As the population ages, more and more people in our community require specialized health care to meet their unique needs. SHN offers a range of programs specifically focused on supporting the health and overall well-being of our more senior patients.
Care plans are developed in partnership with the interprofessional team, patients, their caregivers and their loved ones to ensure patients understand their care and receive the appropriate treatment, discharge and follow up care.
SHN also works collaboratively with other health care and community organizations to support patients after they leave the hospital and facilitate a smooth transition back home.
Complex Continuing Care (CCC) is for patients with chronic, complex, and multiple non-urgent medical needs who need to stay in the hospital for specialized services and resources.
The CCC unit at our Centenary hospital is meant to be a temporary care setting to support patients in improving their abilities and functioning. It is a next step in patients’ recovery journey, on their way to their destination of home or community care. The goals for patients are to optimize quality of life, learn to manage their condition, and transition safely from the hospital to home or a community care facility.
- Comprehensive geriatric assessment and treatment for elderly patients recovering from a major illness or injury
- Complex care for patients with chronic conditions or multi-system disease, such as diabetes, cardiovascular conditions, and stroke
- Short-term inpatient rehabilitation for patients who will be returning home or community setting following an acute care stay at the hospital
Our teams includes highly specialized nurses, physicians, physiotherapists, occupational therapists, physical and occupational therapy assistants, social workers, speech and language pathologists, dietitians, pharmacists and recreational therapists. They are committed to patient-centered, senior-friendly care that actively involves patients and their families.
Complex Continuing Care
3rd Floor, Margaret Birch Wing
416-284-8131 ext. 7363
SHN’s outpatient rehabilitation at our Centenary and General hospital includes physiotherapy and occupational therapy for patients who have been discharged but require follow-up care, as well as patients who have been referred by their physician.
- Audiology and Speech Language Pathology (SLP)
- Neurology (Stroke)
- Hand program
- Musculoskeletal program for hip and knee replacements, amputations, complex fractures
- Pre-operative education for patients having a hip or knee replacement procedure
Our outpatient rehab space is located on the 1st floor of the Margaret Birch Wing at Centenary. It includes a gym, and separate assessment and therapy rooms.
Phone: 416-431-8118 ext. 4
The Geriatric Mental Health Outreach program at SHN conducts assessments and provides reports with recommendations for nursing home staff to help them manage patients who are presenting with concerning behaviours, including agitation, aggression, depression, resistance to care, psychotic symptoms or other indications of mental illness. The service is available to address the needs of patients and staff in the early stages of managing difficult behaviour in an attempt to avoid hospitalization.
The program is associated with Psychogeriatric Resource Consultation Program (PRCP). The team members, which include two registered nurses, occupational therapist and psychiatry, visit nursing homes on a regular basis.
Referrals are accepted from the following Central Scarborough Nursing Homes:
- Bendale Acres
- Hellenic Home for the Aged – Scarborough
- Kennedy Lodge Nursing Home
- Leisureworld Senior Care Corporation – Scarborough
- Mong Sheong Scarborough Long-Term Care
- Rockcliffe Nursing Home
- Shepherd Lodge
- Tendercare Nursing Home Ltd.
- The Wexford Residence
- Scarborough McNicoll – Yee Hong Centre for Geriatric Care
- Houses of Providence
- Chester Village
- Fieldstone Commons
- Seven Oaks
- Tony Stacey
- Yee Hong – Finch
- Rouge Valley Extendicare
- Scarborough Extendicare
Staff receive referrals from a designated person, usually a social worker, who acts as the liaison for the facility/nursing home. The designated person provides regular updates about the patient’s status. Referrals must be sent with consent from the patient’s Power of Attorney and an order from the resident physician.
Geriatric Outreach staff can also help to arrange a pre-planned admission to SHN’s psychiatric unit, if needed and if beds are available, to avoid unnecessary visits to the emergency department.