-related issues such as cognitive decline, mobility impairments, and sensory deficits. The National Commission on Correctional Health Care's (NCCHC) position statement on "Care for Aging Patients in the Correctional Setting" is a pivotal step in addressing healthcare gaps for this population. In this article, we underscore the urgent need for a holistic, age-appropriate care model in correctional settings to ensure equitable care. Aging while incarcerated accelerates physical and psychological decline, with research suggesting each year in prison reduces life expectancy by two years. The correctional environment exacerbates this process, making individuals appear older than their non-incarcerated counterparts. The lack of age-appropriate healthcare, coupled with pre-incarceration health disparities, highlights the need for targeted interventions. The NCCHC's recommendations for comprehensive assessments, early identification of cognitive decline, and preventive measures are vital for improving outcomes and reducing healthcare costs. Equity and personalized care for the aging incarcerated population are essential, emphasizing the ethical need to restore dignity and autonomy. This requires patient-centered care, respecting treatment preferences, and aligning end-of-life care with individual wishes. Environmental modifications to enhance mobility, prevent injuries, and standardized health screenings at intake are also crucial for proactive care. In conclusion, the NCCHC's recommendations offer a framework to address the healthcare needs of older incarcerated adults, but implementation requires systemic changes, adequate funding, and a trained workforce in geriatric and correctional health.

In 2011, a historic Supreme Court decision mandated that the state of California substantially reduce its prison population to alleviate overcrowding, which was deemed so severe as to preclude the provision of adequate healthcare. To comply, California passed the Public Safety Realignment Act (Assembly Bill [AB] 109), representing the largest ever court-ordered reduction of a prison population in U.S. history. AB109 was successful in reducing the state prison population; however, although the policy was precipitated by inadequate healthcare in state prisons, no studies have examined its effects on prisoner health. As other states grapple with overcrowded prisons and look to California’s experience with this landmark policy, understanding how it may have impacted prisoner health is critical. We sought to evaluate the effects of AB109 on prison mortality and assess the extent to which policy-induced changes in the age distribution of prisoners may have contributed to these effects. To do so, we used prison mortality data from the Bureau of Justice Statistics and the California Deaths in Custody reporting program and prison population data from the National Corrections Reporting Program to examine changes in overall prison mortality, the age distribution of prisoners, and age-adjusted prison mortality in California relative to other states before and after the implementation of AB109. Following AB109, California prisons experienced an increase in overall mortality relative to other states that attenuated within three years. Over the same period, California experienced a greater upward shift in the age distribution of its prisoners relative to other states, suggesting that the state’s increase in overall mortality may have been driven by this change in age distribution. Indeed, when accounting for this differential change in age distribution, mortality among California prisoners exhibited a greater reduction relative to other states in the third year after implementation. As other states seek to reduce their prison populations to address overcrowding, assessments of California’s experience with AB109 should consider this potential improvement in age-adjusted mortality.

The fulfillment of convicts’ rights in various aspects, particularly in terms of healthcare services, is still not optimal. This article aimed to identify the actualization of hifdz al-Nafdz's theories in granting prisoner’s rights to healthcare through an approach to the philosophical values of Islamic punishment and national law. Field research is research that raises data and problems in the field (research location). The sources of data obtained were primary and secondary data. This study employed qualitative research using a normative approach. The results of the study showed that textually, the implementation aligned with the hifdz al-Nafdz' mission in Maqashid Sharia. However, empirically, the implementation of hifdz al-Nafdz' in terms of health services has not shown perfect evidence. Islam placed great importance on the benefit aspect. Currently, the detention center accommodates 222 occupants, exceeding its maximum capacity of 100 occupants. Thus, the government should consider expanding the land area of detention centers and establishing polyclinics with additional healthcare personnel. Furthermore, appropriate treatment for detainees is necessary. Regarding law enforcement, the government has implemented regulations to ensure a balanced legal process and prevent any imbalances.  

A prisoner is recognized as an individual who is deprived of liberty, arbitrary possessions and free movement, but the prison doesn’t prevent the prisoner to reach the basic rights including the health and treatment rights. If the health and treatment rights of prisoners are not observed during their imprisonment period, it is considered as a concern while this right has been proved by testimony of verses, Hadiths and verdicts of jurists in Islamic Sharia and practical experiences of Muslims in history of prisons. The current research is to analyze and prove rights to health, preclusion and treatment of prisoners from the Islamic Sharia point of view which is done with a descriptive-analytical method by collecting library and documentary information. The obvious result of this research is getting to rights of health care, personal health, environmental health, nutritional and mental health of prisoners. Also, it includes the rights of treatment, delay in punishment and commutation of a prisoner due to illness. Proof of the rights means to ensure justice in implication of punishments on prisoners.

