COMPANY DESCRIPTION Founded in 1976, Home Nursing Foundation (HNF) is a leading charity that provides home healthcare services in Singapore, regardless of our patients' ability to pay. Dedicated to all-round support for our patients, HNF delivers comprehensive care programmes to look after patients' emotional well-being and healthcare needs. Our HNF Wellness Day Care & Rehabilitation Centres offer an array of social activities, social support and holistic healthcare services to help our elderly stay independent in their own community. RESPONSIBILITIES Conduct biopsychosocial and financial assessments, including InterRAI, for clients and caregivers, identifying medical, functional, psychosocial and financial needs. Develop care plans and coordinate follow-up actions to address client and/or caregiver's needs. Work collaboratively with multidisciplinary, healthcare and community partners (doctors, nurses, therapists, Home Care staff, community partners) to ensure continuity, coordination and smooth care transitions. Provide direct counselling, emotional support, and psychoeducation to clients and caregivers, to facilitate coping with illness, grief, loss, and life transitions. Provide crisis intervention and make timely referrals to specialised services for complex or high-risk cases. Conduct home visit independently or jointly with the Home Care team as required. Maintain accurate, comprehensive, and timely documentation of assessments, interventions, care plans, and progress notes in accordance with professional standards and organizational policies. Participate in departmental and organisational quality improvement, service development and programme evaluation activities.Support outreach, education and publicity to raise awareness and boost enrolment in department/organization's programmes. Attend relevant training, supervision sessions, and casework discussions for continued professional growth. Perform any other related duties as directed by the reporting officer