The development of appropriate care pathways for older prisoners with mild cognitive impairment and dementia

Background No standardised specialised services or care pathways exist for older prisoners with mild cognitive impairment or dementia in England and Wales. Current service provision is suboptimal and ad hoc . Aim: Identify service needs and appropriate care pathways for older prisoners with cognitive impairment throughout custody and on release into the community; Method To identify service needs and develop an appropriate care pathway for older prisoners with dementia/mild cognitive impairment we adopted a Balance of Care approach. Data from the quantitative aspects of the study was used to create sub‐groups of people with similar care needs, from which were developed a series of representative case studies. Each case study was presented to multidisciplinary staff from prison and community settings at a series of workshops. Staff were asked to design an appropriate care package for each case study. Feedback notes from workshops were collated and summarised using a care plan template. Key themes were identified which formed an initial draft of as assessment and treatment care pathway. A further workshop was held with professionals to adjust and further develop the final pathway. Findings The final pathway (figures 1 & 2) outlines the steps to be taken within prison and community services to streamline the diagnostic process. Additional guidance is provided around environmental modifications in prison, the development of adapted, specialist wings and circumstances under which care out of the prison setting, for example release on temporary license or some type of secure nursing home/hospital accommodation should be considered.