Individuals who sustain catastrophic impairments such as brain injury or spinal cord injury, require extensive support. Our case management professionals have the expertise to effectively liaison with hospital personnel, medical specialists, therapeutic health care professionals and school personnel to assist with home, school and community reintegration. In addition to medical coordination, our Case Managers provide significant education to family members and care providers to ensure quality healthcare and achievement of realistic functional and/or cognitive outcomes. Services include:

Hospital Discharge – Our Nurse Case Managers coordinate a client’s discharge from hospital to their home or alternate living arrangement. The patient may be mobility dependent and require assistance with his/her daily activities. The purpose of hospital discharge involves assessing the home environment and determining the need for special aids/devices or equipment to enable a safe discharge that maximizes functional independence.

Attendant Care Assessment - A standardized assessment of an injured individual's ability to perform their basic and essential personal care activities. A Form 1 is completed to itemize the activities and associated costs of the individual’s required assistance.

Life Care Plans - Life Care Plans are developed by health care professionals to determine long term care and treatment issues for individuals with chronic and/or permanent impairments. The plan identifies associated costs for items such as therapy, education, continuing medical treatment, drugs, architectural renovations, special transportation, home care, and facility costs.


Counselling services are provided to the client within their home. Social Work staff also communicate with other treating professionals, caregivers, and family to ensure a collaborative approach to rehabilitation. Therapeutic counselling within the home provides timely services to individuals who, based on their injuries, cannot access appropriate services in the community. A focus on accepting change, developing hopefulness and creating an awareness of coping mechanisms, will assist clients in the early stages of recovery from illness or injury.