Tuesday, 13 March 2012

Dying Inside

Earlier this year I listened to a radio programme broadcast on BBC Radio 4 about the growing phenomenon of older prisoners in the UK. The program was presented by Rex Bloomstein a documentary film-maker, whose films on human rights, crime and punishment and the Holocaust have become major themes in his work.

The programme explained how the UK has the largest European prison population of over 8000 older prisoners. This group of offenders is also the most rapidly growing, which is in part due to the fact that forensic evidence/advancement is continually developing and improving meaning that more 'historical' cases are now being solved. Also the number of offenders serving long term or life sentences has increased over the years. 

The programme spoke to a number of older prisoners who shared their experiences of being 'older' and living in prison either for the a long time or for some the rest of their lives. Older prisoners have a higher incidence of diabetes, hyper tension and coronary heart disease as well as the general mobility and cognitive disabilities which older people develop with age. However added on top of these are problems of adjustment, loss of liberty, loneliness and isolation caused by living away from family and loved ones. Living in a prison and/or secure environment where the majority of the population are younger individuals can prove to be a frightening and threatening environment for older prisoners/offenders which can have a detrimental effect on their mental health. 

There is currently no national strategy for older prisoners/offenders, meaning that this client group is at risk of being overlooked and needs not being met.

Whilst reflecting on my current client group in the secure unit where I work last week and realised that there were some reoccurring themes with regards to needs between the clients over the age of 50 (which is classed as being an 'older' offender). This was not surprising as it is universally acknowledged that with age comes different obstacles to overcome both physical and cognitively. What I realised through my reflection however was how this client group and their specific needs run the risk of being unintentionally overlooked by the service. I began to think back to my work experience in a Prison and found that the same issues arose. 
The diagram below depicts some of the common problems which in my experience older prisoners/offenders have faced.

From my work in a Prison setting I tackled some of the problems by doing things such as:
  • Collaborating with the gym instructors to provide a separate gym room which did not have the 'loud' music channels playing in, had cardio. exercise equipment and which provided specifically designed exercise classes for the older client. 
  • Providing different activities for the older clients to engage in, activities such as dominoes and card games which proved most popular.
  • Setting up support groups/ social events for older clients.
  • Practical solutions to physical/mobility problems such as moving the clients to a cell which was on the ground floor, had grab rails/ had little obstacles or stairs to negotiate.
  • Finally many of the older clients complained about the noise which the younger clients make whether whilst socialising or when watching their TVs or playing their music loudly and late at night. By creating quieter sections on the wings where the older and quieter clients were based reduced this problem effectively.
  • The provision of mobility and functional aids. Eg, wheelchairs, walking frames/sticks, grab rails etc.
This is obviously only a small snap shot into some of the solutions which can be found for meeting the needs of this particular client group and depending on the individual concerned solutions may differ or completely different needs may arise. 

With the increasing number of older prisoners/offenders in the UK, health professionals, including Occupational Therapists, should be ready to meet the needs and solve the problems of this client group and be more aware of the implication that being 'locked up' has on the older prisoner/offender. 


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  1. Wow Kate! I love your blog, it's so thought provoking! How long have you worked in this setting? I did one of my placements in low secure forensic unit and loved it!I continuously wonder if I could work in that environment. xxxx

  2. Hi Sophie,
    Thank you very much for your comment. I current work in a Medium secure unit - it's my first post since qualifying this summer so have been working there for about 3months now and loving it. Previous to that I had my final placement and volunteered over the summer at my local Prison. Love the challenge and reward of forensic OT. Are you still studying of working now? x

  3. Awhh im so glad you're loving it! I agree with the challenge and reward of forensic ot, although with mediam secure how do you deal with the high level of risk/behaviour? Do you get lots of support? I graduated last Summer and got a job on a rotation!It's largely a physical rotation, and I constantly long for my days back in mental health!MH jobs are so few and far between though! xxxx

  4. That's a hard question to answer and something which is still very much a work in progress I suppose. I guess its all about managing risk and adapting activities and the resources that are available and safe to the intervention/occupation. Relational security is also central to practice, in that its crucial to have an understanding of a client, the environment and how that can be safely managed to create appropriate care.Fingers crossed you get some MH work soon then :) x