transitional care
When things get complicated we can help you make sense of your medical follow-up, home health care, and outpatient services. We can also help coordinate care among multiple physicians and be your advocate. We can connect you to other resources in the community and can interface with your doctors to help you avoid unnecessary hospitalizations and medical appointments.
Start by scheduling a two-part Home and Safety Evaluation. After a thorough discussion of your general health, any recent changes, medications, and your support network we work with you to develop a plan. We can help with family meetings, care coordination and planning, appointment advocacy, or facility discharge planning. We hope to become trusted partners in your care.