About the Program
To enhance the health care and well-being of vulnerable seniors in our community by supporting access to primary care and other social services. Provided by a Registered Nurse and Community Health Worker in the home.
Additional Details
Services are provided to help seniors maintain their health and independence. All referrals are screened through a central intake to ensure criteria are met. See the criteria below.
Services offered:
Home visits
Chronic disease monitoring
Accompaniments to medical appointments as appropriate
Geriatric health assessments
Care plans
Advocacy - for the individual client and the senior's community as a whole
Social prescribing
Case management
System navigation
Collaborating with community partners
Criteria for referral:
Over 65 and
Experiencing barriers to following through on their Health Care
This may include but not limited to-
Frailty
Homebound
Cognitive Impairment
Poor medication management
Isolated/Lives alone or with minimal support
Lives with risk
Decline in function
Has difficulty managing chronic medical issues
We do not serve:
Under 65
Those who live in LTC, retirement homes or assisted living facilities
Acutely palliative
Outside the CCHC catchment
To find out if you are in our catchment give us a call or visit this website: coalitionottawa.ca/en/find-your-chrc.aspx
Similar Programs
