st. clair west services for seniors crems 2010 roundtable december 3, 2010 embracing diversity,...

St. Clair West Services for SeniorsCREMS 2010 ROUNDTABLE

December 3, 2010

Embracing Diversity, Encouraging Independence, Ensuring Dignity


We are a non-profit charitable organization serving seniors and/or adults with disabilities. Our agency welcomes multilingual and multicultural caregivers, participants and clients.

ABOUT US

OUR FUNDERS

Supported by:

St. Clair West Services for Seniors


Celebrating more than 35 years

1973 :St. Clair West Meals on Wheels was established by local churches, with a federal grant, to deliver meals three days weekly. Our name originates from our initial location.

2010:• We employ 86 staff the majority Personal Support Workers

• We benefit annually from the contribution of 50 placement students and over 200 volunteers.

• Our client and participant base is 1700

• We are leaders in innovation in Meals on Wheels and Intake and Assessment

• We are community focused and partnership driven



Adult Day Centre, Respite Care, & Case Management, Information and Referral

Adult Day Centre, Respite Care, & Case Management, Information and Referral

Our Service Boundaries


Our Service Boundaries

Home Help, Meals on Wheels, & Transportation

Home Help, Meals on Wheels, & Transportation


Demographics

• Toronto inner suburb area.

• In the immediate environs, 26% - 39.9% of families live below Statistics Canada low-income cut-off line.

• However, the catchment area is diverse and our clients and participants range from very poor to affluent.

• Immediate community and its seniors are concerned about safety.

• Greater than average incidence of diabetes, hypertension and heart disease.

• Low levels of literacy, a high immigrant population and many individuals whose first language is not English.

• Service area is one of the most multicultural communities in Canada populated by significant numbers of Italians, Portuguese, Latin Americans, Somalis, West Indians, South Asians and Eastern Europeans.


• Adult Day Centre• Case Management, Information and Referral• Community Programs• Home Help and Respite Care• Meals on Wheels• Supportive Housing• Transportation

• Donating • Volunteering

OUR SERVICES

OPPORTUNITIES TO GIVE



Community Development

The Agency has a Community Development focus.

Training in Community Development, funded by United Way has assisted us on our path.

At St. Clair West Services for Seniors Community Development is a participatory process that includes clients, participants, volunteers, employees and supporters. This process creates mutual and equitable opportunities that build sustainable communities and empower individuals and groups to influence decisions which affect their lives.


Adult Day CentreSupervised social, recreational and therapeutic programming.

• Service 7 days a week, with extended hours

• Meals, transportation to the program, and assistance with personal care

• Modest fee (Subsidy available).

Three program streams:1.Adult Day Program for Frail Seniors2.Alzheimer Day Program3.Interlude Program (Overnight Respite Care)



Adult Day Centre

Baking

Celebrations

Snoezelen Therapy

Outings

Therapeutic fun - Dr. Clown:http://www.youtube.com/watch?v=8F-E_t2EUMw

http://www.youtube.com/watch?v=8F-E_t2EUMw

http://www.youtube.com/watch?v=8F-E_t2EUMw


“The program gives the caregiver time for themselves to do or enjoy some “me” time without having to worry about their loved ones because they are in good hands”, Caregiver, St. Clair West Services for Seniors (SCWSS)

“The Interlude program allows caregivers time to attend functions that otherwise they may not be able to such as attend a wedding, visit family in another city or even attend a baseball game”, Staff Member, SCWSS

“I feel that the program is a blessing. It will allow me to keep him home longer. I wish to avoid him from going to a long term care facility.” Caregiver, Downsview Services to Seniors

Interlude Program


Case Management, Information and

Referral

Case Management: Friendly and professional team available to provide assistance and supportive counseling in response to identified needs or crises. Information and Referral: provides information about the eligibility criteria to access programs, and referral and connection to appropriate agencies providing services within specified geographic areas. • Services offered in Portuguese, Italian, Somali, Spanish, Urdu and others

• No fee applies.



Home Help and Respite Care

Home Help: Assistance for seniors with routine household activities, and other services that enable their independent living.

