“…This intervention involved scheduled telephone calls from a surveillance nurse to regularly assess the client’s well-being, care plan status, use and need for services (e.g., adult day programs, physiotherapy, home support), and home environment (e.g., family caregiver support). The nurse provides the client with information, education, and coaching, and if necessary collaborates with other health care and support professionals (e.g., occupational therapists, physiotherapists, social workers, dietitians, home care nurses, general or nurse practitioners), and community resources (e.g., Alzheimer’s Society, meals on wheels) (Kelly & Godin, 2015).…”