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

摘要/摘要 老年人是被监禁人口中增长最快的部分。绝大多数人 目前在美国监狱服刑的老年人是男性和种族/少数民族，特别是黑人男性。 监狱中的老年人是一个医疗弱势群体，因为在监狱度过的时间放大并引入了新的 由于高度限制的环境和稀缺的资源造成的疾病负担。一直在监狱里的人 报告显示健康状况有所下降。与普通人群相比，监狱中的老年人健康状况更好。 限制因素，如行动不便、认知障碍、服用多种药物、多种合并症以及 老年性疾病，这可能威胁到他们独立生活的能力。这些健康挑战造成了 不仅对惩教系统造成负担，而且对这些人将返回的社区也造成负担。 从监狱返回社区的人面临着巨大的挑战，无法重新融入社会 成功地融入社区生活是累犯的主要驱动因素之一。然而，人们对其健康状况知之甚少。 在这一关键的重新入狱时期，老年人的出狱状况及其对他们过渡的影响。它是 知道离开监狱的老年人将面临比年轻人更大的挑战，但 研究还没有研究有健康限制的额外风险。老年人可能会回到 环境的特点是获得医疗资源和护理人员的机会有限，住房不稳定，以及 具有挑战性的经济和家庭状况，特别是如果监禁时间过长，需要社会支持 随着时间的推移，系统已经恶化了。糟糕的健康状况可能会加剧这些现有的挑战。具体目标 这项研究的目的是：(1)调查老年人成功重返大气层的相关因素和差异 成人出狱(N=80)；(2)引发关于阻碍或 促进有健康限制的老年人重返社会(N=30)；及(3)使调查结果适用于重返社会个案 管理计划，以开发特定的模块，以满足老年人出狱的需要。发现 将适应循证干预，Project Start+，一种再入病例管理模式 由研究团队成员开发。我们的研究是创新的，因为我们研究了关键的再入时期。 针对医学上脆弱、高需求、但特征不足的人群。研究问题和假设 在理论上是有根据的，结果将为实施提供实际的结果。结果就是这样 项目，我们将开发一种干预措施，可以用未来的资金进行测试。与该公司的伙伴关系 威斯康星州惩教署和威斯康星州最大的社区服务机构 威斯康星州为出狱人员提供再入境服务的组织是一个关键优势。

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.