The Saskatchewan Health Authority (SHA) is easing some visitor restrictions at its facilities put in place early in the coronavirus pandemic.
Health officials said the authority is expanding its criteria for compassionate reasons based on recommendations of its family presence expert panel.
Among the inclusions to compassionate care, to come into effect immediately and with full implementation within a week, are:
- Using quality-of-life considerations for residents at long-term care facilities
- Including all critical care and intensive care patients in the compassionate care definition
- Ensuring that there can be one family member or support person for inpatient, outpatient, emergency/urgent care patients who have specific challenges resulting in compromised comprehension, decision-making or mobility due to disability or onset of a medical condition
“Compassionate care means different things to different people, so we worked hard together to review this and come up with adjustments that still ensure we are protected when living or coming into these facilities,” said Heather Thiessen, a patient and family adviser on the panel.
“Like so many others, I need my partner there with me if I require emergency care. Otherwise, I am in danger of not understanding or being able to communicate what is happening to me to my care providers.”
The SHA said decision tools have been created for care teams to assist with knowing when a patient or long-term care resident can have a family member or support person with them in person.
Officials said this includes ensuring clear guidelines for designated family members or support people to follow such as screening, hand hygiene and limited movement within a site.
Individuals will also have to review a SHA family presence commitment document, created by the family expert panel.
“We needed to tightly control who was coming into our facilities given the potential consequences for our long-term care residents and our patients. That hasn’t changed,” said SHA CEO Scott Livingstone.
“But we have also learned that we need find the right balance between physical safety and mental health and well-being. We have heard that clearly from our residents, patients and families. So, together, we are trying to find the right path forward in the weeks and months ahead.”
Under the policy, patients or residents can determine whom they would like to designate as their family member/support person.
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Health officials said this can be a loved one, friend, religious/spiritual care provider, paid caregiver or other support person of the patient/resident’s choosing.
Livingstone said strict protocols, listed below, will be in place to support physical safety and the well-being of residents and patients.
Long-term care homes
Two healthy individuals can now be designated to help a resident whose quality-of-life or care needs cannot be met by staff, with one person present at a time, health officials said.
Visiting arrangement should be made in advance and everyone entering a facility will be screened, including a temperature check and completing a questionnaire.
They will also be required to wear a medical-grade mask unless it is a barrier to communication. In those cases, physical distancing of two metres must be maintained.
The exception is outdoor visits. The SHA said those can include more than one person provided physical distancing is maintained. Family members from the same household do not have to follow this protocol.
The SHA is also relaxing restrictions on bringing personal items, gifts and food to long-term care homes, under the following criteria:
- All items must be individually packed in a container that can be wiped down with disinfectant wipes
- Only food from licensed food establishments is allowed to be brought into a facility
Delivery of flowers from a florist or dry paper (i.e., letters, photos, artwork) is permitted in long-term care homes and acute care sites.
Floral arrangements may not be permitted in some settings due to pollen or plant allergens, and officials said staff should be consulted beforehand.
Inpatients, outpatients and urgent care patients
One family member or support person can be designated for inpatient, outpatient and emergency/urgent care patients who have specific challenges resulting in compromised comprehension, decision-making or mobility due to disability or onset of a medical condition.
Health officials said those can include hearing, speech, communication barriers, intellectual or mental health disabilities, and visual or memory impairment.
The attending physician or unit manager/charge nurse, in consultation with the designated family member/support person, will make the determination.
For patients undergoing major surgery, one family member or support person can be present at the discretion of the patient’s care provider.
It also applies to patients who are in intensive or critical care, although officials said it must be the same person throughout the patient’s stay.
However, one additional family member or support person, including children, are allowed for patients in intensive or critical care provided physical distancing can be maintained between family members and health-care providers. Officials said in this instance, the additional person can be alternated.
End-of-life care
The SHA said one designated family member/support person can be present for patients who are at a high risk for loss of life.
The designated family member/support person must remain the same for the entire length of the patient’s admission to hospital, palliative care or hospice care.
An additional person can join the designated family member/support person if physical distancing can be maintained between the family members/support persons and health-care providers, and can alternate between family members and loved ones.
Officials said children are welcome if they are accompanied by the designated family member or support person.
Maternal services
The SHA said detailed plans have been implemented at maternal services units to reduce the spread of the novel coronavirus and lessen the risk of infection.
For maternal, postpartum and pediatric intensive care units, one family member or support person can be designated for the entire length of a patient’s admission.
Two family members or support people can be designated for the entire length of patient’s admission to a neonatal intensive care or pediatric unit.
Health officials said the designated person(s) must remain the same throughout the patient’s stay in hospital, and they should plan not to leave the hospital.
They said approval is required in advance to bring in personal items along with food and beverages.
Designated people will not be allowed to wait in family rooms or other common areas, and officials said in some areas, they will be required to stay in the patient’s room.
Questions about COVID-19? Here are some things you need to know:
Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.
To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out. In situations where you can’t keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.
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