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Abstract Criminal justice-involved older adults have high rates of early onset disease and disability and they experience significant health disparities. Yet, research focused on this population and the consequences of criminal justice involvement on health in later life is deeply under-developed. In response, the Aging Research in Criminal Justice Health Network was established in 2019 and we are excited to celebrate its achievements! We will discuss the process of building this network and how the ARCH Network has made significant strides in promoting the importance of considering geriatric conditions (e.g., functional and cognitive impairment, falls, polypharmacy) when evaluating the health of justice-involved older adults. We will also highlight accomplishments including the significant number of publications championed by the ARCH Network and the successful creation of a GSA Interest Group devoted to Incarceration and Aging.

Abstract Introduction to the Problem: Elderly prisoners face significant challenges in accessing adequate healthcare within correctional institutions. Limited facilities, lack of trained personnel, and ineffective implementation of health policies contribute to disparities in healthcare services, affecting their physical and mental well-being. Purpose/Study Objectives: This study aims to explore the urgency of fulfilling the health rights of elderly prisoners, identifying barriers to healthcare access and proposing systemic improvements to enhance their well-being. Design/Methodology/Approach: The research employs a qualitative approach, collecting data through in-depth interviews with 15 elderly prisoners and 10 prison officers, as well as conducting observations on prison health conditions. Findings: The study highlights several key issues, including inadequate healthcare facilities, insufficient medical resources, and a lack of proper training for prison officers. Additionally, existing health policies in prisons are not effectively implemented, leading to disparities in healthcare access. The research emphasizes the need for systemic improvements, such as officer training and policy reinforcement, to ensure better healthcare for elderly prisoners. Paper Type: This is an empirical research study based on qualitative analysis.

The study focused on examining the relationship between prison health care service provision and protection of inmate rights using the case of Monrovia Central Prison in Liberia. The study investigates how access to medical care, the treatment of diseases, and the availability of health information for prisoners influence the realization of inmates' fundamental health rights. Simple random sampling was used for the selection of the 150 inmates for the study, while purposive sampling was used to determine the 28 key informants who constituted the qualitative sample. Quantitative data analysis was based on 127 questionnaires that were complete / retrieved for the study. The findings revealed an overall low satisfaction with prison health care services, with mean scores falling within the "disagree" range on key indicators such as access to medical care (mean = 2.48), ongoing treatment (mean = 2.46), and access to health information (mean = 2.42). Respondents also expressed significant dissatisfaction with the extent to which healthcare provision upholds inmates' rights (mean = 1.89). Qualitative interviews echoed these findings, highlighting concerns such as delays in treatment, limited availability of medication, and inadequate communication about health conditions. Despite these concerns, a statistically significant and moderately strong positive correlation (r = 0.60, p < 0.01) was found between the quality of health care services and the protection of inmate rights. Regression analysis further confirmed this relationship, showing that improvements in health care provision positively predict increased rights protection (β = 0.439, p = 0.000). These findings suggest that strengthening prison health systems is critical to advancing the health rights and overall dignity of incarcerated individuals. Based on the findings, the study recommends that the prison administration enhance healthcare services by improving access to medical care, strengthening illness prevention strategies, and ensuring inmates are adequately informed about their health status. The implementation of routine health examinations and timely medical interventions is essential for safeguarding inmates' health rights.

This study analyzes the protection of the social right to health for the prison population during the management of the health crisis caused by the new coronavirus in the Brazilian state of Goiás. To address this issue, both the structural problems in the provision of fundamental health guarantees for inmates in Brazil and the development of the COVID-19 health crisis in the prison units of Goiás are examined. The study is qualitative in nature and is based on a bibliographic and documentary review, prioritizing as sources the public regulations issued by the Government of the State of Goiás and the General Directorate of the Penitentiary System during the period from March 2020 to March 2021. The findings show that, in the analyzed temporal and spatial context, the state government did not effectively guarantee the social right to health for prisoners. This finding results in a severe detriment to the protection of human rights, exceeds the scope of ius puniendi, and constitutes an abuse of the state's punitive power, thus amounting to a flagrant unconstitutional state of affairs that must be addressed both during the pandemic and after the health emergency has ended.

Despite falling crime rates in England and Wales over the past 20 years, the number of prisoners has doubled. People over the age of 50 constitute the fastest growing section of the prison population, and increasing numbers of older prisoners are dying in custody. This article discusses some of the issues raised by these changing demographics and draws on preliminary findings from a study underway in North West England. It describes the context behind the rise in the numbers of older prisoners; explores the particular needs of this growing population; and discusses some of the practical and emotional challenges for prison officers, health care staff, and fellow prisoners who are involved in caring for dying prisoners in a custodial environment.

