Welcoming Caregivers to Ontario’s Long-Term Care Homes

The Ontario government is updating the visitor policy for long-term care homes, to help operators implement consistent visiting practices across the province. The policy is clarifying guidance about visits from caregivers, to help all homes welcome caregivers, as of September 9th, 2020. Since March, ‘essential visitors’ to long-term care homes have included individuals performing essential support services or those visiting a very ill or palliative resident. Under this umbrella, ‘caregivers’ are essential visitors and important partners in care, who provide direct care to residents, such as helping with feeding, mobility, hygiene, or cognitive stimulation. They can be family members or friends, privately hired caregivers, paid companions and/or translators. Operators have been encouraged to facilitate visits by caregivers, however, implementation has been inconsistent. The updated policy provides clarity; caregivers are allowed to visit homes at any time, including during an outbreak, subject to direction from the local public health unit. This will support better implementation across homes. The updated visitor policy outlines things this way: Each resident and/or their substitute decision maker may designate a maximum of two caregivers. Caregivers can visit, without time limits. If a home is not in outbreak, and the resident is not self-isolating or symptomatic, caregivers can visit together. If a home is in outbreak, or the resident is self-isolating or symptomatic, caregivers must visit one at a time, to limit risk of transmission, and follow direction from the local public health unit. “Bringing comfort and care, caregivers make a vital contribution to the overall well-being of long-term care residents,” said Dr. Merrilee Fullerton, Minister of Long-Term Care. “Today’s announcement will ensure that guidelines on their visits are applied consistently across homes so all residents get the support they deserve.” All visitors should pass active screening before entering a home. This includes a temperature check, questions on symptoms and exposures to COVID-19. All support workers, 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. Where a support worker requires immediate access to the home in an emergency situation, the home does not need to ask for a verbal attestation for a negative COVID-19 test result. 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 of having, or confirmed to have COVID-19. For general visitors, the scheduling of visits will continue to be up to individual homes’ discretion, as long as residents are assured at least one visit, with a maximum of two general visitors per week, lasting a minimum of 30 minutes. Homes are encouraged to make these visits longer, if possible. Visits begin when residents and visitors are seated in the visiting area, and staff are expected to respect resident privacy. Direction on safety in long-term care homes will continue to be updated as Ontario’s experience with COVID-19 grows. The government will continue to make every effort to support the safety and emotional well-being of residents and the staff who care for them.