An Aging population: Geriatric management in corrections
Elderly, or geriatric, detainees are the fastest-growing demographic in corrections.¹ “Geriatric” in corrections is defined 10-15 years earlier than in community health care due to health disparities between populations.² Facilities with high geriatric populations spend 5 times more on medical care than those with lower populations.³
Do a health assessment around 14 days
Geriatric detainees may experience decline throughout the day (sundowning), making it hard to get the full picture during intake screening. Even if they have a known mental health issue, health staff should rule out underlying or additional medical issues.
Get weight and vitals at booking to get a baseline that can be compared against a full health assessment around 14 days. Baselining the detainee’s weight helps make fluctuations easier to detect. Weight fluctuations may indicate:
Difficulty chewing or swallowing due to dental issues
Decreased movement ability
Medication issues
Do a health assessment around 14 days to uncover potential health issues that may not present at booking.
Baseline mental health status
As a general rule, detainees 50 years of age or older should be referred for a mental health assessment upon booking. This assessment can help get a baseline and detect when a detainee begins acting “differently.” Geriatric detainees have higher incidence of depression, anxiety, and suicidal ideation.1 Medical issues in geriatric detainees can also appear as behavioral problems or confusion at first. Baseline mental health status to rule out medical and mental health issues.
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1. Skarupski, K. A., Gross, A., Schrack, J. A., Deal, J. A., & Eber, G. B. (2018). The Health of america's aging prison population. Epidemiologic Reviews, 40(1), 157–165. https://doi.org/10.1093/epirev/mxx020
2. National Commission on Correctional Health Care. (2024). Care for aging patients in the correctional setting. https://ncchc.org/position-statements/care-for-aging-patients-in-the-correctional-setting/
3. Martin, E. (2025). Minn. prisons face soaring costs as aging inmate population grows. Corrections1. https://www.corrections1.com/correctional-healthcare/minn-prisons-face-soaring-costs-as-aging-inmate-population-grows
Disclaimer
All materials have been prepared for general information purposes only. The information presented should be treated as guidelines, not rules. The information presented is not intended to establish a standard of medical care and is not a substitute for common sense. The information presented is not legal advice, is not to be acted on as such, may not be current, and is subject to change without notice. Each situation should be addressed on a case-by-case basis. When in doubt, send them out!®
