Williams Brie A, Lindquist Karla, Hill Terry, Baillargeon Jacques, Mellow Jeff, Greifinger Robert, Walter Louise C
Division of Geriatrics, University of California, San Francisco, California, USA.
J Am Geriatr Soc. 2009 Jul;57(7):1286-92. doi: 10.1111/j.1532-5415.2009.02286.x.
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.
尽管老年囚犯的数量不断增加，但对于监狱中的老年残疾或医疗保健情况却知之甚少。虽然惩教人员常常充当囚犯与医疗系统之间的联络人，但他们在识别老年残疾方面的作用尚未得到明确界定。本研究的目的是评估惩教人员对其所负责的老年囚犯残疾情况的评估，并将他们的观点与加利福尼亚州惩教与改造部（CDCR）的报告进行对比。对分配到11所监狱中618名随机挑选的老年囚犯的71名惩教人员进行了问卷调查。还分析了惩教人员认定为“高危”的另外41名囚犯的信息。通过惩教人员问卷（日常生活活动（ADL）受损情况、老年综合征、护理级别）、病历审查（医学诊断）以及CDCR数据（人口统计学、残疾认定）来确定囚犯的残疾和健康状况。总体而言，211名（34.1%）老年囚犯其惩教人员并不了解。在407名已知囚犯中，惩教人员报告称5.0%有ADL受损情况，3.1%存在不安全因素。惩教人员与CDCR关于残疾情况的报告之间存在差异很常见，惩教人员报告的残疾率更高。与随机样本相比，这41名高危囚犯更有可能出现ADL受损情况（22.0%对5.2%，P<0.01）以及跌倒和大小便失禁等老年综合征。总体而言，近三分之一的老年囚犯其负责的惩教人员并不了解。惩教人员认定的残疾情况比CDCR更多认定为高危的囚犯有养老院级别的功能障碍。惩教人员和CDCR在残疾评估方面需要有显著改进。
