Hamilton Council on Aging
Hamilton Council on Aging

The Hamilton Council on Aging (HCoA) is a senior-driven initiative that was founded by a group of concerned citizens in the community.

HCoA is a non-profit, charitable organization dedicated to enhancing the quality of life of all seniors in Hamilton.

Our strength is in our membership. A volunteer Board of Directors, subcommittees, as well as HCoA staff, volunteers and community partners work together to support current projects and community initiatives.

Visit Hamilton Council on Aging’s website

Expertise and Experience with the Target Population: The Hamilton Council on Aging (HCoA) has successfully provided leadership in creating and managing numerous projects to improve life for older adults. The HCOA has provided the “backbone functions” and supported the development of collaborations with many community partners and older adults in Hamilton. Our experience as successful convenors of several community collaborations includes: Hamilton’s Committee Against Abuse of Older Persons, consisting of almost 30 organizations serving older adults in Hamilton, and the co-convenors (alongside the City of Hamilton) of Hamilton’s Plan for an Age-Friendly City. HCoA is recognized as a leader and connecting force among agencies serving older adults and older adults in Hamilton.

The Hamilton Council on Aging (HCoA) has successfully managed numerous projects to improve life for older adults, all of which have been collaborations with many community partners and older adults in Hamilton. For more information about all of the Hamilton Council on Aging’s projects, please visit www.coahamilton.ca.

Project Title: Connecting Hamilton’s Initiative to Reduce Social Isolation Among Seniors (Backbone Functions)

Summary Contribution to Outcomes: The HCOA as the backbone to this change initiative will ensure that the various collaborating organizations have opportunities to plan and work together, to solve problem as they arise, and develop strategic priorities; to be a sounding board to support the development and implementation of research and to assess best practices. In other words the role of the backbone will be to effectively guide the projects vision and strategy and ensure the alignment of all the existing activities and projects. By building a supportive collaborative and mobilizing public will, HCOA will leverage the contributions of all contributors.

St. Joseph's Home Care
St. Joseph's Home Care

Since 1921 St. Joseph’s Home Care has provided high-quality, values-based home and community services in a spirit of compassion and dedication. We have evolved from a nursing agency to offering a much broader range of services, and our steadfast commitment to delivering exemplary client-focused care to the Hamilton community continues. Our efforts to live our quality promise were rewarded in 2014 when SJHC achieved Accreditation with Exemplary Standing.

At SJHC we tailor our home care programs to meet the needs of each individual client. We serve a wide variety of clients with diverse cultural and socio-economic backgrounds. As a faith-based organization, we are committed to serving all clients regardless of their beliefs or background. Our organization reflects the diversity of ethnicity, culture and religion in our community. We understand and respect each individual’s requirements and are sensitive to each individual’s beliefs and spiritual care needs.

Visit St. Joseph’s Home Care’s website

Expertise and Experience with the Target Population: St Joseph’s Home Care (SJHC) has been providing services to seniors in the community since 1995. The focus of our services and programs is to ensure that vulnerable/isolated seniors remain safe and independent in their homes by providing them with the support and linkages to other services as needed. SJHC is committed to working collaboratively on LHIN wide and local community networks and community initiatives and is a key stakeholder at the many regional and city wide planning tables and community collaboratives and committees. Through our participation in these groups SJHC is always finding ways to work collaboratively with key partners to find efficiencies within and between their organizations to better meet the needs of vulnerable and socially excluded seniors. SJHC has in-depth knowledge of the barriers seniors face and understand the impact of social determinants of health, including poverty and social isolation on the ability of an older adult to live safely and with dignity in their own homes. SJHC is funded by the Ministry of Health (LHIN) and has an outstanding reputation in the community health sector. We have received and managed many funding proposals including those from ESDC.

