Date of Award

12-2024

Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Gerontology

First Advisor

Jan Mutchler

Second Advisor

Elizabeth Dugan

Third Advisor

Andrea Leverentz

Abstract

THE PROVISION OF HEALTHCARE FOR OLDER ADULTS IN A MASSACHUSETTS JAIL/HOUSE OF CORRECTION: PERSPECTIVES FROM PROVIDERS November 2024 Laura C. Driscoll, B.S., Boston University M.S.P.T., Boston University DPT, MGH Institute of Health Professions M.S., University of Massachusetts Boston Ph.D., University of Massachusetts Boston Directed by Professor Jan Mutchler The aging population in U.S. jails is growing rapidly presenting significant challenges for healthcare provision within carceral settings. Older adults in these facilities often experience complex health conditions, including chronic diseases and age-related impairments, that require specialized care. Despite this, limited research has explored the experiences of healthcare providers tasked with caring for this vulnerable group in jails. This dissertation examines the perspectives of healthcare providers working with older adults in short-term confinement in a Massachusetts jail/house of correction, focusing on how the unique relational, structural, organizational, and policy-based constraints of the carceral environment shape their ability to deliver care. Drawing on a socio-ecological model of health promotion and Watson’s Theory of Human Caring, this study employs qualitative methods to investigate the lived experiences of healthcare professionals. Findings reveal that while providers strive to offer patient-centered and equitable care, they face numerous barriers, including limited resources, policy restrictions, and the inherent conflicts between custodial priorities and healthcare needs. The study also highlights the impact of COVID-19 on healthcare delivery in jails, exacerbating existing challenges. The results point to the need for policy reforms that prioritize geriatric care and improved healthcare models to support both the incarcerated population and the professionals serving them. These findings contribute to the growing body of literature on healthcare in correctional settings, with specific attention to the needs of older adults, and provide recommendations for improving care

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