The Maryland Division of Correction houses 24,000 inmates in 27 geographically disparate facilities. The inmate population increasingly includes a frail, elderly component, as well as many inmates with chronic or progressive diseases. The Division houses about 900 human immunodeficiency virus (HIV)-positive detainees, almost one quarter with an acquired immune deficiency syndrome (AIDS) diagnosis. A Ryan White Special Project of National Significance (SPNS) grant and the interest of a community hospice helped transform prison hospice from idea to reality. One site is operational and a second site is due to open in the future. Both facilities serve only male inmates, who comprise more than 95% of Maryland's incarcerated. "Medical parole" is still the preferred course for terminally ill inmates; a number have been sent to various local community inpatient hospices or released to the care of their families. There will always be some who cannot be medically paroled, for whom hospice is appropriate. Maryland's prison hospice program requires a prognosis of 6 months or less to live, a do-not-resuscitate (DNR) order and patient consent. At times, the latter two of these have been problematic. Maintaining the best balance between security requirements and hospice services to dying inmates takes continual communication, coordination and cooperation. Significant complications in some areas remain: visitation to dying inmates by family and fellow prisoners; meeting special dietary requirements; what role, if any, will be played by inmate volunteers. Hospice in Maryland's Division of Correction is a work in progress.

Ensuring adequate end-of-life care for prisoners is a critical issue. In France, data investigating the impact of laws allowing release of seriously ill prisoners are lacking. To assess the number and characteristics of prisoners requiring palliative care in French prisons. A prospective, national survey collecting data over a 3-month period. All healthcare units ( n = 190) providing care for prisoners in France. The prison population was 66,698 during the study period. Data collection concerned prisoners requiring end-of-life care, that is, with serious, advanced, progressive, or terminal illness and life expectancy <1 year. Estimated annual prevalence of ill prisoners requiring end-of-life care was 15.2 (confidence interval: 12.5-18.3) per 10,000 prisoners. The observed number of prisoners requiring palliative care ( n = 50) was twice as high as the expected age- and sex-standardized number based on the general population and similar to the expected number among persons 10 years older in the free community. In all, 41 of 44 (93%) of identified ill prisoners were eligible for temporary or permanent compassionate release, according to their practitioner. Only 33 of 48 (68%) of ill prisoners requested suspension or reduction in their sentence on medical grounds; half (16/33) received a positive answer. The proportion of prisoners requiring palliative care is higher than expected in the general population. The general frailty and co-existing conditions of prisoners before incarceration and the acceleration of these phenomena in prison could explain this increase in end-of-life situations among prisoners.

This article describes key findings from a UK/U.S. prison health researcher exchange in September 2023. The aims were to increase familiarity with the research context and to observe the roles of peer caregivers in U.S. prison settings. The researchers identified several differences and similarities in peer caregiving between UK and U.S. sites and detail six recommendations related to policy and practice concerning both sides of the Atlantic. It is believed that the adoption of such recommendations will contribute to improved care and, thereby, the health and well-being of vulnerable people incarcerated in prison.

French prisons are experiencing the same phenomenon observed across western societies, that of an ageing population. In addition to the structural inability of prisons to deal with inmates' loss of autonomy, it is the very sense in keeping highly vulnerable and dependent people behind bars which should be questioned.

Increasing numbers of people require palliative end-of-life care (PEOLC) within prison settings, mainly because of aging populations and increasingly long sentences. There is limited research in this area, but evidence suggests that prisons possess limited resources to provide adequate care for aging and frail people at the end of life. This study aimed to explore how PEOLC is provided in prisons in different countries and identify factors that facilitate or impede its provision. A cross-sectional qualitative study using semistructured interviews was utilized to interview prison and health care staff involved in the organization and/or delivery of PEOLC to incarcerated adults in six countries. Sampling was purposive and adopted a snowball technique. Data were analyzed using framework analysis. This study provides evidence that numerous barriers exist that can impede the organization and delivery of PEOLC to people in prison, including barriers at the individual, staff, organization, and regulatory levels. Facilitators coexisted alongside the barriers. Similar barriers and facilitators were identified in each country. Despite some good practices, multiple challenges remain in providing the same quality of PEOLC that is available outside prison, and thus, those dying in prison continue to be disadvantaged.