Project Title: Hospital Care Connectors for Isolated Seniors, St. Joseph’s Healthcare

Summary Contribution to Outcomes: The Hospital Care Connector works as part of the interdisciplinary team (CCAC Care Coordinators, discharge and social work teams at area hospitals, Health Link staff and BSO teams) to support the patient to transition back to the community. The position provides timely support and follow up by linking isolated senior patients to the agreed upon resources set out in the plan which compliments and does not duplicate existing services. The Connector remains involved until the isolated senior is “anchored” into community services. The Connector works closely with CSS organizations and the CCAC Information and Referral team to ensure that relevant programs and service information is continually updated and available in a consistent manner.

AbleLiving Services
AbleLiving Services

AbleLiving is a non-profit charity that has been serving adults with physical disabilities for more than 35 years. We provide the assistance that people may need to manage their lives as independent adults. In addition to a wide array of supportive care options, we offer training in life skills, self-development, falls prevention, and dementia care. Among our clients are adults with physical disabilities, elderly people who are becoming frail, and family members who need respite from the role of caregiver. We provide services and accommodation in several communities: Burlington, Binbrook, Mississauga, Stoney Creek, and Hamilton.

Visit AbleLiving’s website

Expertise and Experience with the Target Population: AbleLiving has solid partnerships within the community leading to a coordinated approach to service delivery, the capacity to fulfill administrative and reporting functions, a knowledge of the issues faced by the seniors population, the capacity to counsel, educate, and support isolated seniors, a program model which supports a holistic approach to service delivery and a comprehensive understanding of the principles and goals of this initiative – all of which are key components of the organization’s capacity to ensure the fulfillment of activities and goals of the program as well as the delivery of excellent services. AbleLiving has extensive knowledge of the barriers seniors face and approaches which will provide the most opportunity for them to surpass these barriers. AbleLiving has been identifying ways to address and resolve an ALC reduction plan with the LHIN and area hospitals. We are committed to continue to think of new and innovative ways to ensure that we maintain our levels of excellence and enhance our best practices and improve the supports that are available to the community. AbleLiving has been in business for the past 40 years and funded by the Ministry of Health (LHIN) and has an outstanding reputation in the community health sector. We have received and managed Trillium Proposals, CMHC seed grants, Halton Region Community Investment Fund Program, and Hamilton City Housing as well as other funders.

Project Title: Hospital Care Connectors for Isolated Seniors, Hamilton Health Sciences

Summary Contribution to Outcomes: The Hospital Care Connector works as part of the interdisciplinary team (CCAC Care Coordinators, discharge and social work teams at area hospitals, Health Link staff and BSO teams) to support the patient to transition back to the community. The position provides timely support and follow up by linking isolated senior patients to the agreed upon resources set out in the plan which compliments and does not duplicate existing services. The Connector remains involved until the isolated senior is “anchored” into community services. The Connector works closely with CSS organizations and the CCAC Information and Referral team to ensure that relevant programs and service information is continually updated and available in a consistent manner.

Gilbrea Centre for Studies in Aging (McMaster University)
Gilbrea Centre for Studies in Aging

The Gilbrea Centre is an interdisciplinary research hub that is dedicated to addressing issues of aging through collaborative and policy-relevant research. The Centre produces and disseminates knowledge that helps to broaden the understanding of aging, addresses the challenges that exist, and suggests directions for change.

Our vision is to address the needs of an aging population through collaborations with researchers, educators, community organizations, and older people. This research extends beyond McMaster’s campus through partnerships across various sectors at both the national and international levels.

Visit Gilbrea Centre’s website

Expertise and Experience with the Target Population: The Center maintains long standing collaborations with community groups and seniors.  These relationships help us foster research relevant to the needs of our community and provide an important foundation for making a difference in seniors lives.

The Centre works closely with partners to develop new knowledge and suggestions for improved practice and policy for older people.  We are involved in a number of initiatives including the National Centre of Excellence on Aging and Technology (AGE-WELL).

