A multisite study implementing palliative care for people with cancer to address the gaps between evidence and practice, reduce variation in clinical care, and ensure that best quality care is both timely and delivered routinely for all.
There is an increasing older prisoner population worldwide. With the frequency of multiple concurrent chronic diseases and premature ageing within the prison setting, more prisoners are likely to face their end of life in custody. Prisoners aged greater than 50 years represent 15% (6,100+) of the Australian prison population, and have increased in numbers by 84% from 2005 to 2015. Ensuring optimal palliative and end of life care for prisoners with chronic and advanced progressive disease is therefore a pressing and escalating challenge, with limited understanding of the population or evidence adding to its complexity.
Palliative care in the Australian prison setting is rudimentary at present. In particular, there are not established models of in-prison hospice or palliative care services such as those existing in some regions of the United States and United Kingdom. To date there is little known globally about prisoner patients and their experiences at the end of life including their patterns of care and health care. For example, in some jurisdictions, a prisoner’s decision to accept, decline or delay treatment may be influenced or constrained by access to such care being only available through relocation to a maximum security prisoner setting.
Recent studies in the United States have shown, when compared to a non-incarcerated population, prisoners die at a younger age (7, 8) and have higher rates of cancer, liver disease and mental health disorders. Less than a third of prisoners die in a palliative care bed.
A greater understanding of end of life for hospitalised prisoner patients will help to inform the provision of optimal palliative care for this group.
We are undertaking a program of work using mixed methods to understand the patterns of health care, experiences of receiving and of providing end of life care to people who are prisoners. Through our collaborations we are seeking to understand how Australian experiences compare and contrast with international experiences, with a goal of establishing tailored, effective services for people who are prisoners with palliative care needs.
- Dr Carolyn Lethborg,
- Dr Tamsin Bryan
- Dr Stacey Panozzo
- St Vincent’s Hospital
- Correctional Health Services
- European Taskforce on Palliative Care in Prisons
Inclusive Health Fund – St Vincent’s Hospital
Professor Jennifer Philip's Palliative Care Nexus group
Seeking to effect positive and systemic change in palliative care practice, and accelerate the translation of research-generated knowledge to improve patient care.