Aging at Home Strategy

About the Strategy

The Aging at Home Strategy was designed to enable seniors to live healthy, independent lives in their own homes by creating opportunities that reflect their lifestyle choices and how they truly want to live. These supportive opportunities for seniors also avoid the unnecessary loss of independence due to premature admission to higher care long-term care homes and/or hospitals.   The Aging at Home Strategy is of critical importance, both for its potential to improve the lives of Ontario seniors, and also because it will help ensure the sustainability of the overall health system. 

Aging at Home Information "Placemats"

Click here for access to the project "placemats" created by providers as a quick reference for key information  

snapshot2

Programs funded to date.  Click on the link for more details

Aging at Home Programs

Adult Day Program Expansion - Elgin:

Increases the opportunity for more seniors to participate in a day away program to maintain their health and the health of their caregivers.  Overnight stay component is also part of the program

Funded Program Partners:

  • City of St. Thomas - Valley View

Total Base Funding as of Year 3:

  • $461,459

Adult Day Program Expansion - Middlesex (Dorchester Adult Day Program):

Increases the opportunity for more seniors to participate in a day away program to maintain their health and the health of their caregivers.
 

Funded Program Partners:

  • VON Middlesex Elgin

Total Base Funding as of Year 3:

  • $110,754
Assisted Living Elgin - West Lorne, St Thomas (2 sites): 

Provides 24-hour, seven day per week availability of personal support services including bathing, toileting, dressing, medication assistance, homemaking services such as light housekeeping, shopping, meal preparation, social programs, and care management in apartment buildings in St.Thomas and West Elgin.

Funded Program Partners:

  • Canadian Red Cross Woodstock
  • Von Middlesex Elgin
  • West Elgin Community Health Centre

Total Base Funding as of Year 3:

  • $1,326,224.00

Assisted Living Tillsonburg (ALCom):

Provides a new model of supportive housing for people in their current home instead of needing to move to a supportive housing building. 24-hour, seven day per week availability of personal support services including bathing, toileting, dressing, medication assistance, homemaking services such as light housekeeping, shopping, meal preparation, social programs, and care management in Tillsonburg.

Funded Program Partners:

  • Tillsonburg & District Multi-Service Centre
  • South West Community Care Access Centre

Total Base Funding as of Year 3:

  •  $619,339.00

Behavioural Support System for Older Persons with Behavioural Challenges:

3 Geriatric Mental Health Response Teams (North, Central and South) will be integrated within geographically designated Geriatric Cooperatives (all providers of geriatric services) and will build upon the local capacity necessary to address challenging behaviours where people reside

Funded Program Partners:

  • St. Joseph's Health Care London (RMHC)
  • Stratford General Hospital
  • Grey Bruce Health Services
  • London Health Sciences Centre
  • Woodstock General Hospital

Total Base Funding as of Year 3:

  •   $3,083,500.00

Capacity Building of Community Support Services:

Establishes consistent standardized policy and procedures and enhances recruitment and retention of volunteers for services heavily reliant on volunteers to provide the service. Encourages the volunteerism of diverse community members to better respond to the needs of community members.

Funded Program Partners:

  • Knollcrest Lodge Community Outreach Services
  • Mitchell and Area Community Outreach
  • St Marys and Area Home Support
  • Stratford Meals on Wheels
  • Town and Country
  • Midwestern Adult Day Program

Total Base Funding as of Year 3:

  •   $812,220.00

Caregiver Support Circle (Formally Caregiver Connects):

Provides information, counseling support, and relief services required by caregivers.

Funded Program Partners:

  • VON Grey Bruce

Total Base Funding as of Year 3:

  •   $173,757.00

Community Stroke Rehab:

A team of rehabilitation specialists assist individuals who have had a stroke to make further gains in their recovery after leaving the hospital so that they can continue to live independently.

Funded Program Partners:

  • St. Joseph's Health Care London
  • Stratford General Hospital
  • Grey Bruce Health Services

Total Base Funding as of Year 3:

  •   $2,135,642.00

First Link (Elgin, Grey/Bruce, Huron, London/Middlesex, Oxford, Perth)

Connects people with their local Alzheimer Society for learning opportunities, counseling support and linkage to community services appropriate to them at different stages of the disease

Funded Program Partners:

  • Alzheimer Society  (Elgin-St. Thomas, Grey Bruce, Huron County, Perth County, London Middlesex and Oxford County branches)

Total Base Funding as of Year 3:

  •   $1,587,972.00

Flo Collaborative & Flo Expansion: 

Enhances processes to improve flow through units in hospitals

Funded Program Partners:

  • South West Community Care Access Centre 
  • Grey Bruce Health Services

Total Base Funding as of Year 3:

  •   $137,500.00

Geriatric Emergency Management (GEM): 

Assesses patients in Emergency Department to determine if their needs can be met with support outside of the hospital and connect them with the appropriate service

Funded Program Partners:

  • London Health Sciences Centre

Total Base Funding as of Year 3:

  •   $150,000.00

Grey Bruce Falls Prevention and Intervention Program:

Provides a falls prevention program that screens seniors who are at risk of falling, that provides awareness and education, and provides exercise services to those at risk in their homes through the assistance of their personal support worker.