The Centre also manages the membership of the Seniors Helping Advance Research Excellence (S.H.A.R.E), a group of over 355 seniors aged 55+ involved in Centre initiatives and research. This group helps ensure that our research is grounded in experience, and can be shared in the most appropriate ways with the largest possible audience.

Project Title: Reducing Senior’s Social Isolation: Linking Community in a Participatory Research Initiative

Summary Contribution to Outcomes: The proposed project, led by the Gilbrea Centre for Studies in Aging and supported by the McMaster Institute for Healthier Environments, will link community partners and stakeholders – including older people—in a participatory research initiative aimed to reduce social isolation among seniors. The project will identify the best available knowledge, provide guidance to community partners, and co-create innovative solutions to reduce social isolation. Our cross-cutting project on research and policy will use an integrated knowledge exchange model to assist in building a supportive collaboration, facilitating community response, and improving and coordinating current Hamilton supports. Our primary expected result is to build a community equipped with the tools to impact low income senior’s social isolation and change senior’s sense of involvement in their community.

Thrive Group
Thrive Group

Thrive Group provides a spectrum of integrated services to support and care for individuals, and help them to live as independently as possible. By bringing together like-minded organizations, Thrive Group develops and delivers quality services that are responsive and innovative; enhances collaborative approaches to service provision; informs government directives; influences health care system transformations; and creates efficiencies and reduces duplication.

Visit Thrive Group’s website

Expertise and Experience with the Target Population: Thrive Group supports multiple organizations with back office supports in areas of technology, finance, and human resources. Thrive Group has a history of working as a Non-Profit to improve and eliminate duplication for other non-profit agencies. Thrive Group’s objective is to enhance clients’ experience by improving the range and quality of services provided by member organizations. Both St. Peter’s Residence at Chedoke (Long Term Care -10years) and Ableliving Services (Independent Living CSS -40 years) have strong track records and well-respected reputations for helping people, and seniors in particular, to maintain their dignity and independence. The combined experience of Thrive and its contributing organizations spans more than 50 years in working with the target population. Thrive has extensive experience working both with multiple stake holders in a collaborative nature and with the client group defined in the outcomes. Thrive is very familiar with the CSS sector and its member organizations and the challenges they and is able to assist agencies with the implementation of the CareDove Interactive Community Access and Referral System.

Project Title: CareDove – Interactive Community Access and Referral System

Summary Contribution to Outcomes: Interactive coordinated access project will provide a local approach to support an older adult’s journey or navigation through a very complicated system. This approach has been proven to dramatically simplify access to services, supports and activities, and will help in early detection of need and directs service links for seniors at risk of social isolation. The primary objective of this project and the CareDove program is to implement a tool that will link all of the community support sector (CSS) agencies in Hamilton. This CareDove tool (please visit www.caredove.com/wwcss to view the WW CareDove site) will enable all of the staff within the 110 Hamilton agencies to navigate through support services within a client’s geographic location, make immediate referrals to other CSS agencies and follow through to make sure services are in place.

Wesley Urban Ministries
Wesley Urban Ministries

Wesley Urban Ministries offers daily support, every step of the way, to over 1,250 children, youth, adults and seniors living in poverty in Hamilton. As a multi-service organization, Wesley has a portfolio of over 30 different programs in 19 locations in the areas of Children, Youth & Family Services, Housing & Homeless Services, and Neighbourhood & Newcomer Services. The long-term impact of our programs includes improved education, successful employment, and supportive independence. Wesley has been responding to poverty in the Hamilton community since 1955, when a seniors’ outreach program began in the basement of Wesley United Church in downtown Hamilton. Wesley’s services are possible through a broad base of funding support from government, business, foundations, individuals, and churches.

