How Ontario Health atHome Can Help You

Please keep in mind: this is a general overview of how the Ontario healthcare system works. Every situation is unique, and care plans are always tailored to individual needs.

What Happens After Hospital Discharge?

1. Notification of Discharge
The hospital will notify the family or Substitute Decision Maker (SDM) that discharge is being planned. This notice may be as short as 24 hours or extend up to several days, depending on the situation.

2. Needs Assessment is Completed
A hospital discharge planner or social worker (SW) will assess the client’s needs and outline what is required for a safe return home.

This includes care needs, equipment, and supports
They guide the process, but families/SDMs often take the lead in arranging services

3. Coordination of Services
Families or SDMs typically coordinate essential arrangements, such as:

Booking follow-up medical appointments
Managing medications (removing old, organizing new prescriptions)
Preparing the home (safety modifications, food, accessibility)

👉 Ontario Health atHome may assist with coordinating government-funded home care services where eligible.

4. Ontario Health atHome (HCCSS) Integration
The hospital connects the client with Ontario Health atHome (formerly Home and Community Care Support Services).

They will:

Assess eligibility for publicly funded home care
Determine the type and amount of support available (e.g., PSW visits, nursing care, therapy services)
Develop a care plan based on clinical needs

5. Transfer Home
Transportation home may be arranged by:

Family/SDM
Private transportation services
Hospital-arranged medical transport or ambulance (if medically required)

6. Ongoing Care & Supervision
A successful transition home depends on several key factors:

Clean and safe living environment
Proper nutrition and hydration
Medication adherence
Mental stimulation and social engagement
Regular communication between healthcare providers and family

Where Help Now Healthcare Fits In

While Ontario Health atHome provides government-funded services, these supports are often limited in hours and scope.

Help Now Healthcare bridges the gap.

We provide:

Flexible private home care services tailored to your schedule
Faster service start times (no long waitlists)
Consistent caregivers for continuity of care
Support beyond funded hours (evenings, overnight, 24/7 care)
Assistance with discharge coordination and home setup

Why Families Choose Help Now Healthcare

Seamless Transition Home: We work alongside hospital teams and Ontario Health atHome to ensure nothing is missed
Responsive & Reliable: Last-minute support, urgent coverage, and ongoing care
Holistic Approach: We focus not just on care, but overall quality of life
Peace of Mind: Families know their loved ones are supported every step of the way

Final Note

Navigating the healthcare system after a hospital stay can feel overwhelming—but you don’t have to do it alone.

Whether you are receiving support through Ontario Health atHome or exploring private care options, the goal is the same: a safe, comfortable, and successful return home.

Help Now Healthcare is here to support that journey—every step of the way.

LINKS TO COMMUNITY RESOURCES

Please click on any of the following links for more information

You may also contact us to connect you to more community resources!

General Homecare and Support Resources:

Home and Community Care Ontario – Directory and information for home care services in Ontario.
Ontario Home Care Association – Advocacy, resources, and industry support for homecare providers in Ontario.

General Health and Support Organizations:

Health Canada – Federal department overseeing public health.
Ontario 211 – Helpline and resource directory for community and social services in Ontario.
ACP in Canada – Tools and resources for advanced care planning.
Finding Your Way Ontario – Resources for reducing the risk of wandering in people with dementia.

Dementia and Alzheimer’s Care:

Alzheimer’s Society of Canada – Information and resources for dementia care.
Brainxchange – Tools and resources focused on dementia care.
Dementia Friends Canada – A program offering information and support for those impacted by dementia.

Disease-Specific Organizations:

Parkinson Canada – Resources and support for Parkinson’s disease care.
Multiple Sclerosis Society of Canada – Support and research for MS.
Canadian Cancer Society – Resources for cancer prevention, treatment, and support.
Kidney Foundation of Canada – Information and resources for kidney health.
Osteoporosis Society of Canada – Resources for osteoporosis prevention and management.
Arthritis Society of Canada – Resources for arthritis care.
Canadian Stroke Network – Information and resources on stroke care and recovery.
Diabetes Canada – Resources and support for diabetes care.
Heart and Stroke Foundation – Information on heart disease, stroke, and related health issues.

Palliative and Hospice Care:

Canadian Hospice Palliative Care Association (CHPCA) – Resources for palliative and hospice care.

Pediatric Disease and Support Organizations:

Autism Ontario – Resources for autism care and support.
Children’s Hospital of Eastern Ontario (CHEO) – Pediatric healthcare services and support.
Kids Help Phone – 24/7 mental health support for children and youth.
Ontario Association for Children’s Mental Health (OACM) – Support for children’s mental health services.
Cystic Fibrosis Canada – Information on cystic fibrosis care for children and families.
Ontario Brain Injury Association – Support for children and adults with brain injuries.

Senior Support and Advocacy:

Advocacy Centre for the Elderly – Legal advocacy for seniors, including low-income seniors.
CARP (Canadian Association of Retired Persons) – Advocacy for older Canadians.
Behavioural Supports Ontario – Resources for addressing behavior change in older adults.
Caregiving Matters – Support services and resources for family caregivers.
Caregiver Exchange – Search tool for finding family caregiver support services.
Carers Canada – Advocacy and support for family caregivers.
Powers of Attorney in Ontario – Information on setting up Powers of Attorney.

Financial and Benefits Support:

Benefits Finder – Search for government benefits, including those for caregivers.
Tax Deductions and Credits for Caregivers – Information on tax credits and deductions for caregivers.

Community Resources