We know many people could age well in their homes and community with the right resources and supports. The reality is many face barriers like ageism and challenges finding and procuring resources.
The Aging Well at Home Working Group has come together to encourage new ways of thinking about aging.
Current Challenges
- The FLA OHT region has a growing older population, including more in long term care than the provincial average.
- People in need often face long wait times for publicly funded care and support in their homes.
- Accessing community and home care services can be hard for individuals and their families, in part due to ageism, as well as coordination of care.
- Communication and coordination between health and social service providers can be fragmented and ineffective.
What we are working towards
- Determining how to better support individuals and caregivers to age well at home. This includes how to maintain independence for those in need of anything from minimal to maximum supports.
- Establishing effective collaboration and communication between health and social service providers. That includes creating an advocacy role to help meet the needs of older adults.
- Improving awareness and navigation of resources to support people accessing home and community services.
Aging Well at Home Projects
Living Well with Home Care
This project aims to improve home care services for adults through:
- making health and social services more accessible to people, and
- improving coordination of the primary care team with community services providers.
The Loyalist Family Health Team (FHT) will begin by embedding home care services providers on site with their primary care and allied health team. This initiative will improve communication and collaboration among providers and those people receiving care at home.
This model of care ensures that people receiving health care and community services at home will benefit from more streamlined and personalized support. This initiative also aims to reduce emergency visits and hospital stays, as people and their families are able to take an active role in their care.
People with complex conditions can often stay in their own homes when they are receiving better home care support, including those:
- with chronic conditions
- requiring palliative care
- needing care post-hospital stay
- with disabilities
People are eligible for this Living Well with Home Care project if they:
- are a patient of Loyalist FHT
- have a valid OHIP card
- are 18 years or older
Aging Services Inventory
A new platform with an inventory of resources has been developed for older adults and providers.
- In partnership with Canadian Frailty Network and based on the AVOID Frailty framework.
- Testing and refinement of the new platform was conducted.
- Visit the AVOID Frailty Program for Healthy Aging for more information or to register.
The Loyalist Family Health Team (FHT) and their patient population are piloting these initiatives:
Group Discussions
Aging Well at Home Committee: an interdisciplinary committee to foster understanding of how to effectively assist people to age well at home and plan and facilitate Aging Well at Home Rounds.
Aging Well at Home Rounds: the primary care team and members of pertinent care agencies together identify resources for people determined by the care team as having inadequate supports to age well at home. These rounds increase connections across partners and organizations, awareness of community supports and gaps in services.
New Roles
Aging Well at Home Advocate: the Occupational Therapist at Loyalist FHT developed this role to help people looking for resources to age well at home.
Home and Community Care Support Services Care Coordinator: this role at the Loyalist FHT to improve integration of services and better support people through a collaborative care model.
Health and Social Care Integrator: a new role to support older adults with complex health and social needs, including direct nursing care if needed. This pilot has support from SE Health and SE Research Centre.
Aging Well at Home News
KHSC@Home helps seniors leave the hospital with the care needed at home
June 1, 2023. KHSC@Home has helped over 600 people – mostly but not only seniors – transition safely out of hospitals by providing up to 16 weeks of care in their homes.
Movement as Medicine!
June 1, 2023. Movement is an important aspect of aging well! That is a fundamental view of kinesiologists, human movement specialists. Seniors in the rural FLA counties can join a variety of exercise-based group programs run by registered kinesiologist.
Programs for people 50+: helping people live a healthier life
May 29, 2023. Living Well’s popular self-management health program provides support and practical tools for all people, including those 50+ with health issues, live healthier lives.
Providing aging adults with the right resources to live independent, healthy lives
May 29, 2023. Health-care professionals and community members come together to plan, support, advocate for, and coordinate the regional programs and services to help aging adults thrive at home.
Listening to and learning from two senior community volunteers
June 6, 2023. We spoke with two FLA OHT volunteers - Nona Mariotti and Helen Cooper. We learn about their views on aging, programs and activities for seniors in the region and what motivated them to get involved with the FLA OHT.
Activities for seniors at Kingston Community Health Centres
June 7, 2023. KCHC has rolled out a new weekly Seniors Day, coordinating several activities and events to allow seniors to come together to socialize, exercise, and learn, creating a unique opportunity for connection.
Who's involved?
Community members, primary care providers, home and community care agencies, researchers and specialists from across the region are working together.
Community members include people with lived experience, family, caregivers and others.