The Dementia and Mild Cognitive Impairment in Prison Care Pathway (DECISION): An Initial Programme Theory Informed by Umbrella Review and Participatory Co-Design Workshops

Abstract

In England and Wales, approximately 8% of prisoners aged 50 and over are likely to have dementia/MCI, but they do not receive equivalent care to their counterparts in the community. We previously designed DECISION (Dementia and Mild Cognitive Impairment in prison), a care pathway and training/awareness package for use in prison. The aim of this article is to describe the development of an initial programme theory (IPT) and logic model for the DECISION care pathway. Development of the IPT and logic model was an iterative process involving: i) an umbrella review approach to synthesising information from seven systematic reviews of dementia in prison; ii) co-design workshops with key stakeholders including experts by experience; and iii) reviewing our previous qualitative work. Key elements of the IPT and logic model include specialist training for and ongoing supervision of dementia care coordinators; ageing awareness training for all staff in prison; use of two cognitive screening tools; and release planning, including awareness-raising among probation and third sector groups who work with people released from prison who have dementia/MCI. The IPT and logic model will provide stakeholders with a proposed framework for the innovation or further development of dementia care and support in prison.