Geriatric Medicine Across the Great Divide

Geriatric Medicine Across the Great Divide: Medical Education Needs of Legal Professionals in the Criminal Justice System

PIs: Tacara Soones, MD and Brie Williams, MD

Other Collaborators: Sarah Garrigues, David Faigman, MA, JD; Sarah Hooper, JD; Megan DeLain, JD

Project Objective:
 This research seeks to assess the geriatrics knowledge and educational needs of legal professionals who interact with older adults in the criminal justice setting. Researchers from the UCSF Division of Geriatrics conducted a study of legal professionals’ experiences with and knowledge of issues relevant to older adults, and identified opportunities for education and training for legal professionals. The researchers then contacted the UCSF/UC Hastings Consortium for assistance in identifying existing legal literature about aging adults in jail.

Project Description: In 2009, over 500,000 older adults (age 55 and older) were arrested, up from 350,000 in 1996. In this same time period, the overall jail population grew by 53% while the number of older inmates increased by 278%. However, little is known about legal professionals’ knowledge about common medical conditions that could affect older adults’ ability to participate meaningfully in the legal process, benefit from alternatives to incarceration, or contribute to their likelihood of re-arrest even though the public and individual health opportunities within local criminal justice systems are significant.

Researchers from the UCSF Division of Geriatrics conducted self-administered surveys with 61 legal professionals in the San Francisco county jail system and qualitative interviews with a subset of 10 survey respondents. The surveys included questions designed to assess both attitudes towards and knowledge about older adults. The researchers used the validated, 14-item “Likert scale” to assess attitudes about older adults; they then assessed geriatrics knowledge that stakeholders deemed important for legal professionals and based these questions on validated survey items when available. Questions related to epidemiology, health, and functional status, social needs and the availability of common social services. Lastly, participants were given free-text areas to convey other thoughts regarding older adults in the justice system and potential areas for education.

At the end of the quantitative attitudes and knowledge survey, participants were asked if they would be willing to participate in a 1-hour interview to explore their answers in more depth. In the qualitative interviews, participants were asked about the extent of their professional experience with older adults, perceived challenges working with this population, knowledge of factors specifically affecting elders’ ability to participate in the justice system, and potential areas for geriatrics specific training and education.  All interviews took place over a 6-month period in 2011-2012.

The UCSF researchers then contacted the UCSF/UC Hastings Consortium for assistance in identifying legal literature referencing aging adults in jail, as well as to answer specific questions that arose in the course of their medical research. The Consortium is currently conducting legal research on these questions.

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