Constructing Care and Community: A Practice Model for Providing Supportive Services That Reunite Aging People in Prison with Their Families and Communities

Background: The experiences of aging people in prison has been gaining greater attention as evidence shows how correctional staff and prison settings are not designed to provide adequate care for frail elders and those with serious and terminal illnesses (Maschi et al.,2012,2014,2015). However, little attention has been paid to the reintegration preparedness of service providers and formerly incarcerated elders. This qualitative study attempts to fill that gap be answering the following research questions: What do service providers and formerly incarcerated elders report about what factors facilitated or created barriers to successful community reintegration? In the era of health and criminal justice reform, these findings have important implications for social work and inter-professional practice in providing culturally responsive care transitions for formerly incarcerated elders and their families.

Methods: This qualitative study was conducted in two phases. In phase one, sixteen service providers from sixteen community reentry programs responded to an online survey using the Dillman et al., (2009) online survey method. The survey was divided into four parts and included open-ended questions about what factors influenced the community reunification of older adults. In phase two, thirty-one formerly incarcerated older men and women participated in one ninety-minute in-depth semi-structured interview. The qualitative data were analyzed interpretive content analysis methods as outlined in Drisko and Maschi (in press).  Inductive analyses methods were conducted using N-VIVO 6 and initial codes and categories were constructed using constant comparative methods. Three coders were used and strategies for rigor included the use of memos and audit trail and peer debriefing. In the final stage of analyses, clustered matrices and conceptual model were developed to create a model of the relationship among the identified concepts.

Findings: Community service providers shared their views on what factors that influenced elders’ access to services following their most recent incarceration. Participants most commonly reported structural barriers, such as employment and housing (i.e., homelessness) that posed a challenge to successful reintegration of elders to their family and community. They also reported personal and social barriers that included a history of substance abuse and lack of family and other social supports. Two major themes emerged from the life course interview data of formerly incarcerated elders: (1) Person in a community care context and (2) Determinants (facilitators and barriers) to successful reunification.  Most participants reported a breakdown in access to family and community care that influenced their pathway to prison and the challenges faced upon reentry. Participants also noted determinants of successful reintegration were based on the access to basic needs (e.g., food, clothing, safety, and shelter) as well as family and other supports.

Conclusion. These findings suggest that the quality of informal and formal caregiving before, during, and after prison had a powerful influence on formerly incarcerated elders’ notions of family and community and how they navigated their most recent community reunification experience. A holistic transition care assessment tool and reintegration model for elders released from prison as well as advocacy tools, such as the use of compassionate and geriatric release laws are presented.