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Background and Objective: With an aging population, it has become increasingly important that nurses are equipped to provide appropriate psychogeriatric care. Patients with dementia are more likely of committing legal violations related to their behavioural and psychosocial symptoms. Thus, it is imperative that we explore how nursing staff can effectively manage psychogeriatric care in a forensic setting, in order to minimize stress and burnout of staff.
Material and Methods: Three populations were explored with the context of dementia and the justice system: patients with dementia who enter the forensic system, aging inmates in corrections, and criminal offenders in long-term residential care. The literature suggests that there is a dilemma as to where this population is best managed as there are no appropriate designated psychiatric facilities for the elderly offenders. Four options for geriatric service enhancement will be explored: Provide Gentle Persuasive Approach (GPA) training to forensic staff; modification of existing policies and procedures to support appropriate geriatric care; implement the use of Psychiatric Care Aides in skill mix; and create a secure forensic unit for geriatric populations.
Results: The recommendation for action is to implement education specific to psychogeriatric care, while also adjusting policies and procedures for a forensic centre to support therapeutic care.
Conclusions: The author argues that further research is needed that will determine the design of a new Psychogeriatric Forensic Centre.
2. Kim J, Chu K, Jung K, et al. Criminal manifestations of dementia patients: Report from the National Forensic Hospital. Dementia and Geriatric Cognitive Disorders EXTRA 2022;1(1):433–38. doi: 10.1159/000330929.
3. Kennedy B. Stress and burnout of nursing staff working with geriatric clients in long-term care. J Nurs Scholar 2005;37(4):381–82.
4. Àstrom S, Nilsson M, Norberg A, and Winblad B. Empathy, experience of burnout and attitudes towards demented patients among nursing staff in geriatric care. J Adv Nurs 1990;15(11):1236–44.
5. Heck A and Herrick S. Geriatric considerations in restora-tion of competence to stand trial: Two cases of impaired cognition. J Forens Psychol Pract 2007;7(2):73–82. doi: 10.1300/J158v07n02_06.
6. Tomar R, Treasaden I, and Shah A. Is there a case for a specialist forensic psychiatry service for the elderly? Int J Geriatr Psychiatr 2005;20(1):51–56. doi: 10.1002/ gps.1247
7. Department of Justice, Government of Canada. The Review Board systems in Canada: An overview of results from the mentally disordered accused data collection study. Ottawa: Author; 2015. Available at: Retrieved from: http://www.justice.gc.ca/eng/rp-pr/ csj-sjc/jsp-sjp/rr06_1/p1.html
8. Valdez K, Maust D, and Streim J. Training geriatric psychiatry fellows in the medicolegal aspects of psychi-atric consultation in the nursing home. J Psychiatr Law 2012;40(1):43–61. doi: 10.1177/009318531204000104
9. De Smet S, Van Hecke N, Verté D, et al. Treatment and control: A qualitative study of older mentally ill offenders’ perceptions on their detention and care trajectory. Int J Offend Ther Compar Criminol 2015;59(9), 964–85. doi: 10.1177/0306624X14521129
10. Advanced Gerontological Education. Hamilton: Author; (n.d.). Available at: https://www.ageinc.ca/
11. Culley H, Barber R, and Hope A. Therapeutic lying in dementia care. Nurs Standard 2013;28(1):35–39.
12. Elvish R, James I, and Milne D. Lying in dementia care: An example of a culture that deceives in people’s best interests. Aging Ment Health 2010;14(3):255–62.