The Three Streams of Care
About Complex Continuing Care
Information for Patients and Families
Palliative Care
The Three Streams of
Complex Continuing Care
The Complex Continuing Care Program of the Brant Community Healthcare System serves those whose complex needs will best be met in a multidisciplinary hospital setting as they require skilled, technology based care. There are 3 current streams in the CCC program.
Medically Complex
Persons identified for this stream of care will require close medical monitoring with regular visits by their attending physician. They may require admission for three to eighteen months.
The multidisciplinary management of their care needs may include any of the following requirements:
- parenteral feedings
- suctioning
- tracheostomy care
- ventilator/respirator care
- treatment for burns
- extensive wound care, amputation of pressure ulcers stage 3 and 4
- IV medications
- radiation treatments
- transfusions
- chemotherapy
- dialysis
- high risk of aspiration pneumonia
Reactivation
Those identified for this stream of care require multidisciplinary, therapeutic services to achieve their maximum level of functioning following an acute episode or following an unexpected/unexplained decompensation that may require a geriatric assessment.
Prior to admission a tentative discharge plan will be established as a goal for their reactivation. Persons must be prepared to participate in an active reactivation program. They should demonstrate potential for improvement as assessed by the multidisciplinary team through a slow paced program. The average length of stay is approximately one to three months.
The therapeutic services include at least one of the following therapies 5 days per week:
- Physiotherapy
- Occupational Therapy
- Speech Language Pathology
- Nursing Rehabilitation
- Clinical Nutrition
Other therapeutic services may include:
- Respiratory Therapy
- Therapeutic Recreation
- Rehabilitation Therapy
- Social Work
Palliative Care
People in this stream of care will require short term management of the end-stage of their illness. The focus of palliative care is to enhance the quality of life for those who are dying, taking into account their physical, spiritual, psychosocial and cultural needs. Their stay in the Hospital is for medical intervention and 24 hour nursing care to achieve pain and/or symptom control.
