Care Coordination

Determined by the unique needs of each individual our Care Coordinators provide the following supports:

  • Conduct an assessment and develop an initial Care Plan

  • Facilitate Advance Care Planning

  • Provide ongoing psychosocial support

  • Initiate referrals to hospice services

  • Facilitate healthcare navigation to link with other support agencies i.e. transportation services

  • Provide information and education on end-of-life issues

  • Advocate for increased services

  • Liaise with Community Palliative Care Physician

  • Liaise with the Residential Admissions Coordinator when transition into our Residential Care Program is planned