Managing Intensive Clinical Needs Outside the Hospital Ward
When a senior lives with multiple chronic diseases, progressive neurological disorders, or complex medical equipment, family members are often told that long-term institutional care is their only option. At OnPoint, we believe that with experienced clinical leadership and specialized nursing, high-acuity care can be safely delivered in the comfort of home.
Our Complex Care at Home service brings hospital-caliber clinical expertise into your living room. From enteral tube feeding (PEG/G-tube) and indwelling Foley catheter maintenance to supplemental oxygen monitoring, tracheostomy care, and complex multi-drug regimens, our licensed nurses provide rigorous, compassionate oversight around the clock.
"High medical acuity does not have to mean a hospital room. We deliver intensive, evidence-based nursing care right at the bedside."
Complex Medical Conditions We Frequently Manage
High-level care customized to individual diagnostic profiles:
Neurological & Motor Disorders
Advanced Parkinson's disease, Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis, and severe post-stroke hemiplegia.
Advanced Cardiopulmonary Diseases
Congestive Heart Failure (CHF Stage III/IV), severe COPD requiring continuous oxygen/BiPAP, and pulmonary fibrosis.
Enteral Nutrition & Feeding Tubes
Gastrostomy (G-tube) and Jejunostomy (J-tube) formula administration, flush protocols, site dressing, and pump management.
Catheter & Ostomy Management
Indwelling urethral (Foley) and suprapubic catheters, colostomy/ileostomy appliance maintenance, and skin barrier protection.
What Our Complex Care Nursing Delivers
Rigorous medical protocols executed by Registered Nurses and Licensed Practical Nurses.
Enteral Nutrition & Feeding Tube Care (PEG / G-Tube)
Our nurses oversee enteral formula administration, pump programming, scheduled water flushes, medication crushing and delivery through the tube, and sterile stoma site cleansing.
- Continuous and bolus enteral feeding administration
- Stoma site skin inspection, cleansing, and dressing changes
- Troubleshooting tube clogs and verifying retention balloon volume
- Aspiration prevention and head-of-bed positioning protocols
Respiratory Support, Oxygen Therapy & Suctioning
Managing supplemental oxygen concentrators, BiPAP/CPAP non-invasive ventilation, nebulizer treatments, oral-pharyngeal suctioning, and respiratory distress triage.
- Continuous SpO2 and respiratory rate surveillance
- Aseptic suctioning and oral hygiene maintenance
- Nebulized bronchodilator and steroid administration
- Emergency oxygen titration protocols under physician orders
Indwelling Catheter & Urological Care
Sterile insertion, scheduled bag changes, catheter irrigation, and vigilant monitoring to eliminate catheter-associated urinary tract infections (CAUTIs).
- Sterile catheter insertion, replacement, and anchoring
- Urine output volume, color, and sediment tracking
- Early identification of urosepsis symptoms and prompt escalation
- Suprapubic catheter site cleansing and dressing management
Advanced Wound & Pressure Injury Management
Clinical staging, sterile debridement monitoring, NPWT (wound vac) maintenance, and advanced dressing changes for Stage 3/4 pressure injuries and diabetic ulcers.
- Wound measurement, photography, and healing rate documentation
- Specialized hydrocolloid, alginate, and foam dressing changes
- Negative pressure wound therapy (wound vac) operation
- Strict Q2H repositioning schedules to prevent new tissue breakdown
Complex Polypharmacy & Subcutaneous Injections
Accurate administration of complex multi-drug schedules, insulin titration, anticoagulant injections (e.g. Lovenox), and monitoring for toxicities or interactions.
- Subcutaneous, intramuscular, and oral medication delivery
- Blood glucose testing and sliding-scale insulin administration
- Pain assessment scoring and opioid administration tracking
- Direct coordination with prescribers for dosage adjustments
Mechanical Lift Transfers & Bed Mobility
Providing safe, two-person mechanical Hoyer lift transfers, ceiling track operation, and gentle repositioning for individuals with severe mobility impairments.
- Certified mechanical lift operation with zero risk of strain
- Pressure-relieving mattress setup and repositioning
- Gentle passive range-of-motion (ROM) exercises to prevent contractures
- Skin integrity inspections over all bony prominences
"Complex clinical care is not just about operating medical devices; it is about bringing calm, human compassion to individuals facing acute health challenges."
Four Pillars of Complex Home Care
Licensed Nursing
High-acuity care delivered exclusively by trained Registered Nurses and Licensed Practical Nurses.
Infection Control
Hospital-grade aseptic techniques for all catheter, feeding tube, and wound care procedures.
Vigilant Monitoring
Real-time vital trends tracking that identifies clinical decompensation before emergencies arise.
Physician Partnership
Direct collaboration with treating specialists, hospital clinics, and family physicians.
What Is Included in Complex Care Services
Fully customized to your loved one's specific medical directives and equipment needs.
Standard Procedures & Oversight:
Why Healthcare Providers and Families Trust OnPoint
Nurse-Led Clinical Excellence
Headed by Risper Murunga, RN, BSN, MPH with extensive acute care hospital and long-term complex care leadership.
24/7 Continuous Bedside Availability
Providing seamless, awake day and night nursing coverage that prevents hospital readmission.
Seamless Health Authority Coordination
We work in close synergy with VCH and Fraser Health specialized community clinics and hospital discharge teams.
Responsive Clinical Communication
Our nurses provide transparent shift handover summaries and real-time medical updates to families and physicians.
Where We Provide Complex Home Nursing
Delivering advanced clinical care across all municipalities in the Greater Vancouver region.
Common Questions About Complex Care at Home
Complex care is tailored for seniors with high medical acuity: Parkinson's, ALS, advanced dementia, congestive heart failure, severe COPD on oxygen therapy, tube feeding (G-tube/PEG), urinary catheters, complex wound care, and multi-drug regimens.
Care is delivered by Licensed Practical Nurses (LPNs) and Registered Nurses (RNs), supported by certified Health Care Assistants (HCAs) under the direct supervision of our Lead Registered Nurse, Risper Murunga, RN, BSN, MPH.
Yes. We offer continuous 1-on-1 bedside nursing and care coverage 24 hours a day, 7 days a week, ensuring clinical stability, scheduled interventions, and immediate crisis management.
Our nurses maintain precise clinical logs, prepare regular medical summaries, and communicate directly with treating family physicians, neurologists, respirologists, and community health authorities.
Book a Complex Care Consultation
Let our Lead Registered Nurse assess your loved one's clinical needs and design an advanced care plan.