The Saskatchewan Health Authority has released new visitor guidelines to balance the need to protect patients and staff from the ongoing threat of COVID-19 with the need to have support, including visits with family members.
The new guidelines were announced on June 3 and come into effect immediately, though officials estimate it will take about a week to ensure they’re rolled out properly across Saskatchewan.
“Our initial (COVID-19) response required a fairly narrow definition of compassionate grounds for visitation,” explained SHA CEO Scott Livingstone.
“Given the devastation that has occurred in other provinces in outbreaks in health facilities, in particular long-term care homes, this was a necessary step.”
Now though, the province has recognized the need to find a balance between physical safety, mental health and wellbeing.
‘We know that illness and age can make time an especially precious commodity for many in our care,” Livingstone said.
In long-term care, quality of life will be used in addition to care needs to determine if residents’ needs can’t be met without the support of a designated family member or support person. Two family members or support people can be designated, with one present at a time.
All critical care and intensive care patients are also now included in the compassionate care definition, which was previously limited to those at high risk for loss of life. Family presence for palliative care has been expanded to allow two family members or support people to be present at the same time.
The guidelines have also been adjusted to ensure that one family member or support person can be present for inpatient, outpatient, emergency or urgent care patients who have challenges resulting in difficulties understanding, making decisions or mobility difficulties due to a disability or onset of a medical condition. That includes mobility, hearing, speech, intellectual or mental health disabilities and visual or memory impairments.
New guidelines have also been created to support outdoor visits with the visits not limited to one person at a time.
All family members or support people will be provided with a medical-grade mask to wear inside facilities and will undergo screening, including temperature checks.
“We have heard from many people of the hardships that had been created with the absolute lockdowns of long-term care facilities and ICUs where we have vulnerable patients,” Livingstone said.
‘We know we have to start opening up because that is not sustainable. We have to do that safely and in a way where we’re monitoring it very, very carefully.”
Officials said concerns were raised across the system, but specifically with regards to patients with dementia or other neurological disorders such as Alzheimer’s who depend on family members and need them by their side to ensure appropriate quality of life and care.
‘The vast majority of concerns I’ve been receiving are related to those individuals with neurological disorders … where we know major changes to their care have substantive impacts to their day-to-day quality of life,” Livingstone said.
“We have husbands and wives attending facilities daily to support their spouse or loved ones with day-to-day activities. That’s by far the single biggest concern — the worry about people regressing in their care because they’re not having the regular visits from a loved one that was so essential.”
SHA chief medical health officer Dr. Susan Shaw said the province’s expert panel heard family members were concerned about the lost time and connection with their loved ones.
“I think we all share sadness because of that and recognize that’s true,” she said.
The concerns came from conversations held with family members and both patient and family advisory teams across the province. They were assessed by an expert panel made up of patient and family advisors, public health and infection prevention and control experts.
“It’s finding that balance through working within the public health measures and orders that still are in place to ensure safety while also recognizing that health is much more than physical health,” SHA chief medical health officer Dr. Susan Shaw said.
“It’s emotional, spiritual and mental health as well. Quality of life is important to all of us, and perhaps more so for those who are living in care homes.”
Livingstone said that if the SHA saw a major outbreak in a region or in a care home it would back off, identify where they occurred and immediately begin aggressive contact tracing and isolation measures to limit spread.
The new criteria, he added, is already in place.
“The criteria can be used immediately. What we’re working towards is how de make it consistent across the province through all of our facilities and ensuring that everyone is aware,” he said.
“What we’re allowing is more patient and family loved ones coming to visit under criteria that would protect themselves and the staff.”
An overview of the new guidelines
Family members/support people are welcome for compassionate reasons only which may include:
End of life care
Patients with specific challenges
Maternal, postpartum and pediatric units
Long term care residents who require the assistance of a family member or support person.
Need to be scheduled in advance
Physical distancing guidelines need to be followed — so no handing items through the fence or giving a loved one a quick hug
Each long term care home in the province has a different physical set up. Each home will need to work with its current space to set up an area that can accommodate safe outdoor visiting
If you are experiencing any symptoms you will not be able to visit
Outdoor visits can include more than one visitor at a time, provided physical distancing can be maintained. Family members for the same household do not have to physically distant from each other. The family members can be in addition to the designated family members/support persons
End of life Care
Includes palliative care, hospice care or those who are at high risk for loss of life. One designated family member or support person can be present. That designated person must remain the same for the entire length of the patient’s admission
An additional person can join the designated support person if physical distancing can be maintained. The additional person can alternate between various family members or loved ones
Children are welcomed when accompanied by the designated family member or support person
One designated person can be present. They must remain the same for the entire length of the patient’s stay
An additional person can join if physical distancing can be maintained between themselves and the care providers. The person can alternate
Children are welcome when accompanied by the designated support person.
One designated support person can be present at a time for major surgery such as cardiac surgery, cancer surgeries and any surgery that requires critical care.
All patients with specific challenges
One family member or support person can be designated for patients who have specific challenges such as mobility, hearing, speech, intellectual or mental health disabilities or visual or memory impairments.
The support person must be the same for the entire length of stay. You should plan not to leave the hospital.
In some areas, you will be required to stay within the patient’s room.
You are not permitted to wait in family rooms or other common areas
For maternal, postpartum and pediatric intensive care units, one family member or support person can be designated.
For neonatal intensive care and pediatric units, two family members or support people can be designated for the entire length of stay
Virtual visiting is still encouraged