| Title: |
The Development of an Integrated Model of Dementia Care in the Community for Low-Income Seniors |
| Authors: |
Charles, Jocelyn; Liu, Kitty; Hitzig, Sander; Danieli, Einat; Ziegler, Naomi; Smith, Jagger; Landau, Stacy; Cohen, Carole; Motsenok, Marina; Steinberg, Rosalie; Fine, Kiara; Howells, Arlene; Sauer, Renee |
| Source: |
International Journal of Integrated Care; Vol. 26 No. S1 (2026): 25th International Conference on Integrated Care, Lisbon, Portugal, 14-16 May 2025; 379 ; 1568-4156 |
| Publisher Information: |
Ubiquity Press |
| Publication Year: |
2026 |
| Collection: |
International Journal of Integrated Care (IJIC) |
| Description: |
More than 8% of Canadians over the age of 65 are estimated to live with a form of dementia. However, the real number is likely higher for older adults living in social housing as they are disproportionately impacted by poverty, social isolation and poor health, which increases their risk of developing dementia. Community service providers care for persons living with dementia across ambulatory care clinics, hospitals, rehabilitation facilities, nursing facilities and in their homes. Movement across the continuum of care is not necessarily linear from home to hospital, with many persons living with dementia facing re-hospitalizations and increased morbidity and mortality with excess healthcare expenditures. To better identify and support older adult tenants at risk for or living with dementia who reside in Toronto Seniors Housing Corporation (TSHC) buildings, Sunnybrook Health Sciences Centre is collaborating with community partners to expand and integrate three initiatives as part of a new 'Dementia Care in the Community' Strategy (DCSS): 1.Community Psychiatric Services for the Elderly providing at-home psychiatric assessments, coordinating referrals to community agencies, and facilitating a bimonthly support group for dementia family caregivers. 2.Sunnybrook's Homebound Seniors Program, providing team-based, at-home care to patients who have difficulty accessing clinics for primary care. 3.Neighborhood Care Team (NCT), a consortium of 11 service providers that focuses on early identification of needs and seamless access to social and health services for TSHC tenants. An implementation science framework is being used to explore the model’s feasibility, appropriateness, acceptability and sustainability. Specifically, we will use the Consolidated Framework for Implementation Research (CFIR) to guide research that supports evidence-based decision-making to optimize the DCSS strategy including qualitative interviews with key interest groups and analyzing health service utilization patterns amount TSHC tenants to ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://account.ijic.org/index.php/up-j-ijic/article/view/10716/11519 |
| DOI: |
10.5334/ijic.ICIC25379 |
| Availability: |
https://account.ijic.org/index.php/up-j-ijic/article/view/10716; https://doi.org/10.5334/ijic.ICIC25379 |
| Rights: |
Copyright (c) 2026 The Author(s) ; https://creativecommons.org/licenses/by/4.0 |
| Accession Number: |
edsbas.5C27B223 |
| Database: |
BASE |