No CrossRef data available.
Article contents
Crime, Incarceration, and Dementia: An Aging Criminal System
Published online by Cambridge University Press: 12 February 2024
Abstract
Dementia within the criminal system, from arrest through incarceration, has been largely ignored. While the health system has begun grappling with the chronic conditions that will accompany an aging society, the criminal system has yet to meaningfully respond. Dementia is a clinical syndrome characterized by impairment in cognitive domains (memory, executive function, visuospatial). Additionally, dementia often includes behavioral symptoms that increase the likelihood that an individual’s actions may violate social norms and in some circumstances be deemed criminal. Prior studies have established criminal behavior as a trend among individuals living with dementia. Yet, the criminal system has yet to establish protections for individuals who commit a crime while impaired by dementia. This paper will report on an empirical study to evaluate the treatment of persons with dementia within the criminal justice system. We will report on interviews with attorneys (n=15) regarding their experience and perspective on the treatment of persons with dementia post-arrest. In the paper, we will explore topics identified through these interviews including pre-trial release, competency, placement (housing), criminal liability determination, sentencing, and post-conviction release. We will highlight key findings including the lack of a systematic screening process for dementia post-arrest, placement is a significant challenge, attorneys’ lack of training on dementia to be able to understand how the disease could impact decision-making, and the two legal mechanisms available to divert miss the mark given their focus on psychiatric populations. We will use these data and findings to argue for a research and policy agenda to address a gap in legal policies to appropriately manage persons with dementia post-arrest.
- Type
- Articles
- Information
- Copyright
- © 2024 The Author(s)
References
1 Rachael Bedard et al., Aging In Jail: Retrospective Analysis Of Older Patients In New York City’s Jail System, 2015–19, 41 Health Aff. (Millwood) 732 (2022).
2 Rachael Bedard, Elderly, Detained, and Justice-Involved: The Most Incarcerated Generation, 25 City Univ. N. Y. Law Rev. 161 (2022); Bedard et al., supra note 1; Brie Williams, Michele DiTomas & Alison Pachynski, The growing geriatric prison population: A dire public health consequence of mass incarceration, 69 J. Am. Geriatr. Soc. 3407 (2021).
3 Stephanie Grace Prost et al., Standardized outcome measures of mental health in research with older adults who are incarcerated, ahead-of-print Int. J. Prison. Health (2022); Older adults in jail: high rates and early onset of geriatric conditions, SpringerLink, https://link.springer.com/article/10.1186/s40352-018-0062-9 [ https://perma.cc/6998-PGMQ ] (last visited Jun 2, 2021); Cyrus Ahalt et al., Cognition and Incarceration: Cognitive Impairment and Its Associated Outcomes in Older Adults in Jail, 66 J. Am. Geriatr. Soc. 2065 (2018).
4 2022 Alzheimer’s disease facts and figures, https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12638 [https://perma.cc/ELX3-GB4Z] (last visited Oct 7, 2022).
5 Id.
6 Adam Boxer et al., The Advancing Research and Treatment in Frontotemporal Lobar Degeneration (ARTFL) North American Rare Disease Clinical Research Consortium: Progress and Participant Characterization (S2.008), 90 Neurology (2018), https://n.neurology.org/content/90/15_Supplement/S2.008 [https://perma.cc/NLW2-62AM] (last visited Sep 25, 2020).
7 Madeleine Liljegren et al., Criminal Behavior in Frontotemporal Dementia and Alzheimer Disease, 72 JAMA Neurol. 295 (2015).
8 Persons Living with Dementia and the Criminal Justice System, Am. Bar. Assoc., https://www.americanbar.org/groups/senior_lawyers/publications/voice_of_experience/2022/may-2022/persons-living-with-dementia-and-the-criminal-justice-system/ [https://perma.cc/H7BL-FXSH] (last visited Jan 16, 2023).
9 Josiah D. Rich et al., How Health Care Reform Can Transform The Health Of Criminal Justice–Involved Individuals, 33 Health Aff. (Millwood) 462 (2014).
10 Ilker Etikan, Sampling and Sampling Methods, 5 Biom. Biostat. Int. J. (2017), https://medcraveonline.com/BBIJ/sampling-and-sampling-methods.html [https://perma.cc/3CWR-JT67 ] (last visited Dec 29, 2021).
11 Nicola K. Gale et al., Using the framework method for the analysis of qualitative data in multi-disciplinary health research, 13 BMC Med. Res. Methodol. 117 (2013).
12 The use of medication should only be used as a last resort for the safety of a patient. The inappropriate use of chemical restraints on the elderly is still an ongoing legal and ethical challenge.
13 Persons Living with Dementia and the Criminal Justice System, supra note 8.
14 Id.
15 Jalayne J. Arias & Lauren S. Flicker, A Matter of Intent: A Social Obligation to Improve Criminal Procedures for Individuals with Dementia, 48 J. Law Med. Ethics J. Am. Soc. Law Med. Ethics 318 (2020).
16 Mark R. Munetz & Patricia A. Griffin, Use of the Sequential Intercept Model as an Approach to Decriminalization of People With Serious Mental Illness, 57 Psychiatr. Serv. 6 (2006).
17 Id.
18 Jessica H. Blue-Howells et al., The U.S. Department of Veterans Affairs Veterans Justice Programs and the sequential intercept model: Case examples in national dissemination of intervention for justice-involved veterans., 10 Psychol. Serv. 48 (20120827).