Tenancy Risk Reduction Service for Seniors: An Initiative Funded by the Ontario Local Poverty Reduction Fund
Agenda • Project Background • Program Overview • Program Components • Program Eligibility • Program Operations and Referral Processes • Research and Evaluation • Client Stories – Victoria
Project Background In 2014 , CHATS first teamed up with YSSN and VHA , with one year • funding from the Region of York, to design and deliver a program to support seniors with hoarding issues at risk of losing their tenancy. This first small project supported just under 40 seniors and showed some excellent initial outcomes. Sample size small yet we were able to demonstrate that this collaborative model of providing: Intensive case management, physical clutter reduction and therapy intervention improved quality of life. In late 2015 , the same partnership applied for and was successful in • receiving funding from the Ontario Local Poverty Reduction Fund for a two year initiative. This longer and larger pilot also includes partners at York University, who • are formally evaluating the program.
Program Overview Tenancy Risk Reduction Service for Seniors (TRSS) provides a basket of • services to seniors with hoarding behaviours and to seniors living in a condition known as senior squalor, who are at risk of losing their tenancy (renters) or their housing (owners) because of the unsafe living conditions. This initiative addresses the symptoms and the causes of these • conditions — the person and the property. Individualized service plans and customized teams are developed to meet • each client’s unique needs.
Program Components Program is delivered over the course of approximately six months for each • client. Components include but are not limited to the following : • Assessment and Care Coordination (CHATS) Geriatric Mental Health Case Management (YSSN) Physical Clutter Remediation (CHATS) Intensive Cleaning (CHATS/VHA) Occupational Therapy (VHA) Education and Training (All) Client Advocacy (All)
Program Eligibility TRSS is targeted at frail and cognitively impaired York Region seniors who are • at “risk” of increased poverty and homelessness due to hoarding behaviours and/or senior squalor. • For the purpose of this initiative, “at risk“ is defined as: Risk of tenancy loss/housing loss due to inability to maintain home in conditions that are considered safe. e.g. in receipt of warning, eviction notice from landlord, warning/order from municipal/regional services Risk of home environment being designated as “unsafe to provide care”, limiting access to health care and reducing ability to remain safely at home in the community. Risk of illness and accidents for the client, due to general level of housing disrepair combined with client frailty.
Program Operations and Referral Process CHATS August 19, 2016 Clean – Extreme / Comprehensive (VHA) Home support Program worker intervention Coordinator (CHATS) Intake Phone (CHATS) Referral by CHATS Coordinators Initial Phone Screen by Team and Care CHATS Intake: Establish Electronic Advocacy Referral care plan coordination Eligible? File (all) established check-in *age * income Initial face *situation to face visit *risk Written and OT – Consultation Referral Discharge comprehensive - Short term Form intake intervention, 4 visits assessment (VHA) 3 month follow up Progress Monitoring Referral to other service Minor Repairs (CHATS) Referral or Exit Referral or Exit Case Management - 3-6 month service -Complete OCAN -Complete crisis plan (YSSN) Link to primary Referral to other care services Page 1
TENANCY RISK REDUCTION SERVICE TO SENIORS Referral Form REFERRAL FORM Please fax or e-mail to CHATS – Community & Home Assistance to Seniors at Fax: 905-713-1705, E-mail: kchai@chats.on.ca For any questions or concerns, please call CHATS at 905-713-6596 or 1-877-452-4287 (toll-free) • ** This program serves seniors (55 years or older) who are residents of York Region with low or moderate household income (no more than $40,000/annual for 1 person or $50,000 for 2 persons). • Referrer Details Name: Contact information: Relationship to client: Organization/Agency: Client Details Name: Salutation: Preferred name (if different from first name): Phone number: Cell phone number: E-mail address: Address: City: Province: Postal code: Building access #: Major intersection:
Research and Evaluation TRSS is an innovative project, funded by the Ontario Local Poverty Reduction Fund as a test of a new • program model designed to reduce poverty and homelessness. • Just over 40 projects were funded across Ontario. • With the focus of formally testing/evaluating a model of service for transferability and applicability to other jurisdictions, the project has a very strong research component. • CHATS and our partners at YSSN and VHA are working closely with the Program Evaluation Unit at the York Institute for Health Research at York University. The research is focused on testing a Model of Change that addresses the following two questions: • Does building community capacity to identify and support vulnerable seniors keep seniors in their homes longer? What aspects of a multi-ponged approach are most effective in improving the health and well- being of seniors identified as having problematic hoarding behaviours? • The research includes both an individual component and a systems level component. • Many of you may have received a systems level survey…this is targeted as assessing your current knowledge, to give us a baseline.
Client Stories Every client’s level of hoarding/clutter behaviour varies. One client not only • has cluttering behaviour inside the home, but also outside (by-law- enforcement officer involved due to neighbourhood complaint) CM assisted client is riding of all clutter on front lawn (interlocking bricks, statues, fountains, miniature fixtures, etc.) Client was connected with HAMP to assist in whipper-snipping front yard Client is now working on landscaping her yard to her liking to the best of her ability and complaint was not filed.
Geriatric Case Management Advocacy – with landlords, by-law enforcement officers, etc. • • Psychosocial rehabilitation approach Utilize bio-psycho-social model for depressive symptoms & hoarding behaviour Many of these seniors experience isolation due to the state of their home (refrain from inviting people over, embarrassed, ashamed). CM to assist them in building up their social networks again and connecting them with others. Emotional support – family issues/trauma that has led them into their current situation (family breakdown, mental health symptoms)
Geriatric Case Management- Models of Change Harm Reduction : • Every step is a step to be recognized and celebrated CBT Techniques : • Providing a weekly goal planner sheet to create goals about what tasks they would like to complete (regarding taking care of the home) between the time that the HSW comes again Discussing the importance of certain items, what it means to them, along with the positives that will come out of them discarding that object. Support client to reevaluate their thinking about the actual vs. imagined importance of the item and to gain a new perspective on the realistic consequences of not having that item • Case Managers, please refer clients who you think will be a good fit with the program
Key Contact • Program Coordinator, Tenancy Risk Reduction Services • CHATS – Community & Home Assistance to Seniors • 240 Edward Street, Suite 1 • Aurora, Ontario L4G 3S9 • Office: 905-713-3373 ext. 6082 • Cell: 905-751-5715 • kchai@chats.on.ca
Questions? Gaynor McCredie – Project Manager 905.713.3373 x 6227 Kitty Chai – Program Coordinator 905.713.3373 x 6082
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