Care Planning Assessment will identify limitations and strengths in the following areas: physical, cognitive, emotional, functional, environmental, medical, social, home safety and legal/financial resources. This results in a tailored plan of care with specific recommendations and resources.

Managing the Plan of Care involves connecting the client to the most appropriate resources consistent with the defined goals. Medical care, including doctor appointments and medication monitoring are coordinated. Assistance is provided with hiring home care providers with oversight and efficient communication maintained. If indicated, the appropriateness of residential care communities will be evaluated and all aspects of the transition will be coordinated. Regular personal visits will be made to maintain oversight and ensure compliance with the plan of care. Adjustments to the plan of care will be made as changes in needs are identified. The result of this plan of action is that there is one professional point of contact to ensure quality care and communication between the family and the client’s professional team is maintained.

Full Spectrum of Services:

• Act as a liaison for family members not near the client
• Crisis intervention
• Counseling and support
• Professional advocacy
• Assist with entitlement issues and forms
• Information and referrals
• Coordination of additional services, as indictated