• Assessing clients’ physical and mental wellness, needs, preferences and abilities and using these to develop tailored care plans
• Working with clients, family and friend support networks and health care professionals to put care plans in place
• Listening to clients’ concerns and providing counseling or intervention as required
• Recording clients’ progress including charting referrals, home visits and other notable interactions
• Evaluating clients’ progress periodically and making adjustments as needed to improve outcomes
• Following up with discharged clients to ensure they were satisfied with services and they are still in good physical and mental health.