There is evidence of an increasing emphasis on the relevance of the quality of life-paradigm as an outcome measure for clients in geriatric, forensic, as well as correctional care. This paper aims to explore to what extent variables that were categorized according to the main areas of the Good Lives Model ('the self', 'the body' and 'social life') are related to the quality of life domains of older imprisoned offenders. Data were collected by means of a structured questionnaire administered in individual interviews with 93 older prisoners aged 60 years and over in 16 prisons of the Dutch-speaking region in Belgium. Characteristics of the main GLM-areas were identified by specifically designed items as well three validated instruments (psychiatric disorders, loneliness, and frailty). Dependent variables consisted of the four sub-domains of the WHOQOL-BREF instrument which measures quality of life in four domains, namely: (1) physical health, (2) psychological health, (3) social relationships, and (4) environment. Structural equation modelling (SEM) was used for statistical analysis. Individual variables, such as satisfaction with activities, were related to the older prisoners' QoL in several domains simultaneously. Other than suicidal ideation, psychopathological symptoms had no significant relation to quality of life. Approaches enabling older prisoner to disclose their interests, experiences, and feelings are important in prison. Special attention should be given to psychiatric and age-related symptoms of older prisoners, since they may not be noted by the prison staff, as older prisoners seem to be poorer self-advocates as compared to their younger peers.

Although elderly inmates form a small minority in the U.S. prison population (6.6%), this number is expected to increase by 2005. Elderly prisoners consist of first-time offenders, habitual offenders, and those who have "aged in place" (received very long sentences at a young age). Violence is an identified stressor affecting the elderly prisoner. This enduring stressor can add to physical deterioration, particularly in the inmate with chronic illness. Violence in prison falls into three categories: prisoner-prisoner, staff-prisoner, or prisoner-staff (Clear & Cole, 1994). Prisoner-prisoner incidents account for the majority of violence within prison systems. The convict in today's prison will use extremes of violence to combat threats to his or her reputation or self-concept of "machismo," or if the inmate feels "disrespected." The aging prisoner may have chronic, pervasive stress levels disguised under a tough veneer, although he or she may no longer be strong enough physically or emotionally to fend off potential attackers. Interventions with elderly prisoners include thorough physical and cognitive assessment, including signs and symptoms of depression or stress related to environmental disturbances. Educational training for correctional staff about age-specific developmental changes is necessary. Building partnerships with community, state, and national organizations can assist elderly inmates in their adjustment to prison and foster successful community release programs. Special care units may be considered for frail elderly inmates or those with chronic health problems.

Maintaining autonomy, an issue in the care of elderly prisoners. The ageing of the prison population means healthcare workers in prisons are having to care for inmates who are losing their autonomy. To guarantee the right to dignity, caregivers must adapt their practices and their organisation.

As the average lifespan increases, it becomes increasingly likely that elders will be involved in the justice system. Elders may be witnesses, victims, plaintiffs, or defendants in a trial. They are also prisoners and, in some cases, death row inmates. Because there are special needs and costs associated with elders, it is important to consider how they are treated in each of these areas of the justice system. For instance, jurors may have age biases; some prisons are unable to address elders' health problems; and critics have questioned the constitutionality of executing frail elders. In order to determine whether the court system is treating elders fairly, this analysis reviews current policies, research, and anecdotal evidence from recent high-profile cases. Recommendations for future research and policy changes are offered to ensure that elders are treated fairly in the justice system.

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The arrival of an elderly person in a remand centre reveals the extent to which the prison system is ill-equipped to deal with this type of detainee. The cooperation between the prison, nursing and social care teams however compensates for the many difficulties his case presents.

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Due to the growing number of ageing prisoners in the American correctional system, penal institutions are increasingly caring for patients with chronic and potentially terminal medical conditions. To address this problem states have attempted sentencing reform initiatives and adopted compassionate release programmes; however, these efforts have failed to significantly reduce the number of elderly or seriously ill inmates. Correctional mental health services are now called upon to aid in the care of prisoners at the end of life. This article presents the common elements of prison hospice programmes and the role psychiatry plays in this multidisciplinary effort. The right-to-die movement holds future implications for correctional mental health professionals. The historical and legal background of this international movement is presented with particular attention given to landmark cases and statutes protecting institutionalized patients.

Large and increasing numbers of inmates with chronic and terminal illnesses are serving time, and dying, in U.S. prisons. The restriction of men and women to die in prisons has many ethical and fiscal concerns, as it deprives incarcerated persons of their autonomy and requires comprehensive and costly health-care services. To ameliorate these concerns, compassionate release policies, which allow inmates the ability to die in their own communities, have been adopted in federal and state prison systems. However, little is known about the content of compassionate release policies within U.S. states' department of corrections, despite recent calls to release incarcerated persons who meet eligibility criteria into the community. The current study provides an overview of compassionate release policies in the United States, which vary widely across the compassionate release process. Specific policy recommendations are made to assure the timely access and utilization of compassionate release among eligible incarcerated individuals.

