Service Information
Let’s Go Home Program
Community Support Connections
Category:
Hospital Transition to Home Support
Internal Referrals Only
Service Details
Description:
This program is offered to support individuals being discharged from hospital. The individual is connected with a Care Planner who will be involved to help with the transition from the hospital to their home. In the four to six weeks after discharge, the individual will be provided with practical support services through Community Support Connections including Meals on Wheels, homemaking and grocery shopping, and transportation as well as system navigation with other community agencies to ensure a smooth transition home.
Languages:
English
Cost to Client:
Free
Eligibility Criteria
Other Criteria:
Minimum Age:
18 yrs
Criteria:
- The client is a senior or adult with physical disability being discharged or recently discharged from hospital to home (not long-term care, retirement, shelter) and in need of personal resources/supports for recuperation from hospitalization.
- The client is medically stable for discharge and is at risk of: readmission to hospital / long-term care admission / ED visit post discharge. Client may also be present at the Emergency Department with needs related to social determinants of health.
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Referral Contact Information
Referral Fax:
1 (519) 648-3737