A GERIATRIC APPROACH TO SENIOR FORENSIC DETAINEES

Abstract

Introduction The past two decades have ushered in a nationwide “forensification” of state hospitals, a rapid surge in the number of criminal defendants, especially those committed as “incompetent to stand trial” (IST). Since some of these individuals require protracted hospitalization to attain restoration of competency (RTC), the number of incarcerated patients awaiting forensic treatment has reached unprecedented levels. Moreover, the population of geriatric detainees which, according to Human Rights Watch grew by 63% between 2007 and 2010, has exacerbated this problem as this group requires twice the hospital length of stay of younger individuals to attain RTC. Methods A retrospective review of records from 10/14/2018 to 10/14/2019 of patients over the age of 65 committed as IST was conducted at the California Department of State Hospitals, Patton facility. Results Of 27 individuals over the age of 65 with IST commitment, 13 (48.14%) were found to carry a primary or secondary diagnosis of cognitive dysfunction and a length of hospitalization longer than 365 days. Conclusions Our study has replicated the findings of Bartos BJ et al. (2017) and Morris and Parker (2009) showing that older individuals with or without cognitive deficit may require time-intervals in excess of statutory timeframes to attain RTC. Development of community forensic-geriatric centers, providing individualized competency or diversion programs, may at least in part, alleviate the shortage of forensic beds in state hospitals. This research was funded by: None