Every year in France 100 inmates die in prison from illness, but their experiences with end of life (EOL) have not been investigated to date. The purpose of this article is to highlight the realities regarding inmates at the end of life, putting into perspective the viewpoints of the sick prisoners with those of the health and correctional professionals accompanying them. Based on qualitative research, the challenge is to identify potential barriers to palliative care for inmates in order to consider possible improvements. The study results reveal that EOL inmates were not fully considered as patients and did not benefit from a comprehensive palliative care approach. For most dying inmates, and according to many health professionals, compassionate release on medical grounds remains the best approach to deal with EOL issues.

A rapidly aging correctional population has led to an increasing number of patients with serious progressive and terminal illnesses in correctional settings. "Compassionate release" describes a range of policies offering early release or parole to incarcerated patients with serious or debilitating illnesses. However, in many states that have compassionate release policies, few patients are actually granted release. We describe how the continued incarceration of patients with serious or debilitating illness can constitute a violation of human dignity if appropriate palliative care is unavailable. We argue that, given the importance in medical ethics of upholding dignity, physicians should advocate for the appropriate application and use of compassionate release. We describe several opportunities for physicians to take leadership on this issue.

Several States have instituted compassionate release programs to allow terminally ill inmates to be released early. The programs are politically sensitive, and the California program is highlighted. Early release, called recall of sentence under the State penal code, is a lengthy and cumbersome process that has resulted in early release of nearly 100 prisoners in the past 5 years. Guidelines for community activists who are trying to establish similar programs are provided. The guidelines include contact and discussion with prisoners, outside support through influential organizations, support of State legislators and policy makers, and media involvement in building support for the initiative.

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The COVID-19 pandemic has reshaped health care delivery for all patients but has distinctly affected the most marginalized people in society. Incarcerated patients are both more likely to be infected and more likely to die from COVID-19. There is a paucity of guidance for the care of incarcerated patients hospitalized with COVID-19. This article will discuss how patient privacy, adequate communication, and advance care planning are rights that incarcerated patients may not experience during this pandemic. We highlight the role of compassionate release and note how COVID-19 may affect this prospect. A number of pragmatic recommendations are made to attenuate the discrepancy in hospital care experienced by those admitted from prisons and jails. Physicians must be familiar with the relevant hospital policies, be prepared to adapt their practices in order to overcome barriers to care, such as continuous shackling, and advocate to change these policies when they conflict with patient care. Stigma, isolation, and concerns over staff safety are shared experiences for COVID-19 and incarcerated patients, but incarcerated patients have been experiencing this treatment long before the current pandemic. It is crucial that the internist demand the equitable care that we seek for all our patients.

Author notes that the New York State compassionate release program, which permits the early release of dying inmates, has been ineffective due to both flaws in the statutory scheme and the program's implementation. He suggests changes to broaden the program without increasing risks to society.

The Canadian federal prison population is increasingly aging within institutions that were never intended or designed to meet the complex medical and mental health needs of older incarcerated persons. Increasing numbers of incarcerated persons are "aging in place," and many are dying within federal correctional institutions. Persons convicted of sexual offenses comprise a large-and growing-proportion of this aging population. The Correctional Investigator Canada has recently called for an expansion of access to compassionate release for the aging federal prison population, yet little progress has been made. In this article, we explore the significant challenges faced by the aging population in federal institutions, including insufficient access to appropriate care, challenges in application for compassionate release, and how questions of risk may affect the potential for community transfer. Questions of risk overshadow decisions on early release of incarcerated persons, especially those convicted of sexual offenses. Nurses play a central role in the provision of care to aging incarcerated persons and in advocacy for better access to services when a patient's needs cannot be met within the institution. This article presents a call to action for forensic nurses in Canada (and beyond) to advocate for both improved services within federal correctional institutions and for expedited access to compassionate release of aging incarcerated persons, especially those nearing end of life. The significant disparity in access to health care for aging incarcerated persons compared with their nonincarcerated counterparts represents a significant concern.

