title: Caregiving behind bars: correctional officer reports of disability in geriatric prisoners.
abstract: Despite increasing numbers of geriatric prisoners, little is known about geriatric disability or health care in prison. Although correctional officers often act as a liaison between prisoners and the healthcare system, the role of officers in recognizing geriatric disability has not been characterized. The goals of this study were to assess officers' assessment of disability in their assigned geriatric prisoners and to contrast their views with reports from the California Department of Corrections and Rehabilitation (CDCR). Questionnaires were given to 71 officers assigned to 618 randomly selected geriatric prisoners in 11 prisons. Information about 41 additional prisoners identified by correctional officers as "high risk" was also analyzed. Prisoner disability and health were determined through correctional officer questionnaires (activity of daily living (ADL) impairment, geriatric syndromes, level of care), chart review (medical diagnoses), and CDCR data (demographics, disability designation). Overall, 211 (34.1%) geriatric prisoners were unknown to their officer. Of the 407 known prisoners, officers reported that 5.0% had ADL impairment and 3.1% were unsafe. Discordance between officer and CDCR reports of disability was common, with officers reporting higher disability rates. The 41 high-risk prisoners were more likely to have ADL impairment (22.0% vs 5.2%, P<.01) and geriatric syndromes such as falls and incontinence than the random sample. Overall, nearly one-third of geriatric prisoners were unknown to their assigned officer. Officers identified more disability than the CDCR, and prisoners they identified as high risk had nursing home-level functional impairments. Significant improvement in disability assessment is needed for officers and the CDCR.
authors: Division of Geriatrics, University of California, San Francisco, California, USA. brie.williams@ucsf.edu
authors: Brie A
authors: BA
authors: Williams
authors: Karla
authors: K
authors: Lindquist
authors: Terry
authors: T
authors: Hill
authors: Jacques
authors: J
authors: Baillargeon
authors: Jeff
authors: J
authors: Mellow
authors: Robert
authors: R
authors: Greifinger
authors: Louise C
authors: LC
authors: Walter
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002140:California; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D035846:Law Enforcement; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D011795:Surveys and Questionnaires