Personalized Support and Stabilization Plus (PSS+) - Reablement Care for Seniors

Provided by Vancouver Coastal Health

Provides up to eight weeks of community/home support and “reablement care" to increase self-reliance and optimal functionality for the frail elderly.
In support of timely transitions from hospital to home, applying a reablement and team-based approach to care, PSS+ provides rapid access to short-term comprehensive, coordinated and client-centred care in the home for individuals with high priority time-sensitive care needs to improve health outcomes and prevent unnecessary Emergency Department visits and / or hospital admissions.

The PSS+ team focuses on clients who are at high risk of potential adverse health events or experiences during the transition from hospital to home. These are clients who have some combination of the following:
  • Change in their clinical or functional baseline during or following their acute care experience
  • Clinical risks such as: potential for mismanagement of medications, falls, issues accessing healthcare supports when they return home, issues understanding their care plan during the transition from hospital to home
  • Non-clinical risks such as: living alone, lack of formal support such as primary care provider, lack of informal support to assist through the transition at home such as a family member or close friend


The PSS+ team will work with the client to develop a plan of care to:
  • Prioritize activities that enable them to recover and increase their ability to be independent
  • Build on individual strengths and goals
  • Focus on activities that are important to them
  • Connect them to ongoing community support services as required

604-499-2565

Service is available in English.

Cost: No cost

Brochures and Info
Associated Programs/Services

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Availability

Service area: Vancouver Coastal Health Area

Service Types Provided
Seniors Services
Ways to Access
  • Provided at home

The listing of this service in Pathways is not a recommendation or endorsement by Pathways.

Pathways does not provide medical advice. If you have an emergency please call 9-1-1. If you require assistance navigating services please call 8-1-1.

For general inquiries or for assistance, please email us:

community-services@pathwaysbc.ca

If you are requesting clinical access to medical Pathways, please provide the following information via the email above:

  1. First Name
  2. Last Name
  3. Email
  4. In which city/town do you work?
  5. What is your role? E.g. Family Physician, Office Staff, Medical Resident
  6. Employer Name (for office staff)
  7. Office Phone

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