Hwang Ye In Jane, Ginnivan Natasha Ann, Simpson Paul Leslie, Baidawi Susan, Withall Adrienne, Williams Brie, Butler Tony
School of Population Health, University of New South Wales, Sydney, Australia.
Department of Social Work, Monash University, Clayton, Australia.
Int J Prison Health. 2021 Oct 18;17(3):245-257. doi: 10.1108/IJPH-10-2020-0078. Epub 2021 May 17.
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.
DESIGN/METHODOLOGY/APPROACH: 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.
ORIGINALITY/VALUE: 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.
本评论的目的是借鉴与澳大利亚新冠疫情及老年在押成年人管理相关的现有文献和实践，以突出在当前及未来传染病大流行期间，为更好地对这一人群进行风险管理和护理的关键事项。
设计/方法/途径：本评论借鉴了澳大利亚关于老年在押成年人的健康、需求和管理的现行政策、实践和文献，以讨论新冠疫情期间该人群的风险、护理和提前释放问题。
与普通社区人群相比，在押人员健康状况较差，且与年龄相关的衰退加速。当前形势为填补知识和实践空白提供了契机，包括工作人员培训政策、痴呆症和认知衰退的识别、行动能力问题评估、解决就医障碍、医疗或同情性释放的可能性、风险评估和释放规程以及释放后的需求等。
虽然澳大利亚监狱已认识到老年人的脆弱性，但仍需更有针对性地调整新冠相关政策，将45岁及以上成年人纳入考虑范围。需要对该人群进行适当的伦理识别和病例管理，同时也需要就非监禁化和医疗释放问题展开讨论。将在押成年人重新概念化为“需要护理的公民”，而非“需关押的罪犯”，将大有裨益。需要有力的本地证据来辅助决策。
原创性/价值：这是对全球范围内一个需求复杂且特别易受新冠疫情影响的不断增长的囚犯亚群体的相关证据、政策和实践进行的全面且有针对性的综述。
