Older adults comprise the fastest growing demographic in correctional facilities in the United States. Studies have shown older adults in prison report difficulty accessing healthcare and navigating the prison environment. Little is known about how older adults navigate aging and access healthcare in the jail setting. We sought to explore experiences of older adults incarcerated in a county jail. We conducted semi-structured qualitative interviews with 20 older adults (> 50 years old) who were incarcerated at a local county jail and were referred to the emergency department for acute care needs. Interviews focused on experiences of aging while incarcerated and access to healthcare. We used an inductive approach to code data and identify overarching themes. Participant demographics were representative of the broader jail population demographics. Two major themes emerged. First, participants reported difficulty navigating the jail environment related to aging and unaddressed disabilities. Examples included climbing to use the top bunk of a bunk bed, difficulty grasping objects due to a Parkinsonian tremor, and significant visual impairments. Participants relied on other inmates for assistance with limited systemic accommodations. Second, participants faced numerous challenges when attempting to access healthcare, including lack of clarity around procedures for accessing care and mutual distrust sometimes marking their relationship with medical staff. Participants described difficulty using a digital kiosk system to submit medical requests, and successful healthcare experiences involved an element of serendipity such as advocacy from a sympathetic officer. Despite a constitutional right to healthcare and high rates of medical comorbidities, older prisoners experienced a challenging physical environment in jail and difficulty accessing healthcare. Further work is needed to identify potential age-friendly modifications to the jail environment and improved healthcare delivery.
Suh et al. (Tue,) studied this question.