Aged Care Insite Issue 109 | Oct-Nov 2018 | Page 18

industry & policy Later life behind bars How aged care works in prison. Phillip Snoyman interviewed by Megan Tran T he number of aged inmates in custody is rising, but what strategies are in place to provide a safe environment for this growing cohort? While most aged and frail inmates are housed in mainstream jails, some correctional centres contain areas set aside exclusively for older inmates. Offender Management & Programs Corrective Services NSW documents show that inmates who are Aboriginal or Torres Strait Islander and 45 years or older, or non-Indigenous and 55 years or older, are eligible for identification as aged and frail for the purposes of placement and the provision of relevant services and programs. Dr Phillip Snoyman, director of statewide services at Corrective Services NSW, said his department uses a multidisciplinary approach for elderly inmates whereby they are screened for services at the commencement of custody and, where identified, support programs are co-designed with the offender. He said the team must balance the rights and needs of the older inmates with the needs of the broader inmate population, as well as safety and security. Aged Care Insite spoke with Snoyman to hear more about how Australia approaches aged care in custody. ACI: What’s the current model for elderly prisoners? PS: Corrective Services NSW has a duty of care to provide a safe, secure and humane environment for elderly inmates. Through a multidisciplinary approach, elderly inmates are screened for services at the commencement of custody. Identification commences from the case management reception teams. Processes ensure that they can be identified as having specific 16 agedcareinsite.com.au needs by any staff at any stage of incarceration. If Corrective Services NSW staff suspect that an elderly offender has a specific need, they make a referral to the statewide disability services. Corrective Services also works collaboratively with the Justice Health & Forensic Mental Health Network, including some multidisciplinary case management models of care, to ensure adequate services and program provision for security, physical, cognitive and health needs. The Corrective Services offender- centred collaborative case management model includes the provision of services and programs targeting responsivity issues, general wellbeing and consideration of individual life goals. And in new reform, if we sentence an offender with more than three months to serve, we’ll have an individualised case plan which is co-designed with the offender. Corrective Services and Justice Health guide the specific intra-agency policy framework for elderly and frail inmates, and this surrounds the case management placement and access to additional living resources. What challenges do older people face in prison? They face many challenges. Elderly inmates may under-report their needs. In prison, there’s a balance between privacy and confidentiality with safety and security, and this is challenging in relation to third parties being involved with interviewing elderly inmates. It may be relevant to obtain information for assistance purposes from a family, or to have the custodial representative from a wing to participate in an inmate’s assessment with Justice Health to ensure that information [is accurate]. An inmate may be masking a hearing problem, may have incontinence, lack of insight or may be masking their own cognitive decline. Or they may just be reluctant to talk about things or require prompting, and this is why a third party is often necessary. The ability of elderly offenders to conform to mainstream prison’s structured days can also be challenging. Elderly offenders may struggle to remain in the yard for the duration of the established routine, to successfully navigate their way around the environment, to hear well and to understand and remember verbal instructions, or to meet the time access for showers. Offenders have been incarcerated for many years, and they may be institutionalised or inflexible with their thinking. Substance