COAST for Seniors

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BSO Web Header RJThe St. Joseph’s Healthcare COAST program in partnership witih Dementia Alliance serves the residents of the City of Hamilton who have serious mental health issues. COAST is a multidisciplinary team consisting of child and youth crisis workers, mental health workers, nurses, social workers and plain-clothes police officers.

Behavioural Support Ontario (BSO) provide a Community Outreach Team (COT) at COAST who will respond to individuals in crisis who have a diagnosed dementia or cognitive behavioural concern. The BSO population and their caregivers, as a result of the cognitive impairment and nature of behaviours, are at risk of being unable to cope with the activities of daily living or the stresses associated with assuming the caregiver role over a long period of time. This vulnerable population is especially challenged during times of crisis, which may occur spontaneously or during times of transition between care settings. Additional BSO staff (BSO COT) were added to strengthen the existing crisis teams in the HNHB LHIN to enhance the current response to the BSO clients and their caregivers when they are in crisis. BSO COT have been added to St.Joseph’s Healthcare COAST team.

The goal of the COT is to build capacity within identified mobile outreach teams regarding: geriatric mental health expertise, enhanced ability to provide practical support and outreach, and building greater system capacity through education and training.

Process

Clients and caregivers will be connected with the COT through the existing crisis team phone numbers. (905-972-8338) Calls may be directly from clients/caregivers, agency staff, hospital emergency department staff, EMS, police officers,etc. The COT will respond to each crisis based on the needs of the client, through:telephone calls reaffirm existing linkages with providers contact EMS,face-to-face outreach (mobile visit). Ensuring that clients transitions from crisis into longer-term support through agency involvement and services.

 A mental health worker will respond to a call on the COAST crisis line and make a preliminary assessment regarding the mental health concern. The worker will determine whether to respond with telephone support or a mobile visit or refer to the BSO COT.

The goal is to help the individual/family deal with the crisis in the environment of choice where a management plan will be developed to defuse the crisis situation. A follow-up plan will also be provided.

If necessary, the follow-up plan may involve linkage to additional community agencies or support networks. Clients will be given the opportunity for support services following a crisis situation.

Clients requiring support or follow-up will receive assistance from the support team within 24 hours of the crisis situation.

The client will receive support or follow-up until either the difficulties have been resolved or the client has been linked to appropriate community resources.