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Last Updated: 2022/09/23 Page 1 of 1 Palliative Patient Status UpdateNAME: ADDRESS: CASELOAD: HCN/BRN: DATE d/m/ y : ATTENTION: PPS %:_ Pain scale : /10 Current Pain Regime: Areas of Concern: Suggestion of Treatment Orders: Additional Information: SIGNATURE: DESIGNATION: AGENCY PHONE NUMBER: RESPONSE OR ORDERS Response Required:  YES  NOSouth West Home and Community […]

Last Updated: 2022/09/23 Page 1 of 1 Palliative Patient Status UpdateNAME: ADDRESS: CASELOAD: HCN/BRN: DATE d/m/ y : ATTENTION: PPS %:_ Pain scale : /10 Current Pain Regime: Areas of Concern: Suggestion of Treatment Orders: Additional Information: SIGNATURE: DESIGNATION: AGENCY PHONE NUMBER: RESPONSE OR ORDERS Response Required:  YES  NOSouth West Home and Community […]

Last Updated: 2022/09/23 Page 1 of 1 Palliative Patient Status UpdateNAME: ADDRESS: CASELOAD: HCN/BRN: DATE d/m/ y : ATTENTION: PPS %:_ Pain scale : /10 Current Pain Regime: Areas of Concern: Suggestion of Treatment Orders: Additional Information: SIGNATURE: DESIGNATION: AGENCY PHONE NUMBER: RESPONSE OR ORDERS Response Required:  YES  NOSouth West Home and Community […]

Last Updated: 2022/09/23 Page 1 of 1 Palliative Patient Status UpdateNAME: ADDRESS: CASELOAD: HCN/BRN: DATE d/m/ y : ATTENTION: PPS %:_ Pain scale : /10 Current Pain Regime: Areas of Concern: Suggestion of Treatment Orders: Additional Information: SIGNATURE: DESIGNATION: AGENCY PHONE NUMBER: RESPONSE OR ORDERS Response Required:  YES  NOSouth West Home and Community […]

Adult Day Programs provide fun, engaging activities in the community for people with physical or cognitive challenges, as well as those with Alzheimer’s disease and related dementias. There are 10 Adult Day Programs at 17 locations in the Home and Community Care Support Services Mississauga Halton region. Check out our brochure to see a map […]

Last Updated: 2018 02 01 Page 1 Palliative Patient Status Update NAME: ADDRESS: CASELOAD: HCN/BRN: DATE d/m/ y : ATTENTION: PPS %:_ Pain scale : /10 Current Pain Regime: Areas of Concern: Suggestion of Treatment Orders: Additional Information: SIGNATURE: DESIGNATION: AGENCY PHONE NUMBER: RESPONSE OR ORDERS Response Required:  YES  NO South West LHIN […]

Last Updated: 2020 -01 -13 Page 1 Enteral Feed Order Form Section 1: Patient Demographics Name: Address: City: Postal Code: Date: BRN: Phone: Section 2: Tube Details Type of Tube: □ Nasogastric □ Percutaneous Endoscopic Gastrostomy (PEG) □ Percutaneous Endoscopic Gastrojejunostomy (PEG-J) ☐ Jejunostomy Date of Insertion: Physician who inserted the Tube: Plan for Tube […]

Patient Name: D.O.B.: Address: Allergies: Phone # Health Card # Delivery or Pick Up MD or NP NOTIFIED DATE KIT INITIATED: SIGNATURE: DATE: Acetaminophen 650mg Supp. Refill x 2Mitte: 5 Suppositories Sig: Insert 1 suppository rectally Q4H PRN for temperature over 101 F (38.5 C) Metoclopramide 10mg/2ml LU481 ( pseudo DIN 09857224) Refill x 2Mitte: […]

Rev. June 2021 Palliative Pain and Symptom Management Consultation Services Request/Referral for Consultation Palliativ e Pain and Sympto m Management Co nsu ltants (PPSMCs) pro v ide su ppo rt to serv ice pro v iders in ho me care agencies, lo ng -term care homes, community support services, and primary care. T hey pro […]

A Guide to HOME AND COMMUNITY CARE SUPPORT SERVICES Hamilton Niagara Haldimand Brant Connecting You with Home and Communi ty Care “Imagine what we can achieve together when we care, listen and act ” Home and Community Care Support Services Hamilton Niagara Haldimand Brant helps people:  Access care and support services available through Nursing […]

o Liver disease o Asthma o Smoking o Malignancy o Autoimmune o Immunosuppressed o Substance use o Hypertension Providing Care for Our Patients with COVID@Home Primary Care Providers (PCP) have continued to support their patients throughout the pandemic. This document provides a simple framework for PCPs to utilize when following their own patients with COVID@Home. […]