Advance Care Planning in the Delivery of Adult Protective Services

ABSTRACT

In ensuring the safety and protection of older adults from abuse and exploitation, adult protective services (APS) workers face a variety of situations involving serious illness and end-of-life conditions. Many older adults encountered in APS will present with one or more chronic conditions that may warrant discussion of advance care planning with clients and their families. This study surveyed APS workers (n = 508) in 21 states regarding encounters with end-of-life situations and the practice of future care planning. Results revealed that three-fourths of APS workers encounter clients with serious illnesses and about two-thirds do discuss planning in advance for care. More than one-half of the respondents indicated client incapacity and refusal to address future care needs as barriers to discussing planning in advance for care. Recommendations to enhance advance care planning among APS workers are discussed.

KEYWORDS:

• Advance care planning
• advance directives
• elder abuse
• end-of-life care
• adult protection
• adult protective services (APS)

Acknowledgements

This study was supported by a faculty grant awarded to the first author by The University of Alabama Research Advisory Committee. The authors wish to acknowledge Joanne Otto, former executive director of the National Adult Protective Services Association, and Marilyn Whalen, APS consultant, for their assistance in study sample recruitment and survey development and Daniel Durkin, graduate research assistant at the School of Social Work at The University of Alabama, for assistance with data management.

Notes

^a Average of 17 years since graduation with highest degree (SD = 11).