Visit Wesley Urban Ministries’ website

Expertise and Experience with the Target Population: As a multi-service organization, Wesley has a portfolio of over 30 different programs in 19 locations in the City of Hamilton. Wesley serves the most vulnerable populations including seniors, isolated individuals, and those with multiple barriers. Wesley delivers intensive one to one client services to several client populations in all of our program areas. We have been working with seniors since our inception in 1955 when we started a program to assist homeless and impoverished seniors in downtown Hamilton. Although most of our programs currently include work with seniors, our Multicultural Senior’s Outreach Project directly targets vulnerable Multicultural Seniors both downtown and on the Hamilton Mountain. Our focus predominantly on poverty has positioned our organization as a leader in providing client centered and evidence based programs and services that employ strong assessment and referral components, and are flexible to the changing needs of clients and issues arising in the community.

Project Title: Seniors Community Connections

Summary Contribution to Outcomes: The Community Connector project will place community connectors into the targeted neighbourhoods to reach, engage and connect isolated seniors. By providing detailed needs assessments, individualized action plans and one to one support, the project will inform and refer clients to identified services through an evidence based model which ensures follow through and data collection. This model will support isolated seniors through trusting relationships, a strong understanding of community supports, and capacity building within the sector.

YWCA Hamilton
YWCA Hamilton

YWCA Hamilton has been a part of the Hamilton community since 1889. As a women’s-led organization, YWCA is committed to offering valuable programs and services to groups of all ages with diverse backgrounds and needs. The organization is engaged in community collaborative activities and planning groups to work with government and non-profit partners in a variety of sectors to improve the quality of life for women and their families. These collaborative activities and community planning initiatives address issues including but not limited to poverty, housing and homelessness, violence against women, child care, adults with developmental disabilities, youth services, and supports for an aging population.

Visit YWCA Hamilton’s website

Expertise and Experience with the Target Population: YWCA Hamilton has provided services for 126 years in the city and for 40 years have operated two Active Living Centres for adults 55 and older. Our programs offer inclusive, quality services that support social participation and inclusion of older adults and seniors. YWCA Hamilton is a member of multiple collaborative tables and partnerships across the community. The Peer Connector project is consistent with our work with vulnerable and marginalized populations. We have designed and delivered sustainable programs as well as special projects for low income populations through a variety of funding models. Projects for seniors have included community engagement and the provision of activities for those who are isolated due to income and / or cultural diversity. Peer support has been an integral component of a number of programs for many years including our Active Living Centres for 55+ where we have our largest number of peer volunteers. Our in home volunteer programs provide intensive training, monitoring and policies to support best practices.

Project Title: Peer Connectors for Isolated Seniors

Summary Contribution to Outcomes: Volunteer Peer Connectors will be recruited from neighborhoods to engage isolated seniors in their community who have low incomes in regular physical and social activities that contribute to their improved health and reduce their social isolation. Peer connectors will provide home visits and accompaniment to existing community activities and spaces that meet the interests of isolated seniors. Health promotion and nutrition programs will be offered in neighborhoods for the purpose of bringing together isolated seniors and peer connectors to expand their social networks.

TEAM LEADS

Danuta Chuls

Project Lead

Thrive Group
CareDove - Interactive Community Access and Referral System

April Morganti
April Morganti

Executive Director

AbleLiving
Hospital Care Connectors for Isolated Seniors, Hamilton Health Sciences

Marnie Warman
Marnie Warman

Manager, Health and Wellness Programs

YWCA Hamilton
Peer Connectors for Isolated Seniors

Tara-Lyn Prindiville
Tara-Lyn Prindiville

Project Manager

Hamilton Council on Aging
Connecting Hamilton's Initiative to Reduce Social Isolation Among Seniors

Rebecca Buckland
Rebecca Buckland

Senior Manager, Community Support Services

St. Joseph's Home Care
Hospital Care Connectors for Isolated Seniors

Alice Al Houjairy

Manager

    Wesley Urban          Ministries
Seniors Community Connections

Amanda Grenier
Amanda Grenier

Director

Gilbrea Centre for Studies in Aging
Participatory Research Initiative