This program’s objective is to provide caregivers with the relief and support they need, in order to continue to support a family member at home. The program identifies the caregiver needs and pre-existing support networks, and it uses innovative approaches through the use of pre-mediation and elder mediation skills and techniques. District case managers work collaboratively with the certified elder mediator (case manager who is a health care professional) to create a circle of care that involves family members (caregiver, siblings, in laws, children, grandchildren, etc.), service providers, neighbors, and any community agencies. This is the only practice that integrates health care with elder mediation. The program provides funding for services to complete gaps in care plans and these funds are self-directed by the caregiver. The target group is caregivers living at home with an individual with Alzheimer’s disease or other related Dementias in the moderate stages. The assistance to the caregiver helps maintain the caregiver’s health, decrease the risk of hospitalization and reduce premature admission to a long term care home. It provides support to caregivers that might otherwise become exhausted. The program was first evaluated 2 years ago through a survey. The program is reviewed after every elder mediation case, as it is part of the practice to do self-reflection on every case, and each case also has a detailed follow-up process. A number of indicators are tracked quarterly and this data is provided to the LHIN. These indicators are as follows: • Number of clients served • Number of Francophone clients • Number of Aboriginal clients • Number of Emergency visits by caregiver • Number of hospital stays by caregiver (length of stay) • Number of long term care admissions of clients with dementia • Number of alternative level of care of clients with dementia • Number of hospital admissions by caregiver. The information is gathered by the use of an INFO PATH, focus groups, and surveys. Since 2009 we have managed to have no emergency visits by caregivers over the past 3 years; no hospital stays by caregivers over the past 2 years, and no hospital admissions by caregivers over the past 2 years. The number of long term care admissions by clients with dementia has been 14% to 17 % lower than what was targeted over the past 3 years. Our year to date data shows we have 13 clients who have been on the program more than 600 days.
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