Project Details

Older prisoners are the fastest growing group among prisoners worldwide. In Europe, an average of around 18% of prisoners are over 50 years old, with Germany only just below this figure at around 16%. A particularly large number of older people in Germany are in preventive detention, i.e. a measure for those prisoners who are considered to be particularly dangerous and who remain imprisoned beyond their actual sentence: Here, the proportion of over 50-year-olds is around 70% and that of over 60-year-olds around 30%. One reason for this increase is undoubtedly demographic change, as people of an older age are more likely to commit offences and may then also be imprisoned. On the other hand, however, the respective penal practice also has a considerable influence.

Irrespective of the reasons for this increase, older prisoners represent a vulnerable group in the prison system that is particularly burdened by health issues and whose state of health is estimated to be around 10-15 years worse than that of their peers at liberty. The associated multimorbidity is due on the one hand to the structural circumstances and living conditions prior to imprisonment (poverty, homelessness, experiences of violence, etc.), but also to the individual lifestyle of those affected (risky lifestyles, consumption of illegalised and contaminated substances, etc.), which is exacerbated by the conditions of the ‘total institution’ prison that restrict freedom and are detrimental to health. All of this ultimately leads to an increasing number of prisoners requiring care, spending the last phase of their lives in prison and possibly even dying there.

The so-called ‘equivalence principle’ stipulates that healthcare in prison should be organised in such a way that it corresponds to the services provided by the statutory health insurance system. Against this background, the project uses a qualitative-explorative study design to investigate the question of what options are available in prison for hospice and palliative care that is equivalent to the situation in freedom and what social, institutional, professional etc. restrictions it may be subject to. What social, institutional, professional etc. restrictions it may be subject to.