Trail Gatekeeper Program: What Happens to Gatekeeper Referrals
Upon receiving your referral, a crisis line worker will determine if it is a legal, social, or medical issue and contact the appropriate agency. If necessary, the person will be referred to the Continuing Care Program, so that a comprehensive assessment of the client and home can be completed. The continuing care staff is highly skilled in establishing relationships with the elderly and overcoming the initial resistance expected from many older persons who are suspicious, hostile and fearful. Cultivating rapport and trust is imperative because it provides the conduit for completing an assessment, service plan and continuity of care. If needed, psychiatrists or physicians are available to assist with the evaluation and service plan. Our goal is to involve the senior in the decision of which community supports are best for the senior. There are a number of in-home community-based services that we can utilize to maintain the older person's independence and avoid unnecessary institutionalization. These services may include home support, meals on wheels, respite services, lifeline/PERS, transportation. When an older person is admitted to our program, we maintain primary ongoing case management responsibility to ensure continued continuity of care.
