Community reentry for older adults leaving prison with and without health limitations

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ABSTRACT/SUMMARY Older adults are the fastest growing segment among incarcerated populations. The vast majority of older adults currently serving time in US prisons are men and racial/ethnic minorities, particularly Black men. Older adults in prison are a medically vulnerable group as time spent in prison amplifies and introduces new disease burdens due to highly restrictive environments and scarce resources. People in prison consistently report declines in health. Compared to the general population, older adults in prison have greater health limitations such as problems with mobility, cognitive impairment, polypharmacy, multiple comorbidities, and geriatric conditions, which can threaten their ability to live independently. These health challenges create burdens not only on correctional systems but also to the communities where these individuals will return. People returning to the community from prison face formidable challenges and the inability to reintegrate successfully into community living is one of the main drivers for recidivism. Yet, little is known about the health status of older adults leaving prison and how it impacts their transition during this critical reentry period. It is known that older adults leaving prison will face greater challenges than their younger counterparts but existing studies have not examined the added risk of having health limitations. Older adults may be returning to environments characterized by limited access to healthcare resources and caregivers, unstable housing, and challenging financial and family circumstances, particularly if incarceration was lengthy and social support systems have deteriorated over time. Poor health may compound these existing challenges. The specific aims of this study are to: (1) investigate the factors and disparities associated with successful reentry among older adults leaving prison (N=80); (2) elicit narratives about health, social, and community factors that impede or facilitate reentry among older adults with health limitations (N=30); and (3) adapt findings for a reentry case management program to develop specific modules to meet the needs of older adults leaving prison. Findings will be adapted to the evidence-based intervention, Project START+, a reentry case management model developed by members of the research team. Our study is innovative in that we study the critical reentry period for a medically vulnerable, high need, but under-characterized population. Research questions and hypotheses are theoretically grounded and results will provide practical findings for implementation. As a result of this project, we will develop an intervention that can be tested with future funding. The partnership with the Wisconsin Department of Corrections and Wisconsin Community Services, the largest community-based organization in Wisconsin that provides reentry services for people leaving prison, is a key strength.