Caring for the Aging Incarcerated Population

Farah Acher Kaiksow, MD, MPP, is a hospital medicine clinician and health equity researcher.

Her specific area of expertise is at the intersection of incarceration and health, with a focus on the impact of hospitalizations on the rapidly growing population of older incarcerated adults.

Dr. Farah Kaiksow and learner with corrections officer in foreground

Reducing the Risks of Hospitalization for Older Incarcerated Adults

Dr. Kaiksow’s research studies the impact of incarceration-specific care processes on older incarcerated adults.

Hospitalizations are high-risk events that can cause functional and cognitive decline, especially for older adults. 

Dr. Farah Kaiksow and learner with corrections officer in background

The Relationship Between Incarceration, Aging and Hospitalization

At the same time, the incarcerated population is aging. As of 2019, more than 21% of incarcerated adults in the U.S. – nearly 300,000 people – were 50 years or older, ​and the population continues to grow. As this demographic shift happens, more incarcerated adults will require hospitalization. 

People who are incarcerated are more likely to be from racial and ethnic minoritized groups and of lower socioeconomic status. They face higher rates of mental health conditions and cognitive impairment than individuals who are not incarcerated.

Incarceration is also associated with accelerated aging, with one study estimating that every year spent in prison shortens an individual’s lifespan by two years. 

Some incarceration-specific inpatient care practices – such as shackling and limiting social interactions – are likely to worsen the impact of hospitalizations on older incarcerated adults.

Dr. Kaiksow's work aims to reduce the risks of hospitalization on this already vulnerable population.

Active Projects

Identification of Delirium in Older Adults who are Hospitalized While Incarcerated

Identification of delirium in the hospital is poor. Given the challenges associated with providing care to adults who are hospitalized while incarcerated, there is good reason to suspect that identification in this population is even worse.

At the same time, older incarcerated adults likely face higher risk of delirium given their baseline poor health.

The goal of this study is to compare the rates of delirium identification between incarcerated and nonincarcerated adults, adjusting for known risk factors and overall health.

Impact of Stigmatizing Language on Incarcerated Patients in the Hospital

Stigmatizing language is common in the medical record and has been shown to negatively impact the care of people with substance use disorder, both through transmission of bias and through differences in treatment. The effects of stigmatizing language are particularly severe for people from marginalized groups, including Black/African Americans. 

Despite well-known bias against people who are incarcerated, and the disproportionate impact of incarceration on marginalized populations, there is little data on the presence or impact of stigmatizing language in the medical record for this vulnerable group. 

This study aims to qualitatively and quantitatively assess for stigmatizing language in hospital notes for patients who are hospitalized while incarcerated.

Funding Support

Dr. Kaiksow’s work has been funded by the University of Wisconsin Institute for Clinical and Translational Research.

A female clinician in blue scrubs touches the shoulder of a male colleauge in a white coat while walking in the hospital hallway

Help Us Transform Medicine

You can help support research by making a gift to the Department of Medicine.