The diagnosis, management, and prevention of HIV infection in incarcerated populations were among the topics examined at the 21st National Conference on Correctional Health Care, held in San Antonio in November. The presence of HIV/AIDS in the prison system is examined in terms of barriers to prevention strategies, uses of compassionate release programs for terminally ill prisoners, and the accessibility and cost of treatment regimens for prisoners. Findings from two studies, one Canadian and the other from the Ninth National Survey of HIV/AIDS, STDs, and TB in Correctional Facilities, are presented. The Canadian study reveals that the prevalence of HIV/AIDS within the Canadian prison population was 2 percent in the general inmate population, 9 percent among inmates who were injection drug users (IDUs), and 14 percent among IDUs that shared needles. The American study shows an HIV-seropositivity rate in prisons four times greater than in the U.S. population, and the number of inmates living with AIDS is six times that in the total U.S. population. The current prevalence of HIV/AIDS among United States and Federal prison inmates is summarized in a table. Housing and segregation policies regarding HIV/AIDS inmates in U.S. prisons have decreased, although most correctional systems offer some discharge planning services. As of 1996, nearly all prison systems had policies that provide for HIV therapies; however, only 80 percent allow for viral load monitoring. The inmate population and the public at large are best served by a system in which the coordinated efforts of public health and correctional systems develop policies and programs to prevent HIV from spreading and help those who are infected.

Governor Pete Wilson of California vetoed six of ten HIV-related bills approved by the Democrat-led legislature. A plan to encourage people living with AIDS to return to work and a bill to demonstrate the cost-effectiveness of public health care provision for HIV-positive patients whose disease has not progressed to AIDS were among those rejected by Governor Wilson. The governor did approve Assembly Bill 29, granting early prison release to terminally ill inmates who apply through the courts. Assembly Bill 489, allowing people with terminal illness the opportunity to viaticate their group life insurance policies, was also approved. Under the terms of the bill, a person with AIDS could make an absolute assignment for the value of the insurance policy. Senate Bill 1262 allows insurers to use any testing method approved by the Food and Drug Administration (FDA) to screen applicants for HIV. Assembly Bill 441 regulates the screening of sperm donors for infectious diseases, including hepatitis B, hepatitis C, and syphilis. HIV remains on the prohibited list of diseases.

Compassionate release is a program that allows some eligible, seriously ill prisoners to die outside of prison before sentence completion. It became a matter of federal statute in 1984 and has been adopted by most U.S. prison jurisdictions. Incarceration is justified on 4 principles: retribution, rehabilitation, deterrence, and incapacitation. Compassionate release derives from the theory that changes in health status may affect these principles and thus alter justification for incarceration and sentence completion. The medical profession is intricately involved in this process because eligibility for consideration for compassionate release is generally based on medical evidence. Many policy experts are calling for broader use of compassionate release because of many factors, such as an aging prison population, overcrowding, the increasing deaths in custody, and the soaring medical costs of the criminal justice system. Even so, the medical eligibility criteria of many compassionate-release guidelines--which often assume a definitive prognosis--are clinically flawed, and procedural barriers may further limit their rational application. We propose changes to address these flaws.

The California State Assembly is reviewing a bill that would establish firm procedures and timetables for the compassionate release of terminally ill prison inmates. The bill was sponsored by Assemblyman Antonio Villaraigosa, who was concerned about the case of a terminally ill inmate who was not released from prison even after he was in a vegetative state. The inmate's care in the final six months of his life cost the State nearly $890,000. The State currently has regulations establishing the early release of such prisoners, but not all wardens are using the regulations optimally. California Governor Pete Wilson has vetoed similar measures three times in previous Assembly sessions.

The purpose of this commentary is to draw upon available literature and practices related to COVID-19 and management of older incarcerated adults in Australia to highlight key matters for better risk management and care of this population during this and future infectious disease pan/epidemics. The present commentary draws on current policies, practices and literature regarding the health, needs and management of older incarcerated adults in Australia to discuss risk, care and early release for this population during the COVID-19 pandemic. Incarcerated persons experience poorer health and accelerated age-related decline compared to those in the general community. The present situation offers the opportunity to fill knowledge and practice gaps, including policies for staff training, identification of dementia and cognitive decline, assessment of mobility issues, addressing barriers to health-seeking, possibilities of medical or compassionate release, risk assessment and release protocols and post-release needs. While Australian prisons have acknowledged the vulnerability of older persons, more focused adaptation of COVID-19-related policies to consider adults as young as 45 years are needed. Appropriate ethical identification and management of cases in this population is needed, as is discussion on issues of decarceration and medical release. Re-conceptualisation of incarcerated adults as "citizens in need of care", rather than as "offenders to be secured", will be beneficial. Robust, local evidence is needed to assist decision-making. This is a comprehensive, focused review of relevant evidence, policies and practices for a growing subpopulation of prisoners worldwide with complex needs and particular vulnerability to the COVID-19.

