Peter Sayer reports from the 2018 American Geriatrics Society annual scientific meeting, Orlando, Florida.

The talk looked at how prisoners are among the US’s most rapidly ageing vulnerable patient populations, but very little research has sought to understand their healthcare needs. The resulting lack of evidence extends to advance care planning (ACP).

ACP is the process of engaging with health professionals, family, and friends to plan for future healthcare decisions. To address this knowledge gap, researchers investigated perspectives on barriers to ACP in prison among 24 correctional clinicians in different parts of the US.

The researchers found that many correctional clinicians voiced discomfort engaging in ACP in the prison setting, and that misconceptions about ACP were common, including that it is only for patients at the very end of life or that it does not require patient participation.

They also reported unique barriers to engaging in ACP, including profound patient mistrust and obstructive institutional policies.

According to the researchers, their findings suggest that many correctional clinicians would benefit from additional training in this area, and that system-level changes are needed to adapt existing ACP programmes to account for the unique barriers found in correctional settings.