Jowitt Janet, Severance Jennifer, Nnaka Tonychris, Knebl Janice
The University of North Texas Health Science Center, Fort Worth, Texas, USA.
The University of North Texas Health Science Center, Fort Worth, Texas, USA.
Geriatr Nurs. 2025 Mar-Apr;62(Pt B):291-293. doi: 10.1016/j.gerinurse.2024.12.005. Epub 2024 Dec 18.
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.
在美国医疗保健系统中，年长的被监禁成年人是一个易受伤害且被忽视的群体，由于慢性病以及认知衰退、行动不便和感官缺陷等与年龄相关的问题，他们面临着较高的死亡率。国家惩教卫生保健委员会（NCCHC）关于“惩教机构中老年患者的护理”的立场声明是解决这一人群医疗保健差距的关键一步。在本文中，我们强调在惩教机构中迫切需要一种全面的、适合老年人的护理模式，以确保公平的护理。在被监禁期间变老会加速身体和心理衰退，研究表明在监狱中每待一年会使预期寿命缩短两年。惩教环境加剧了这一过程，使个体看起来比未被监禁的同龄人更显老态。缺乏适合老年人的医疗保健，再加上入狱前的健康差异，凸显了针对性干预措施的必要性。NCCHC关于全面评估、早期识别认知衰退和预防措施的建议对于改善结果和降低医疗成本至关重要。为年长的被监禁人群提供公平和个性化的护理至关重要，这强调了恢复尊严和自主权的伦理需求。这需要以患者为中心的护理，尊重治疗偏好，并使临终护理符合个人意愿。改善行动能力、预防受伤的环境改造以及入狱时的标准化健康筛查对于积极护理也至关重要。总之，NCCHC的建议提供了一个框架来满足年长被监禁成年人的医疗保健需求，但实施需要系统性变革、充足的资金以及一支在老年医学和惩教卫生方面受过培训的劳动力队伍。
