Personalized Services

Grampa&Grandson in grass
Planning Assessment:
Conduct comprehensive medical, functional, cognitive, psycho-social, financial and safety assessments to determine the level of care and unmet needs.


Tailored Plan of Action:
Develop an individualized plan for care and needed resources with input from the client, family and community professionals.

Care Coordination and Advocacy:

  •  Assist client/family to hire in-home caregivers and monitor services rendered
  • Accompany client on medical appointments to insure timely, accurate and thorough exchange of  information
  • Coordinate medical instructions of multiple physicians and specialists to ensure correct follow-through
  • Provide medication review and management
  • Provide friendly visits and telephone reminders/reassurances, as needed
  • Monitor whether all care and services delivered are reliable, compassionate and of high quality
  • Offer crises management


Financial Checkup:

  • Provide direct or referred resources for daily money management including timely bill payments, bank statement reconciliation, health insurance claims, and tax preparation
  • Complete paperwork necessary to apply for state/federal benefits and local cost-saving programs
  • Assist with inventory of important documents needed for applications and legal issues

Life Transitions:

  •  Insure safe transfer to/from hospital, rehabilitation facilities and home including medication  reconciliation, follow-up medical appointments, and needed supplies and equipment
  • Relocate from home to alternative living arrangements such as assisted living
  • Discuss with client and family end-of-life issues including advance directives, palliative and hospice care


Family Consultation:

  • Hold family meetings to help with complex care decisions
  • Mediate family differences of opinion in care of a parent
  • Provide short-term respite monitoring for a parent during a caregiver’s business trips, family vacations or needed breaks
  • Act as liaison and advocate for local or out-of-state family to provide alerts if their loved one is not safe and well
  • Keep lines of communication open and maintain regular contact