Aging Well at Home Initiative

Loyalist Family Health Team and its affiliated physicians believe strongly that people should be supported to age well at home. Our Aging Well at Home Program aspires to meet the needs of our older patients who are encountering challenges remaining in their own home. We also assist patients interested in planning their aging journey, to learn how to effectively meet those challenges in the future. 

Our Aging Well at Home Advocate, who is an Occupational Therapist, can, upon referral from one of our physicians, help connect older people and their caregivers with needed resources. We have two dedicated Home Care Coordinators embedded in our team who collaborate with other team members to identify ways to support our aging patients at home. 

For those with more challenging medical problems, we offer consultations with a Care of the Elderly specialist upon referral from one of our physicians. Our team hosts collaborative, monthly, interdisciplinary, inter agency rounds to discuss how to best support those patients identified at most risk of institutionalization. In addition to Loyalist Family Health Team physicians, nurses, occupation therapist, social worker, medical office assistant, and administration staff, these rounds include representatives from Providence Continuing Care Hospital, Community and Social Services, Community Paramedics, Home and Community Care, the VON Smile Program, The Alzheimer's Society and a Care of the Elderly specialist. Our Aging Well at Home Program collaborates with Loyalist Township to present an annual Seniors' Expo to showcase local services designed to support aging well at home.