• Light housekeeping, laundry, and light meal preparation• Assistance with banking, shopping and errands• Companionship• Personal care

Respite Care: Home Help workers offer in-home short-term relief for family and caregivers, allowing them free time for other activities.

• Modest fee (Subsidy available).



Meals on Wheels

Home delivery of nutritious meals. Our staff and/or volunteers deliver hot meals, frozen meals, milk, juice, and fruit and vegetable baskets. They also check regularly on the clients’ safety and wellbeing.

• Innovative delivery system which offers clients variety and choice.

• Modest fee (subsidy available).



Supportive Housing

24-hour on-site personal care and support services for seniors and/or adults with disabilities in designated Toronto Community Housing (TCH) buildings.

• Tenants who require frequent assistance with their Activities of Daily Living or need short-term help because of injury or illness are eligible for this service.

• No fee applies.



Transportation

Personalized door-to-door assisted rides to clients who are unable to use public transportation.

Escort assistance is available for frail seniors who need more help.

• We offer rides to and from medical appointments, grocery shopping, banking and hairdressing, Day Programs, and social outings

• Modest fee, plus parking charges if applicable (Subsidy available).



Community Programs

Community programming offered at 8 locations within our service boundaries.

• Activities include culturally sensitive social dining, exercise, educational workshops, bingo, gardening, outings, special events, line dancing, and much more!

• A Community Development focus drives our work. We are moving from ‘doing for’ to ‘doing with’.

• United Way funded training has assisted us in our transition.

• Modest fee. Some programs are free of charge.


Community Programs

Community Kitchens Social Action Theatre by Seniors (SATS)

Gardening

Summer trips andyear-round outings

Drumming


• Working with others to deliver programming.

• Currently offering dance, computers classes, Community Kitchen, English conversation classes, health workshops.

• Our Agency focuses on building community and neighbourhood inclusion

• Recent Elderly Persons Centre and Ontario Trillium Foundation funding will expand our program offerings and the scope of the centre.

•Nurse Practioner-Led Clinic Opening in April 2011

Eglinton Hill Centre


• ASHTOR (Asociacion de Seniors de Habla Hispana del Gran Toronto)• Art Starts• City of Toronto• Hazel Burns Hospice• Social Planning Toronto• Syme 55+ Centre• Toronto Public Health• Unison Health and Community Services (formally New Heights Community Health Centre and York Community Services)• West Park Healthcare Centre• York Hispanic Centre• York West Active Living Centre• Funders including United Way Toronto and New Horizons for Seniors

Partnership Power


Volunteering

We have various volunteer positions including:

• Board Member• Meals on Wheels Driver and Runner• Office or Program Assistant• Where possible, we can develop volunteer opportunities to accommodate your objectives and skill set


Days of Caring Volunteers


Community Support Services Initiatives

INTEGRATED INTAKE

HOME AT LAST

CNAP

interRAI CHA


Collaborative approach by CSS agencies to provide easy and timely access to community

support services through common processes

INTEGRATED INTAKEWorking Together


Since March 2007

Partner agenciesSt. Christopher HouseSt. Clair West Services for SeniorsWest Toronto Support Services

GoalsProvide easy single point accessibility to partner agenciesProvide live information, referral and intake coverage Share common resources, processes and tools

INTEGRATED INTAKE


Home At Last

Partnership between community support service agencies, Community Care Access Centre (CCAC) and hospitals

Provide planned, escorted discharge from hospital to home following their hospital stay

Preferably for seniors living alone, with an older or frail caregiver or with family away all day

Support with transportation and the services of a Personal Support Worker

Escorted from the hospital and settled in at home safely and

comfortably


Program Goals & Priorities

•Enhance existing hospital/CCAC/ community care processes to minimize delays in discharge

•Ensure that seniors do not remain in hospital any longer than needed

•Facilitate safe and timely discharge

•Coordinates patients, caregivers, hospital and community service staff to smooth the transition from hospital to community

•Ensure that needed community care supports are coordinated and initiated on time to minimize preventable readmissions

Home At Last


•Program Benefits•Allows senior to leave hospital at the earliest possible discharge date

•Prevents a possible trip back to emergency or return to hospital – thus reducing costly hospital expenses.

