Caregiver with patient

Care Navigation in Point Douglas

Care Navigation. Nurse-led. Doctor-supported.

Nurse-led coordination across physicians, specialists, WRHA Home Care, insurance, and community resources — so families stop playing case manager for a system that does not talk to itself.

Care planning in Point Douglas: Point Douglas care planning can connect Health Sciences Centre follow-up with nursing, personal care, care navigation, transportation, dementia support, or continuous coverage. Cultural and caregiver preferences should be discussed directly during assessment, not assumed from the postal area.

How this service connects to local care

A plan for the person, the home, and the schedule

How the service fits

Care navigation can organize referrals, discharge planning, equipment, public Home Care applications, Self and Family Managed Care, insurance, and the handoff between family and paid care.

Hospital and appointment handoff

If care follows a stay or appointment at Health Sciences Centre, share the discharge date, written instructions, medication changes, mobility limits, equipment needs, and follow-up schedule. Prime provides discharge planning, hospital-to-home transportation, appointment escorts, nursing, and post-surgery support.

Home and scheduling details

The nurse assessment should review entrances, stairs or elevators, bathroom access, safe transfers, medication storage, caregiver access, parking, and whether overnight support is required. Confirm preferred visit times, appointment dates, family handoffs, language preferences, and whether overnight care means an awake shift or a live-in arrangement.

What's Included

Physician & specialist coordination
WRHA Home Care liaison
Insurance navigation & direct billing
Hospital discharge planning
Community resource referrals
Funding & benefit application support
Family care meetings
Care plan development & updates

What Your Family Gains

Family burden lifted

Adult children stop being the full-time case manager for a parent.

Funding maximised

We know the programs and paperwork most families never find.

Gaps closed

The cracks between hospital, family doc, specialist, and Home Care get bridged.

Nurse-led

Care navigation with clinical expertise — not a call centre script.

Geographic and facility context for Point Douglas, Winnipeg

Nearest hospital

Health Sciences Centre (~4 min)

Care facilities nearby

Holy Family Home (nearby) · Fred Douglas Place · Convalescent Home of Winnipeg

Area character

Historic industrial-adjacent inner-city neighbourhood at the fork of the Red River — Winnipeg's oldest area, with heritage homes and significant Indigenous community.

Community context

Significant Indigenous (First Nations and Métis) population; elders with distinct cultural care needs and higher rates of chronic conditions. Lower-income area with heavy Home Care Program utilization.

Common Questions