Geriatric justice: Advocating for Equity in healthcare for elderly populations in correctional facilities

Abstract

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.