Geriatric Care Management Services
Care Management
Our care managers are registered social workers, occupational therapists and other allied health professionals. We meet with you and your family in your home to discuss and identify areas of concern. We will identify community resources to assist you and access publicly available services whenever possible. We are your case coordinators. We liaise with your medical team, family members and involved service providers to ensure a coordinated approach to service delivery. Our services include:
Wellness Plan
Where available, our Geriatric Care Manager will meet with and assess the senior in his or her own home. This on-site assessment and interview generally takes between 1.5- 2.5 hours and addresses their function as well as emotional, cognitive and familial issues as well as caregiver issues. Significant others (spouses, adult children) are welcome. The Geriatric Care Manager will complete a written Wellness Plan that documents the areas of concern and need and identifies the recommended goods and services.
We will then review this ‘blueprint’ or ‘roadmap’ with you and finalize an agreement to proceed with its implementation. You may choose to implement any or all of the recommendations yourself or ask us to assist in their implementation.
Wellness Monitoring
As the recommendations and services are implemented, Wellness Monitoring is available. This service includes ongoing monitoring of the older person’s ongoing health and wellness needs and typically includes:
- Regular visits by the Geriatric Care Manager with telephone support and updates to family members
- Liaising with in home support staff
- Liaising with other professional services and accessing of required community based resources.
Retirement Transition Care Planning
This package is designed for individuals whose health has reached a point where it is necessary to make a transition from home to an alternative care setting. The Geriatric Care Manager will work with the senior and significant others in delineating a preferred search area for accommodations. Transition Care Package services typically include:
- Researching and providing a summary of appropriate retirement residences, and other local assisted living and/or long-term care homes – identifying a set number of preferred recommendations
- Researching and helping an individual complete the required paperwork for admission to a care facility
- Coordinating appropriate referrals.
Telephone Consultation
Sometimes you just need a little guidance and support and family members want to discuss issues. Telephone consultations are available with a social worker that understands, knows the system and can guide you from behind the scenes.
What is a Geriatric Care Manager?
In-home Safety Assessment
We provide an in-home visit with one of our occupational therapist/physiotherapists specializing in assistive devices, and accessibility issues. Itemized recommendations and costing for any equipment will be identified. Upon your approval, equipment can be ordered and provided to you.
Counselling
Counselling services provided by a Masters level social worker are available to you in the privacy of your home.
Our Fiduciary Duty is To You, Our Client
We do not take commissions or referral fees from any organizations.
