Assessment of the individual's physical, mental and emotional status, home environment, nutrition, financial resources, social needs and his or her wishes, together with those of the support network.
 

Individual and Family Counseling regarding residential options, home care needs, medical and nursing care, health insurance and life transitions.
 

Coordination of Care including monitoring and supervision of all activities included in the plan.
 

Discharge Planning with hospital or nursing home staff to enable the older adult to function in the least restrictive environment.
 

Referral to other professionals such as psychologists, dieticians, physical, occupational and speech therapists, elder law attorneys and others as needed.
 

Assistance in procuring personnel for cooking, cleaning, personal care, home health care and home maintenance contracted through reputable outside agencies.
 

Regular Visitation to maintain consistent contact and a sense of security.
 

Reimbursement Consultation to assist in receiving maximum benefits from Medicare, Medicaid, Passport and Long Term Care Insurance.
 

Education & Training Services are available for individuals, health care professionals and community groups.