• Provide assessment and develop service plans
• Provide individual personal choice options
• Coordinate services and provide choices of options when making decisions about the future
• Address needs and wants
• Provide guidance from a Personal Life Management Nurse;
• Home visits or phone calls;
• Liaison between client, family and physician
• Ongoing follow up per telephone or in person
• Continued monitoring and updating service options
• Eldercare Mediation

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