The RCN know that people in prisons are likely to have greater risk factors for dementia. These include high blood pressure, consequences of and continuing drug and alcohol misuse including addiction, smoking history and less healthy lifestyle with the restrictions in a prison, than the general population. Access to and engagement with health care can also be disrupted at times. Statistically there is an increased in the use of drugs and alcohol and the average age of natural death for men in prison is 56.
The punishment of prison is loss of liberty. Imagining what it must be like to live with dementia in prison will be a huge challenge for the person and for the staff. We can understand that the environment must be difficult. Often with long corridors, little variation and differentiation of landmarks. The environment can be uniform, noisy and movement restricted. This could become terrifying.
The effects of dementia do not just sit with the individual, for those sharing cells or interacting with someone living dementia the effects of the disease might cause conflicts or vulnerabilities that can escalate. If someone walks into your cell believing it to be theirs or doesn’t know where the toilet is, the potential for confrontation is great. As a family member, you might be worried sick about what is happening and the predicament your kin are in, all sorts of fears might go through your mind.
The RCN Justice and Forensic Nursing and Older People’s forums have started a project to adapt our renowned SPACE principles for use in prisons. SPACE is the acronym for:
- Staff who are skilled and have time to care
- Partnership working with carers
- Assessment, early identification of dementia and post-diagnostic support
- Care and support plans which are person-centred and individual
- Environments that are dementia friendly.
We would like to help the wider prison community deliver care good care for people with dementia in prisons. We welcome that many prisons are actively seeking dementia friendly environment accreditation. We have revised the principles in light of the evidence and context of prisons and are currently checking them out with people in prison and their families.
Next year will see a draft going out to interested parties for their comments and suggestions to further improve the principles. If you would like to be involved, please do let us know by contacting Nikki Mills, Project Co-ordinator via email to Nicola.firstname.lastname@example.org.