The Saskatchewan Health Authority (SHA) has made some changes to the visitation restrictions at long-term care and other facilities to allow family presence for compassionate reasons.
SHA CEO Scott Livingstone and Chief Medical Officer Dr. Susan Shaw provided details about the changes during a COVID-19 media update via teleconference, June 3.
Livingstone said it has been a priority for the SHA to protect the most vulnerable patients and long-term care residents in the health care system from contracting COVID-19.
“One of the first steps taken in response to COVID-19 was the public health order issued by the Government of Saskatchewan early in March to temporarily restrict visitors to our facilities across the province, except for compassionate reasons,” he noted. “Our initial response required a fairly narrow definition of compassionate for grounds for visitation, and given the devastation that has occurred in other provinces and outbreaks in health care facilities, particularly in long-term care homes, this was a necessary step.”
He emphasized the need to protect patients, residents, and staff has not changed, but the SHA also recognizes the importance of finding the right balance between physical safety and mental health and wellbeing.
“We know that illness and age can make time an especially precious commodity for many in our care,” he said. “So together with the advice from patients, residents and families we're finding the right path forward.”
According to Dr. Shaw the SHA created a family presence expert panel about five weeks ago to provide guidance on measures for family presence in health care facilities during the COVID-19 pandemic. The group of around 20 people include patient and family advisors as well as public health and infection prevention and control experts.
“It's finding that balance between working through the public health measures and order that still are in place and necessary to ensure safety as best as we can for the people we serve and the people who work with us, while also recognizing that health is much more than physical health,” she said. “It's emotional, spiritual and mental health as well.”
The updated family presence guidelines for SHA facilities came into immediate effect on June 3 and full implementation was scheduled to happen during the following week.
“So we're really asking that families work with the care staff to determine what's best for their loved ones and working within the guidelines and the public health measures,” she said. “It could be someone who needs reorientation or someone who has memory loss and has a better quality of life from having the presence of a loved one. We're trying to create some limited flexibility while recognizing there’s always going to be tensions between what we want to have happened and what needs to happen right now.”
The SHA has created a task team to provide support to staff and families who need guidance during the implementation of the expanded visitation and family presence guidelines.
“It’s going to take some time for our staff to be able to actually learn how to do this,” Dr. Shaw said. “It’s relatively easy to stop something, it’s really hard to reopen it and restart something well in a way that is consistent and fair. … Health care is a complex system and we now have a new level of complexity added, because we’re recognizing that COVID is here and it’s staying here for the months to come.”
The updated visitor restrictions allow family members and support people to be with their loved ones in long-term care homes and hospitals for compassionate reasons, which may include the presence of family or support persons during end-of-life care, major surgery, intensive care and critical care, or a care partner providing aid in clinical care.
The presence of a designated family member/support person for residents in long-term care will now not only be determined by care needs, but also by quality of life considerations. Two family members/support people can be designated, with one person present at a time.
The compassionate care definition now includes all critical care and intensive care patients, instead of only those at high risk for loss of life. The family presence for palliative care has been expanded to allow the presence of two family members/support people at the same time.
The guidelines have been revised to allow the presence of one family member or support person for inpatient, outpatient, emergency/urgent care patients with various challenges, including intellectual or mental health disability, visual or memory impairment, or mobility, hearing and speech impairment.
There are also new guidelines for outdoor visits in long-term care homes. More than one visitor at a time will be allowed, but on condition that physical distancing will be maintained.
The existing screening measures for health care staff will be applied to visitors that are allowed into SHA facilities under the updated visitation guidelines. It will include questions about any COVID-19 symptoms, if they have been in contact with someone who has symptoms, if they have been out of province or if they are coming from a community where there is an outbreak, and also temperature screening.
Family members and support persons will receive a medical grade mask and they will be asked to wear it during their time in the SHA facility. They will be asked to practice good hand hygiene, to follow physical distancing guidelines, and to respect traffic signage within the facility they are visiting.
The SHA recently expanded the testing guidelines to allow more provincial residents to be tested for COVID-19. Family members and support persons are therefore encouraged to get tested as an additional safety measure before they visit a SHA facility.
More information about visitation guidelines are available online at www.saskatchewan.ca/COVID19 under the new section on visiting SHA facilities.