An exponential rise in the number of older prisoners is creating new and costly challenges for the criminal justice system, state economies, and communities to which older former prisoners return. We convened a meeting of 29 national experts in correctional health care, academic medicine, nursing, and civil rights to identify knowledge gaps and to propose a policy agenda to improve the care of older prisoners. The group identified 9 priority areas to be addressed: definition of the older prisoner, correctional staff training, definition of functional impairment in prison, recognition and assessment of dementia, recognition of the special needs of older women prisoners, geriatric housing units, issues for older adults upon release, medical early release, and prison-based palliative medicine programs.

This article examines policies and programs associated with geriatric inmates. The increasing number of inmates over the age of 50 has raised questions on how corrections departments will address this population's needs. To determine how states are addressing the needs of elderly individuals in prison and through geriatric release, the author conducted a literature review. Results indicate great variety in how states address the needs of the elderly. There is opportunity for improvement to serve the elderly inmate population.

Correctional systems, already struggling to meet the basic and functional requirements of older prisoners, will be further challenged by the increasing medical and psychiatric needs of this population. Mental health and general medical care for older adults requires specific on-site or consultation expertise in geriatric medicine and psychiatry, as well as potential changes in infrastructure, both of which may be prohibitively expensive. However, compassionate and effective treatment of older prisoners requires that prison and legal systems facilitate this expert care. To address this situation, strategic revisions of the criminal justice system are needed to alleviate prison overcrowding and consequent inadequate medical care for inmates, especially the elder ones. The unique, age-related demands of this older population predict an increased need for forensic psychiatrists with a thorough knowledge and expertise in geriatrics, as more forensic psychiatric evaluations will be needed before trial in both civil and criminal cases, during incarceration, and at the time of parole. In this article, we review the current state of elder inmates in correctional institutions and advocate for increased geriatric training for forensic psychiatrists in anticipation of this growing need.

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The growing aged and dying incarcerated population increases demands on corrections health care. People who are incarcerated can assist in care delivery; however, currently, their training is typically face-to-face, home grown, and variable in content and duration. Six focus groups conducted with peer caregivers (PCs) (

The aging process of the incarcerated population is a growing concern, yet there are few data on older adults in this demographic group. Hence, this study sought to examine the health status of older adults who are incarcerated in Mexican prisons and its association with the duration of their imprisonment. This is a secondary analysis of the 2021 Mexico National Prisons Survey. We analyzed 50-year-old and older prisoners and performed a descriptive analysis of the sample's age, sex, sociodemographic variables, and chronic conditions. Multivariate analysis stratified by age was performed to assess the effect of the time spent in prison on older prisoners' health. The mean age was 56.95 (±6.4 SD), and the mean duration of imprisonment was 8.93 years (±6.94 SD). Regarding health conditions, 17.80% had diabetes, 29.62% had hypertension, 10.33% had suicidal ideation, and 40.87% were visually impaired, 17.01% had hearing impairment, and 17.64% had mobility impairment. Multivariate analysis revealed that among categories of imprisonment duration, longer time imprisoned was associated with an increased risk of diabetes and hypertension for all groups but was not associated with mobility impairment or suicidal ideation except in the younger group. Longer periods of incarceration appear to be associated with a greater occurrence of diabetes and hypertension in older prisoners. Sensory impairments and suicidal ideation are mainly identified in younger prisoners, while mobility impairments do not appear to be influenced by the time spent in prison. Further research needs to be done in prisons, where the addition of physical performance tests and cognitive tests could help further study geriatric conditions in older prisoners.

Older adults who are or have been incarcerated constitute a growing population in the USA. The complex health needs of this group are often inadequately addressed during incarceration and equally so when transitioning back to the community. The purpose of this paper is to discuss the literature on challenges older adults (age 50 and over) face in maintaining health and accessing social services to support health after an incarceration and to outline recommendations to address the most urgent of these needs. This study conducted a narrative literature review to identify the complex health conditions and health services needs of incarcerated older adults in the USA and outline three primary barriers they face in accessing health care and social services during reentry. Challenges to healthy reentry of older adults include continuity of health care; housing availability; and access to health insurance, disability and other support. The authors recommend policy changes to improve uniformity of care, development of support networks and increased funding to ensure that older adults reentering communities have access to resources necessary to safeguard their health and safety. This review presents a broad perspective of the current literature on barriers to healthy reentry for older adults in the USA and offers valuable system, program and policy recommendations to address those barriers.

The population of geriatric prisoners in the United States will reach unprecedented levels in the coming decades. Geriatric prisoners are at increased risk for deteriorating health and experience the onset of disease earlier than the aging population at large. Medical parole is an underutilized program that allows aging prisoners to transition to community-based health care. This article presents original key informant interview data and analysis of the perceptions of medical parole. Three dominant themes emerged: (1) drugs and nonviolent crimes; (2) politics, costs, and consequences; and (3) quality of health care and sense of security in prison. Participants rejected the possibility that medical care provided is below the clinical standard or is the cause of geriatric prisoners' deteriorating health and consistently implied that medical care at this prison is better than most Americans receive. Participants perceived their careers more as contributions to public health than criminal justice.

