Sophia is in her mid-70s, and mildly frail.  She speaks English with a strong Italian accent, but can communicate reasonably well.  Sophia went as far as the equivalent of grade 3 in Italy. She has a hard time reading English. 

She lives with Primo, her elderly husband who has many severe health issues (very bad heart and lungs), and neither of them drive so getting to appointments is difficult. In the past she has used the transit system, but is currently unable to walk the 200 meters to the bus stop.  As well, she finds it difficult to climb the stairs to enter the bus.  She does not feel she can afford taxis.  Her daughters have to take time off work to bring her to appointments, and she doesn’t like to ask them to do so.  She has been increasingly isolated last year and has not attended any church functions.

Sophia lives in a three-story house, with the bedrooms and bathroom on the second floor. The bathroom is small with room only for a tub, toilet and sink. The laundry is in the basement, accessed by a steep staircase with one-sided handrails. She also has a stove, fridge and cooking area in the basement.  There are 5 stairs to enter the home.

 Sophia has always loved to cook.  She uses her upstairs kitchen for small day to day meals and reheating, but does her main food preparation in her basement cooking area and here prepares the large family meals.  Because she has had difficulty managing stairs, she has not been eating her traditional Italian meals and has been buying prepared foods.

Her husband is requiring more assistance with his personal care and he has had a few close calls with falls in the bathroom.  Sophia also is having more difficulty getting in and out of the tub lately and has started to sponge bath instead. 

There are no services coming into the home, as Sophia and Primo have declined anything that has been offered previously.