Adult Protective Services Use for Older Adults at the Time of Hospital Discharge

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In this article a description is given of the use of adult protective services (APS) as a “safety net” by healthcare team members (HCTMs) when concerns were evident about an older adult's hospital discharge decisions.

Design and Methods

The study had a descriptive qualitative design and participants' perceptions of discharge destination decisions were explored. A total of 13 semi-structured interviews were conducted with 7 HCTMs, who were the primary discharge planners for 13 frail older adults.


Themes that emerged were safety, “reconciling the differences,” “letting them fail,” having confidence in the family caregiver, and weighing the options. If HCTMs did not view the older adults' discharge decisions as safe, they would first try to persuade the older adults to change their minds, and if that failed, they would report the older adult to APS for follow-up.


The APS system does not augment, nor does it replace, adequate hospital discharge planning. The use of the APS system as a safety net at the time of hospital discharge is a symptom of a grave problem that will only worsen as the number of elderly adults increases and adds stress to an already overburdened healthcare system.

Clinical Relevance

Access to health and social services at the time of hospital discharge is essential to the health and well-being of frail older adults; major gaps in services must be identified and corrected.

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