Caregivers ARE essential visitors/care partners

Advocates for hospital patients, residents of long-term care and retirement homes and their caregivers and families have been (thankfully) especially busy since the COVID-19 pandemic. The very restrictive to ‘zero visiting’ policies instituted in many of these institutions has been well covered in the media. It is the virtual definition of heartbreak. The advocacy is working and there is good news. In Ontario, caregivers are now recognized as essential visitors. Read on for details of changes for family caregivers in Ontario who have family members in long-term care homes.

Caregivers ARE care partners

There is clear evidence that partnerships with family members and caregivers improves patient/resident experience, safety and outcomes. Even prior to this pandemic, there have been campaigns to recognize and treat caregivers as partners in care. This pandemic has brought this need to the surface in a dramatic way. Most of us don’t need to be reminded of the heart wrenching stories of separation between caregivers and family members in long-term care homes with COVID-19. It isn’t an exaggeration to say that it has been traumatizing for many residents and their families.

Patient ombudsman special report: October 2020

Ontario’s Patient Ombudsman recently released a report and recommendations related to complaints received to date during this COVID-19 pandemic. As the Ombudsman, Cathy Fooks, states in this report: “No one in Ontario’s healthcare system wants a repeat of the scenarios we faced in the spring of 2020.”

The Ontario government has been listening to patient and caregiver advocates in terms of visitation and has recently updated its visitor policy under the Long-Term Care Homes Act.

Ontario’s Long-Term Care Homes Act

In Ontario, all institutions that care for the elderly (i.e. nursing homes, long-term care facilities, retirement homes) are subject to the Long-Term Care Homes Act, 2007 (LTCHA) or the Retirement Homes Act, 2010. These laws are meant to safeguard residents’ rights; to improve the quality of their care and make these long-term care homes accountable for their practices and procedures.

The Ontario government has implemented a new directive ( Directive #3) for long-term care homes. The updated policy clarifies that caregivers are allowed to visit homes at any time, including during an outbreak, subject to direction from the local public health unit.  This new visiting policy came into effect October 7, 2020.

Updated visitor policy

• Caregivers are now recognized as essential visitors, as partners in care, who provide direct care to residents such as “helping with feeding, mobility, hygiene, meaningful connection, relational continuity or cognitive stimulation.”
• They can be family members or friends, privately hired caregivers, paid companions and/or translators.
• Each resident and/or their substitute decision maker can name two caregivers.
• Caregivers can visit without time limits.
• If there is an outbreak at the LTC home or the resident is self- isolating or symptomatic, the caregivers must visit one at a time. Otherwise, the caregivers can visit together.

Caregiver visits during COVID-19 pandemic

• All visitors should pass active screening before entering a home. This includes a temperature check, questions on symptoms and exposures to COVID-19.
• All caregivers, as well as any general visitor who is visiting indoors, should verbally attest to the home that they have tested negative for COVID-19 within the previous two weeks and not subsequently tested positive.
• Homes are not required to provide the testing.
• All visitors must wear surgical/procedure masks inside the home. Essential visitors are also required to wear additional personal protective equipment for interactions with residents who are self-isolating, suspected or confirmed to have COVID-19.
• The home should provide training to caregivers that addresses how to safely provide direct care, including putting on and taking off required PPE, and hand hygiene.
• Homes are responsible for providing surgical/procedure masks, gloves, gowns and eye protection (for example, face shield or goggles) for essential visitors.
• Caregivers should be asked by the home to verbally attest that they have read/re-read the home’s visitor policy (prior to first visit and once per month thereafter).
• The home’s visitor policy should include guidance from the following Public Health Ontario resources to support IPAC and PPE education and training for caregivers:

• • • guidance document entitled Recommended steps: putting on personal protective equipment (PPE)
    • video entitled Putting on full personal protective equipment
    • video entitled Taking off full personal protective equipment
    • video entitled How to hand wash  

This updated visitor policy ensures caregivers’ rights to be with, care for, support, comfort and touch their family members in long-term care. It also meets the long-term care homes’ need for the provision of safe care and safety for all residents and staff members and visitors. That sounds like a win-win.

Have you visited a family member since the visitor policy has been updated? We would love to hear from you.