Funded Program Partners:

  • South West Community Care Access Centre

Total Base Funding as of Year 3:

  •   $400,850.00

Grey Bruce Transportation Coordination:

A transportation coordinator improves coordination through a variety of methods such as an updated inventory of resources, best practices and innovative solutions like centralized management and dispatch of existing vehicles.

Funded Program Partners:

  • Home and Community Support Services 
  • Canadian Red Cross - Grey Bruce
     

Total Base Funding as of Year 3:

  •   $200,000.00

Home and Community Support Adult Day Services (Grey Bruce):

Increases opportunity for more seniors to participate in a day away program to maintain their health and the health of their caregivers.

Funded Program Partners:

  • Home and Community Support Services 

Total Base Funding as of Year 3:

  •   $252,737.00

Home at Last:

Offers seniors transportation and assistance to safely settle back home following a stay in hospital

Funded Program Partners:

  • South West Community Care Access Centre
  • VON Middlesex Elgin
  • Canadian Red Cross Grey Bruce
  • Onecare Home and Community Support Services
  • Tillsonburg & District Multi-Service Centre
  • Canadian Red Cross Woodstock

Total Base Funding as of Year 3:

  •   $1,219,598.00

Home Help / Homemaking Services - North, Central:\

Expanded Home help services in Grey Bruce and Huron Perth such as housecleaning and odd jobs to maintain the homes that seniors currently live in.

Funded Program Partners:

  • Home and Community Support Services 

Total Base Funding as of Year 3:

  •   $85,216.00

Integrated Case Management Model Owen Sound:

Assesses patients in Emergency Departments to determine if their needs can be met with support outside of the hospital and connect them with the appropriate service

Funded Program Partners:

  • South West Community Care Access Centre

Total Base Funding as of Year 3:

  •   $200,000.00

Interim Long-Term Care beds - Oxford:

9 Interim LTCH Beds in Oxford County to allow ALC patients to leave the hospital while they wait for a permanent long-term care home bed

Funded Program Partners:

  • Caressant Care Woodstock
  • Caressant Care Courtland
  • Maple Manor Long-Term Care Home

Total Base Funding as of Year 3:

  •   $366,300.00

Long-Term Care Home Rural Pilot Project:

Rural outreach services including Wellness for Seniors, Meals on Wheels, Rural Transportation, and Supportive Housing.

Funded Program Partners:

  • Bluewater Rest Home
  • Town and Country Support Services

Total Base Funding as of Year 3:

  •   $442,888.00

Nurse Led LTC Home Outreach:

Provides individualized resident care planning support and education to LTC Homes to enhance the quality of the resident care and enable homes to address non or less urgent needs of residents at the home rather than having residents visit the ED or be hospitalized

Funded Program Partners:

  • South West Community Care Access Centre

Total Base Funding as of Year 3:

  •   $300,000.00

Quality and Process Improvement Program:

The South West LHIN will advance its quality & process improvement strategy and continue its focus on improvement work across the continuum of care, enhancing its resources in this area to ultimately improve people’s health care experiences, the health of particular populations and the value we receive for the money that we spend.  As outlined in the proposed Excellent Care for All Act, the aim is to “foster a culture of continuous quality & process improvement where the needs of the patients come first”.

Funded Program Partners:

  • South West Community Care Access Centre

Total Base Funding as of Year 3:

  •   $950,000.00

Rural Transportation Coordination (Huron Perth):

A single, coordinated place to call for accessible coordinated transportation in Huron and Perth Counties. Common trip scheduling of transportation vehicles will lead to leveraging the capacity of transportation resources to meet increased demand.

Funded Program Partners:

  • Stratford Meals on Wheels

Total Base Funding as of Year 3:

  •   $231,116.00

Safe at Home:

Assists frail seniors through visits from a nurse practitioner and additional nursing and personal support visits to review medications and how the caregiver is coping, and to provide the medical and personal assistance to keep them safe and living independently in their home.
 