•Contributes to a sense of security and well-being and ensures a speedy recovery.

•Seniors without existing service supports are provided with information and care options to suit their immediate and future needs

•Families see their loved ones well taken care of; settled at home, food and medication arranged, connected to community resources as appropriate.

Home At Last


The Community Navigation and Access Program (CNAP) is a network of over 30 not-for-profit organizations, working together to serve seniors in communities across Toronto

http://www.cnap.ca/content/home/home.aspx

Community Navigation and Access Project (CNAP)

http://www.cnap.ca/content/home/home.aspx


1-877-540-6565 begin_of_the_skype_highlighting 1-877-540-6565 end_of_the_skype_highlighting

Adult Day Program for Frail SeniorsAdult Day Program for Seniors with Alzheimer's Disease and/or DementiaAdult Day Program with Overnight Stay for Seniors with Alzheimer's Disease and/or DementiaCase ManagementCrisis Support and AssistanceFoot CareFriendly VisitingGroup Dining

Health Promotion and EducationHome Help or HomemakingHome Maintenance and RepairHospice CareMeals on WheelsNursingPalliative CarePersonal Care or Personal SupportRehabilitationRespiteSecurity CheckShopping Assistance

Shopping List PickupShopping TripsSocial and Recreational ActivitiesSocial WorkSpecialized Geriatric ServicesSupport for Individuals or Families Caring for a SeniorSupport Groups for Individuals or Families Caring for a SeniorSupportive Housing for SeniorsTransportation

Connect to services for seniors in your community with one phone call:


•interRAI CHA training • August 2008, University of Waterloo

•October 2008 : implementation of the interRAI CHA as standard assessment tool for Supportive Housing Clients

•Paper - hard copy •Research grade software, University of Waterloo

•March 2009: implemented in Adult Day Services•July 2010: Draft Screener/interRAI CHA for community clients

The interRAI CHA:Creating and Acting on Evidence in the

Community Support Sector


Top Five Triggers

Louise Towers

Doug Saunders

Outlook Manor

Eagle Manor

1 Informal support – triggered

Prevention – Triggered because preventive strategy not pursed despite a recent physician visit



2 Cognitive loss – Triggered to monitor for risk of cognitive decline

Cognitive loss – Triggered to monitor for risk of cognitive decline


Informal support – triggered

3 Social relationship – triggered




4 Cardio-respiratory conditions – triggered

Physical activities promotion - triggered with potential for improvement

Cardio-respiratory conditions – triggered

Physical activities promotion - triggered with potential for improvement

5 Physical activities promotion - triggered with potential for improvement

Social relationship – triggered

Social relationship – triggered

Cardio-respiratory conditions – triggered


MAPLe Score

Bldg A Bldg B Bldg C Bldg D Alzheimer Day Program

Frail Day Program

5 1 2 0 7 12 4

4 10 12 3 20 10 6

3 21 22 4 30 3 6

2 2 3 1 4

1 24 6 2 2 1 4

Total 58 45 10 63 26 20




Partnership with EMS Community Service Organization

Notification Program

. Applied for FundingGo ahead with the projectTry in one Supportive Housing Building Consent of clients/tenants


•This proposed demonstration project aims to address service gaps by creating better linkages and establishing protocols with Toronto EMS/hospital emergency departments around SH residents calling 911• •These protocols would initiate timely community services which prevent admission or reduce length of hospital stay

•Services may include monitoring, assessment, provision of home, personal and instrumental supports

•Plans would include expanding these protocols to non-supportive housing settings and to other jurisdictions




• opportunities for client outreach and education, prospects for preventing unnecessary unscheduled hospitalization and for assisting clients to transition from hospital to home as quickly and safely as possible



Community Service Organization Notification Program


For more information please visit our website


www.servicesforseniors.ca

st. clair west services for seniors crems 2010 roundtable december 3, 2010 embracing diversity,...

Documents

embracing diversity

dignity slide

dignity community development

clair west services

clair west meals

seniors community development

transportation slide

service boundaries slide