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Hospital  >  Care Programs  >  Integrated Community Program  >  Specialized Geriatric Services  >  Geriatric Outreach Team

Geriatric Outreach Team


The Geriatric Outreach Team assesses homebound elderly seniors living in the community who have complex problems related to health, day-to-day functioning and social concerns. The assessment is conducted by one or more members of the Geriatric Outreach Team at the client's home. This Outreach Team provides recommendations to improve the patient's level of health, overall functioning and independence. All recommendations are discussed with the client, their family physician, family members and any other health care professionals or caregivers. Patients may then need to be followed until appropriate plans are in place.


The Outreach Team provides information to assist the elderly person and family to understand:

  • The nature of the elderly person's difficulties/problems
  • The most effective ways of meeting his/her needs


The Outreach Team works with the family physician and other health care professionals to coordinate the overall care of the elderly person by linking them with:


The Outreach Team is comprised of the following health care professionals:

  • Nurse Clinician
  • Occupational Therapist
  • Physiotherapist

The composition of the team involved with each patient varies according  to their needs.  All cases are reviewed with a consulting Geriatrician.


For more information, call the Specialized Geriatric Referral Office at 416-480-6888. Referral forms can be downloaded here.

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