Being Old and Doing Time: Functional Impairment and Adverse Experiences of Geriatric Female Prisoners

Abstract

The number of older prisoners is increasing exponentially. For example, the number of geriatric female prisoners in California has increased 350% in the past decade. Despite an increasing population of geriatric female prisoners, the degree of functional impairment in this population is unknown. Therefore, the goals of this study were to describe the prevalence and nature of functional impairment in geriatric female prisoners in California and to identify aspects of the prison environment that may exacerbate functional impairments. Questionnaires were analyzed from 120 geriatric women in California state prisons. Functional impairment was defined as impairment in activities of daily living (ADLs) or in prison ADLs (PADLs), including dropping to the floor for alarms, standing for count, getting to meals, hearing orders, and climbing onto the top bunk. The mean age of participants was 62; 16% were dependent in one ADL, and 69% reported one PADL impairment. Increasing severity of functional impairment was associated with worse health status and more adverse prison experiences. For example, fall rates ranged from 33% in women without impairment to 57% with PADL impairment to 63% with ADL dependence (P=.02). Several prison environmental stressors were identified that likely exacerbate functional impairment. For example, 29% of geriatric women were assigned to a top bunk. Geriatric female prisoners report high rates of functional impairment. ADL and PADL impairment were associated with worse health status and adverse prison experiences. Therefore, the evaluation of functional impairment in geriatric female prisoners needs to consider the unique demands of the prison environment.

The effectiveness of the Older prisoner Health and Social Care Assessment and Plan (OHSCAP): a randomised controlled trial

“…Consequently, the authors emphasised the importance of considering PADL when assessing older prisoners' needs, rather than just the standard ADL. 48 Further research is required to establish the extent to which older prisoners demonstrate difficulties with PADL within the context of English and Welsh prisons. Strikingly, there have been examples of other prisoners inappropriately providing personal care (such as washing, dressing and assistance with incontinence issues) to older prisoners as part of 'buddy' schemes.…”

“…47 Hayes et al 7 found that over one-third of older prisoners in their sample had some level of functional need in activities of daily living (ADL), with 11% having personal care needs, in over half of whom they were unmet. A US study 48 explored prison activities of daily living (PADL) in 120 female prisoners aged > 55 years. These included dropping to the floor for alarms, getting to the canteen for meals, hearing orders from staff and climbing on and off the top bunk.…”

Caregiving Behind Bars: Correctional Officer Reports of Disability in Geriatric Prisoners

“…8 In prison, other prisoners 4,6 or correctional officers (prison guards) 9,10 may provide informal care. For example, officers may talk with distressed prisoners to diffuse crises, consult with clinicians about prisoners' living environments, or alert clinicians to new symptoms.…”

A Reintegration Program for Elderly Prisoners Reduces Reoffending

“…5%). Many studies in western countries confirmed their poor health status [1,11,12,14], but not in Asian countries. Our data supported their poor health status and clarified that elderly prisoners suffered from multiple deceases in many countries.…”

“…We hypothesized that released elderly prisoners who participated in the reintegration programs would reoffend less than those who did not. We also reported their health status in Japan to compare with previous studies [1,11,12,14].…”