SENIORS HOME SUPPORT
The Seniors Home Support (SHS) Program is an integrated primary care program delivered by an interdisciplinary team to home-bound seniors who for medical, social or cognitive reasons cannot access office-based primary care services.
The SHS Program is delivered by a care team which includes primary care physicians, an occupational therapist, a pharmacist, a social worker, a chiropodist, registered nurses, community paramedics, and home care coordinators.
Home-care services are provided in partnership with the Markham Family Health Team (FHT), Markham Stouffville Hospital (MSH), Central Region Home and Community Support Services and York Region Paramedic Services Community Paramedicine Program.
The Seniors Home Support program expresses sincere gratitude to the South East Geriatric Outreach team of Unionville Home Society for their invaluable in-kind contributions from June 2021 - Dec 2022.
Program benefits
As a patient of the program, you will have routine home visits by a primary care provider and have the support of a nurse navigator and community paramedics for urgent issues.
All SHS Program partners have access to one electronic medical record (EMR). The benefits of a shared EMR is having a single client record that will allow patients to only tell their story once and have their health care providers share information between each other.
Meet the SHS program team
Primary Care Providers
Elizabeth Mui MD, CCFP (COE) Lead Physician, Oak Valley Health – Markham Stouffville Hospital
Annie Cheung MD, CCFP (COE) Physician, Oak Valley Health – Markham Stouffville Hospital
Julie Yu MD, CCFP (COE) Physician, Oak Valley Health - Markham Stouffville Hospital
Sivaseelan Sivapalan MD, CCFP Physician, Oak Valley Health (locum for Dr. Julie Yu) - Markham Stouffville Hospital
Administration
Rebecca Briggs Team Coordinator, Markham Family Health Team
Nurse Navigation
Susan Ng RN, MN, CHPCN (c), GNC (c), Advanced Practice Nurse, Oak Valley Health - Markham Stouffville Hospital
Crystelle Burdeos, RN, BScN, Nurse Navigator, Oak Valley Health – Markham Stouffville Hospital
Interprofessional Health Providers
Jasdeep Chahal OT Reg. (Ont) Occupational Therapist, Markham Family Health Team
Shirley Cheung D.Ch., BHA. Chiropodist/Foot Specialist, Markham Family Health Team
Sheetal Desai RPh CDE Pharmacist, Markham Family Health Team
Rhonda Pompilio MSW, RSW Social Worker, Markham Family Health Team
Home Care Coordination Liaison
Marisa Gutta, MSW, RW Care Coordinator, Home and Community Care Support Services
Community Paramedicine
Abraham Poon, Community Paramedic
Shannon Koppenhoefer, Community Paramedic
Delivery of care
Care will be provided in a variety of ways including:
Home visits
Telephone calls
Virtual support (via Ontario Telemedicine Network)
As the patient’s needs change, the SHS Program team will work with you to update your home-care plan as you may need more services.
Eligibility criteria
To be eligible, you:
Are 65 years or older
Have a valid OHIP card
Live in Markham or Stouffville
Are in need of a primary care practitioner to do home visits and willing to transfer care from your existing primary care provider
Are home-bound and unable to attend in-person medical appointments
Meet the following criteria in two of three categories shown below:
Source: Akhtar, Sabrina and Thuy-Nga Pham. “A Canadian Provider’s Handbook to Home-Based Primary Care.” First Edition (March 2015): 14.
Referrals
Referrals can be accepted from:
Patient (self-referral), family, caregiver
Primary care, specialists, acute care
Community support services
Frequently asked questions
What happens if I need to be admitted to an Oak Valley Health hospital?
If you need to be admitted to an Oak Valley Health hospital, your care team will be kept informed of how you are doing. When you are ready to go home again, we will work with you to plan for your transition back home into the program.
Protecting your privacy
Your privacy is important to us. If you are eligible to participate in the SHS Program, your medical record will be held by Markham Family Health Team on behalf of all of participating organizations; if you are not eligible, no record will be created. All participating organizations contribute to the same record, and will have access to your information in that record to provide you with care, to plan and evaluate programs we deliver, for education or as permitted or required by law. In order to protect your privacy, information used for program planning or education will have identifiers removed or be made anonymous. If one of the participating organizations stops participating in the SHS Program, your medical record will continue to be held by Markham Family Health Team.
Health records
If you have any questions or concerns regarding the handling of your personal health information or if you would like to request a copy of your personal health information, please contact the SHS Program team coordinator at 437-248-1642.
Patient relations (compliments, concerns, complaints)
The SHS Program is committed to listening to patients and welcomes all feedback, whether it is a compliment or a complaint, as an opportunity for us to learn and to improve the quality of the care that we provide to our patients.
If you have any compliments, concerns or complaints please contact us at oht.eyrnd@gmail.com
Contact us
Address:
c/o Markham Family Health Team
122 Cornell Park Avenue, Unit 1
Markham, Ontario L6B 1B6
Hours of operation:
Monday to Friday: 9 a.m. to 5 p.m.
Phone: 437-248-1642
Fax: 905-910-0951
After hours and weekends:
If you have a change in your general health status, please call 911 or visit Markham Stouffville Hospital’s Emergency Department at 381 Church St, Markham, ON L3P 7P3.