What is LHSC to Home?
LHSC has partnered with SE Health to bring you LHSC to Home – a program that provides you with care at home after you leave the hospital.
Our team will work with you to develop a care plan and connect you with health-care services in your community, ensuring your needs are being met in an environment where you feel safe and comfortable. The LHSC to Home team includes a number of professionals focused on supporting your health at home, including nurses, personal support workers, occupational therapists, physiotherapists, speech-language pathologists, social workers, and dieticians.
Our goal is to make your first weeks at home as comfortable as possible while continuing to support your health-care needs.
What happens before I leave the hospital?
The LHSC to Home team will connect with you, your family, and your hospital team to create your customized care plan. This plan will be shared with everyone involved in providing your home care. Your first home visit will be scheduled before you leave the hospital so that you are informed about who will be coming to your home and when.
What happens after I leave the hospital?
On the day you leave the hospital, you will get a phone call from a member of the LHSC to Home team to ensure you have arrived home safely. The LHSC to Home team will:
- Visit you within 24 hours of being discharged from the hospital.
- Check in with you every day for the first week after you arrive home. After the first week, you and your care team will create a care plan and decide how often they need to check in with you.
- Work closely with LHSC to ensure your goals are being met after you get home.
- Keep your primary care provider up to date on your progress.
- Work with other local community agencies including meal delivery, transportation services, equipment, and caregiver support programs.
As your needs change, so will your care plan. At times, you may need more services, and as you recover you may need less. The LHSC to Home program was designed to respond to your changing health-care needs.
How long can I use the service?
LHSC to Home provides patients with up to 16 weeks of services to support your transition from hospital to home care services.
Do I need to pay for these services?
In alignment with other hospital to home programs in the province, home care services are funded, but there may be costs associated with transportation and equipment. Any costs would be explained during the development of your transitional care plan.
What happens if I need to be readmitted to the hospital?
If you need to be readmitted to the hospital, the program will continue to support you when you return home if your care needs are unchanged. The LHSC to Home team will be kept informed on your medical condition and help plan for your transition back home.
What happens if I need ongoing care?
After 8 weeks, you and your team will review your progress and plan for your ongoing care. After 12 weeks, if you will require ongoing care, your LHSC to Home team will connect you with home care services provided by Ontario Health atHome.
Who can I contact for more information?
You can contact LHSC to Home’s service provider, SE Health, 24 hours a day, 7 days a week by calling 1-833-991-1971.
