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Older Adults Post-Incarceration: Restructuring Long-term Services and Supports in the Time of COVID-19
Nathan A Boucher1, Courtney H Van Houtven2, Walter D Dawson3
1Sanford School of Public Policy, Duke University, Durham, NC, USA; School of Medicine, Duke University, Durham, NC, USA; Durham VA Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health System, Durham, NC, USA; Duke-Margolis Center for Health Policy, Durham, NC, USA.
Objectives:
To describe long-term care services and supports (LTSS) in the United States, note their limitations in serving older adults post-incarceration, and offer potential solutions, with special consideration for the Coronavirus Disease 2019 pandemic.
Design:
Narrative review.
Setting And Participants:
LTSS for older adults post-incarceration.
Methods:
Literature review and policy analysis.
Results:
Skilled nursing facilities, nursing homes, assisted living, adult foster homes, and informal care from family and friends compose LTSS for older adults, but their utilization suffers from access and payment complexities, especially for older adults post-incarceration. A combination of public-private partnerships, utilization of health professional trainees, and unique approaches to informal caregiver support, including direct compensation to caregivers, could help older adults reentering our communities following prison.
Conclusions And Implications:
Long-standing gaps in US LTSS are revealed by the coronavirus (severe acute respiratory syndrome coronavirus 2) pandemic. Older adults entering our communities from prison are particularly vulnerable and need unique solutions to aging care as they face stigma and access challenges not typically encountered by the general population. Our review and discussion offer guidance to systems, practitioners, and policy makers on how to improve the care of older adults after incarceration.
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