With a rapidly growing population of older adults with chronic illness in US prisons, the number of people who die while incarcerated is increasing. Support for patients' medical decision-making is a cornerstone of quality care for people at the end of life (EOL). This study aims to identify, describe, and analyze existing policies regarding EOL decision-making in U.S. Departments of Corrections. This study performed an iterative content analysis on all available EOL decision-making policies in US state departments of corrections and the Federal Bureau of Prisons. This study collected and reviewed available policies from 37 of 51 prison systems (73%). Some areas of commonality included the importance of establishing health-care proxies and how to transfer EOL decision documents, although policies differed in terms of which patients can complete advance care planning documents, and who can serve as their surrogate decision-makers. Many prison systems have an opportunity to enhance their patient medical decision-making policies to bring them in line with community standard quality of care. In addition, this study was unable to locate policies regarding patient decision-making at the EOL in one quarter of US prison systems, suggesting there may be quality-of-care challenges around formalized approaches to documenting patient medical wishes in some of those prison systems. To the best of the authors' knowledge, this is the first content analysis of EOL decision-making policies in US prison systems.

One of the current debates in the literature on aging inmates asks, what is the most efficient housing/health care model for this "special needs" population? State and federal correctional systems place elderly inmates either in specialized segregated housing units away from the general inmate population, consolidate elderly inmates in housing units within the prison, or provide a combination of both models. In general, proponents of the segregated housing model argue that aging inmates will receive specialized medical services in geriatric units. However, proponents of consolidated housing model argue that aging inmates will have the benefit of both geriatric and non-geriatric health services. This paper examines the association between the type of housing management model for aging inmates and the availability of non-geriatric physical and mental health services. Data for the analysis come from the 2000 Bureau of Justice Statistics Census of State and Federal Adult Correctional Facilities. The results suggest that institutions offering consolidated geriatric care provide more mental health services and that these effects are independent of the characteristics of prison facility.

Nutrition-related health disparities plague prisons in the United States. Unregulated and inadequate prison menus may contribute to noncommunicable chronic health conditions in this vulnerable population. The purpose of this research was to assess nutrition offerings provided by prison menus. Researchers requested the most current version of all master menus and associated nutrition analyses for gendered and age-centric (pediatric vs geriatric) menus. Menu and nutrient data were extracted and entered into a spreadsheet for analysis. Prisons serve gendered or nongendered menus to the general population, and 52.9% of prisons offer nongendered menus where males and females receive the same meals. This approach provides excess calories and saturated fat to females. Sodium was served in excess to both males and females. Fruit and vegetable servings on all gendered menus fell short of recommendations. The average prison menu inappropriately offers calories, sodium, and fruit and vegetable servings in a one-size-fits-all menu development method without considering gender, age, and physical activity. Interpretation and application of Dietary Guidelines for Americans are inconsistent. Nutrition guidelines recommending appropriate nutrients and food groups should be developed and available to corrections systems and dietitians. Current prison menu development practices yield inappropriate nutrition for prison populations.

The aging population in United States (US) correctional facilities has grown dramatically over the last several decades. At present, roughly one in four adults incarcerated in US prisons are at least 50 years of age. Research over the last ten years has likewise expanded to catalog the impacts of incarceration on older adults, and the myriad ways incarceration is unique for this population. In this paper, we summarize the state of the literature at the intersection of incarceration, health, and aging. We begin by outlining the impacts of incarceration on a range of individual health outcomes for older adults. Next, we offer targeted policy implications to address the health consequences of incarceration for older adults. Finally, we conclude by offering a research agenda that emphasizes theory building, jail-based approaches, and expansion of what is known about older women, cognitive impairment, correctional staff perspectives, and interventions to enhance the health of older persons who are incarcerated.

The United States (US) has one of the highest rates of incarceration in the world. Due to the aging of the US population as a whole and limited opportunities for early release, the proportion of older people in prison continues to rise. Some correctional health systems have adopted geriatric and palliative care principles to better care for this aging population, many of whom die in prison. However, not everyone who grows old in prison will die behind bars. In this article, we explore existing literature that highlights the unique physical, cognitive, and psychosocial challenges that formerly incarcerated patients face. We proceed to argue that palliative care providers should screen for a history of incarceration to identify and address the needs of this patient population. We also offer strategies to create a safe, welcoming environment to discuss past traumas related to these patients' time in prison.

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