Transitions is offered to individuals with a life limiting illness and who have a prognosis of one year or less and are either ineligible for hospice services or do not wish to receive hospice care. Many of our Transitions clients suffer from multiple chronic conditions, are older adults and have been diagnosed with illnesses, such as dementia and congestive heart failure, which leave them with complex health and care needs.

Clients are referred to Transitions through their discharge from Gilchrist’s services, as well as through a growing network of outside medical providers. For those who were recently on hospice but whose health stabilized, making them ineligible for end of life care, the program offers continuity of care – a scaled down version of the valuable care coordination and support they received while on hospice. For those not yet eligible for or ready for hospice, it offers a safety net, ensuring that each client has access to the resources they need to maintain the best possible quality of life, while preparing them for the realities that will arise as their illness or condition progresses.

caregivers, families and physicians



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