Funded Program Partners:

  • South West Community Care Access Centre

Total Base Funding as of Year 3:

  •   $2,902,572.00

Services and Supports for Aboriginal Seniors:

Increases opportunities for cultural safety across the system, ensure effective culturally appropriate service delivery and augment services and supports for seniors in the aboriginal community

Funded Program Partners:

  • South West Community Care Access Centre
  • South West Regional Healing Lodge - Kiikeewanniikaan
  • Southwestern Ontario Aboriginal Health Access Centre
  • Oneida First Nation of the Thames

Total Base Funding as of Year 3:

  •   $1,215,211.00

Share the Care:

Provides a defined process and tools to assist an informal care group to help look after a seriously or chronically ill person

Funded Program Partners:

  • South West Community Care Access Centre

Total Base Funding as of Year 3:

  •   $110,250.00

SMART and In-Home Volunteer Exercise:

Provides physical activity and wellness education related to health issues and nutrition for seniors across Grey and Bruce Counties in community settings and in senior's homes.

Funded Program Partners:

  • VON  Grey Bruce

Total Base Funding as of Year 3:

  •   $125,397.00

Supportive Housing Grey Bruce (and Security Check):

In selected apartment buildings in Grey and Bruce Counties, 24 –hour, seven day per week availability of personal support services including bathing, toileting, dressing, medication assistance, homemaking services such as light housekeeping, shopping, meal preparation, social programs, and care management.

Funded Program Partners:

  • VON  Grey Bruce

Total Base Funding as of Year 3:

  •   $898,789.00

Supportive Housing London:

Provide 24-hour, seven day per week availability of personal support services including bathing, toileting, dressing, medication assistance, homemaking services such as light housekeeping, shopping, meal preparation, social programs, and care management.

Funded Program Partners:

  • Cheshire Homes of London

Total Base Funding as of Year 3:

  •   $502,881.00

Supportive Housing Middlesex:

Provides additional supportive housing for seniors in selected apartment buildings in Strathroy, 24-hour, seven day per week availability of personal support services including bathing, toileting, dressing, medication assistance, homemaking services such as light housekeeping, shopping, meal preparation, social programs, and care management. Mental Health services provided by Crest Centre to a portion of population.

Funded Program Partners:

  • VON Middlesex Elgin
  • Crest Support Services

Total Base Funding as of Year 3:

  •   $1,135,680.00

System of Care for High Risk Seniors who live in their own homes:

This project aims to define a framework for a system of care for high risk seniors currently living in the community and implement and evaluate the framework in London before spreading to the entire LHIN.  Following an acute care episode, individuals living at home and defined as high risk will receive appropriate levels of care initially in the  home setting through a London pilot. The framework developed will include a variety of care settings including home, assisted living, transitional care, complex continuing care, rehabilitative care or long-term care.

Funded Program Partners:

  • Cheshire Homes of London
  • South West Community Care Access Centre

Total Base Funding as of Year 3:

  •   $2,400,000.00

Transitional Care Unit Parkwood Hospital:

Provides step down unit for patients needing slow stream recovery following an acute episode who meet admission criteria for the unit

Funded Program Partners:

  • St. Joseph's Health Care London
  • South West Community Care Access Centre

Total Base Funding as of Year 3:

  •   $433,535.00

Wellness for Seniors:

Collaborative effort to provide and standardize physical activity and wellness education such as health issues and nutrition for seniors across Huron and Perth Counties in community settings.

Funded Program Partners:

  • Knollcrest Lodge Community Outreach Services
  • Mitchell and Area Community Outreach
  • St Marys and Area Home Support
  • Stratford Meals on Wheels
  • Town and Country
  • Midwestern Adult Day Program

Total Base Funding as of Year 3:

  •   $710,315.00

Wrap Around for Immigrants and the Francophone Community:

Creates individualized supports for culturally diverse seniors through professionals and community members from those communities based on the unique needs of the senior.

Funded Program Partners:

  • London InterCommunity Health Centre

Total Base Funding as of Year 3:

  •   $55,790.00

Continue with, and expand, implementation of self-management strategy:

"This strategy encompasses a range of approaches that aim to develop people’s self management skills and resources while providing skills, tools and resources to providers to enable them to support their patients in their self management efforts. The initial components include:

Programs For Providers:

  • Self Management Toolkit
  • Motivational Interviewing and 3 Minute Empowerment™
  • Coaching Support

Programs For Clients:

  • Stanford Self Management Programs
  • Other programs to be developed over time

The strategy also involves co-ordination of all of the self management related efforts that are occurring within the LHIN to ensure best use of the resources, consistency, quality and that the right supports are available to clients and providers, no matter where they live in the LHIN.
 

Funded Program Partners:

  • South West Community Care Access Centre

Total Base Funding as of Year 3:

  •   $949,000.00