Edmonton Home Living - Care of the Elderly

Alberta Health Services - Edmonton Zone


Description
The team provides specialized geriatric consultation services for complex frail seniors in Home Living.

COE coverage is provided to Home Living clients as a limited and concentrated resource. The COEs are assigned specific to geographic location, with part-time on-site availability. This varies per Home Living network office. The COE is a consult service and does not assume the role of the most responsible health care provider (MRHP).
. Consultation on complex clients
. Attendance at home care team or client/family conferences
. Attendance at Home Care client case reviews
. Home visits to homebound Home Care clients who requires an assessment
. Home Care clinic visits for complex/geriatric assessments
. Provides support for post-acute discharged clients presenting with geriatric syndromes

Indications for COE Referral
. Multiple co-morbidities and presentation of geriatric syndromes (aging, dementia, depression, delirium, incontinence, vertigo, falls, failure to thrive, neglect and abuse, sleep disruption, polypharmacy)
. Exhibits unexplained decline in cognition (acute or gradual)
. Dementia requiring support for care planning and medical intervention
. Challenging and/or unmanaged responsive behaviors (gradual onset)
. Assessment to support determination of capacity
. Unexplained decline in function from baseline daily activities (gradual onset)
. Unmanaged safety concerns
. Medication optimization (cannot be only reason for referral)
. Significant caregiver stress, no caregiver (cannot be only reason for referral)
. Transitions of care and/or support with decisions related to relocation to higher level of care, acute care or rehabilitative care.
. Chronic and/or neuropathic pain in the older adult

COE Referral

All COE referrals, including those from Transition Services should be made in collaboration with client's primary case manager (CM), or System Case Manager. While it may be helpful to discuss the client's case with the COE prior to referral, this is not required. A COE referral is not indicated for coverage of the MRHP. Any requests for COE support for non-Home Living clients must be discussed and approved by Home Living Leadership before proceeding.


Key Provider: care of the elderly physicians, occupational therapists (OTs), physical therapists (PTs), registered nurses (RNs)
Eligibility
Yes, Must be admitted to the Home Living program.
Application Process
Service Access: Professional Referral Required, Healthcare providers should consult the Alberta Referral Directory for service referral information. Referrals can be made by the AHS Home Living Case Manager, System Case Manager or by Nurse Practitioners for Clients that are currently admitted to the Home Living program.
All referrals require approval by the most responsible health care provider.
Referral Process: N/A


Waiting Period: Yes,

Current waiting list is 2-3 weeks


Telephone
780-496-1300
Fees
Fee: N/A
Fee Reduction: N/A
Membership Fee: N/A
Accessibility
Wheelchair access: Yes -
Other disabled access: N/A -
Topic(s)
Agency Information
View Agency Profile
Last Verified On
July 21, 2023
Address
13140 St. Albert Trail
Edmonton, AB, T5E 6R3
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Hours of Operation
Mon
08:00 AM to 04:15 PM
Tue
08:00 AM to 04:15 PM
Wed
08:00 AM to 04:15 PM
Thu
08:00 AM to 04:15 PM
Fri
08:00 AM to 04:15 PM

Closed on Statutory holidays