Continuing Care

Effective July 13, Alberta is moving to ease remaining restrictions for continuing care facilities.

Review the Alberta Health Visiting Policy for more information.

Designated Support Person & Visitor

A designated support person:

• Is a consistent individual identified by the patient as a needed support;
• Is someone the patient wants involved in their care and health matters;
• Is 14 years of age or older;
• Can be a family member, close friend, or an informal/hired caregiver;
• Should be included as much as the patient/alternate decision-maker requests for palliative and end-of-life care, critical care, life-threatening diagnosis disclosure or as requested by the care team;
• Cannot be on isolation or quarantine for suspected or confirmed COVID-19 unless meeting the criteria of an exemption (see below); and
• Can support a patient with suspected/confirmed COVID-19 but must pre-book access with the service area and their visitation be approved by and under the direction of IP&C.
• A patient may identify a replacement designated support person if the original individual cannot perform their role due to quarantine, isolation, caregiver fatigue, etc.

A visitor is anyone not identified as a designated support person, and access is currently limited to:

• Individuals that have received government approved compassionate exemptions;
• Spiritual/faith/religious leaders, elders, traditional knowledge keepers or legal supports requested by the patient/alternate decision-maker at the end of life; and
• Those with a scheduled visit to see a patient at the end-of-life.

Considerations, Variation and Chief Medical Officer of Health Exemptions

• Pediatric Ambulatory: On a case-by-case basis, exceptions for having two (2) designated support persons may be considered by the clinic (in consultation with the site leadership) for circumstances where they are required, and where physical distancing requirements can be maintained. Examples could include but are not limited to:
  • End-of-life or goals of care discussions;
  • Significant diagnosis/change in medical status leading to poor prognosis and patient implications;
  • Behavioural challenges requiring two caregivers;
  • Medical or equipment needs requiring two caregivers; or
  • Involvement of Children’s Services; or
  • Other situations where requested by the care team
• Pediatric Inpatient: On a case-by-case basis, and in consultation by the service area with site leadership:
  • An additional support person (e.g., disability support worker) may be permitted in addition to the two (2) designated support persons; and
  • Sibling visitation can be considered for long-stay pediatric patients with approval from site leadership and in consultation with IP&C. An adult must accompany children under the age of 14.
• CMOH Exemption – quarantined or isolated persons who have minor children requiring medical care: A quarantined or isolated person required to arrange or provide for the healthcare needs of a minor child needing medical care that can only be provided in a doctor’s office, hospital, or other medical facility and it is not possible that another parent or legal guardian not subject to isolation/quarantine can accompany the minor for medical care if complying with the requirements outlined in the Exemption: quarantined and isolated persons who have minor children that require medical care (alberta.ca).
• CMOH Exemption - designated support person for obstetrical patients who are under quarantine/isolation: A quarantined or isolated designated support person of an obstetrical patient with a confirmed case of COVID-19 may accompany the patient to a medical facility for the purposes of the obstetrical patient receiving needed medical care and provided that they comply with the requirements outlined in the Exemption - Designated family and support person for obstetrical patients - June 10, 2020 (alberta.ca).
• CMOH Exemption - quarantined and isolated persons who have adult dependents that require medical care: A quarantined or isolated person required to arrange or provide for the healthcare needs of another person 18 years or older (dependent adult), and the dependent adult requires medical care that can only be provided in a doctor’s office, hospital, or other medical facility and it is not possible that another person can accompany the dependent adult; that person is exempt from the provision of the CMOH quarantine/isolation order to take dependent adults for scheduled medical care or for admission to hospital or other medical facility to the extent necessary to allow the dependent adult to receive scheduled medical care if complying with the requirements outlined in the Exemption: quarantined and isolated persons who have adult dependents that require medical care - Open Government (alberta.ca).
• Patient Passes: Patients with an Alternate Level of Care designation, those in dedicated rehabilitation programs and Addiction and Mental Health patients may require an off-site pass.
• The pass is deemed an essential part of the patient’s treatment plan by the care team and must be ordered by a physician or designate. Please discuss with the patient’s care team regarding pass requirements.
• Indigenous Wellness: AHS acknowledges the significance and importance of traditional Indigenous practices and protocols and promotes the involvement of AHS cultural helpers, traditional wellness counsellors, Indigenous Health and Hospital Liaisons or designated Community Health representatives where possible and per this guidance.
• Outdoor Visitation: Outdoor visitation is not encouraged at this time but will remain under review.
• Patient Belongings: Patients can have necessary belongings brought to them (e.g. electronic devices, charging cables, toiletries, supportive footwear, and clean clothing in a cleanable container). Items must be cleaned or disinfected as appropriate, prior to being brought in by the patient’s designated support person and again at the service area before being given to the patient. Please refer to the Tip Sheet for Acute Care Patients and Designated Family/Supports during COVID-19 for Pandemic guidance.

This guidance will be adapted as the circumstances of COVID-19 change. Patients or family questions/concerns should be directed to the patient’s care team or Patient Relations at 1-855-550-2555.

View Designated Support Person & Visitor Access Guidance - printable version (also available in most Translated Resources).

Know Your Risk / Know Your Role

We are encouraging staff, patients and designated support persons to work together to reduce the amount of time spent in AHS sites by considering what support needs to be provided in person and what can be provided virtually.

Designated support persons should assess their risk of exposure and transmission of COVID-19 before they enter an AHS site. To support this, we have created two brochures: Know Your Risk and Know Your Role.

Masking at AHS facilities

Our goal at AHS is to work with patients and designated support persons to accommodate their needs while ensuring that everyone is protected.

To ensure the safety of all staff, physicians, patients and families, masking will continue to be required in all AHS and Covenant facilities, provincewide. This masking mandate will be in place at all acute care, continuing care, and community sites – including COVID-19 testing sites, immunization clinics and labs.

This Directive will continue to be applicable to all staff, physicians, volunteers, designated support persons, and visitors.

Please be aware Albertans entering AHS facilities, who have an authorized mask exception, may be provided with safety precautions such an alternate to a mask, instructions on movement while in the facility, practice physical distancing as well as frequent hand hygiene.

Please let our staff know if you are experiencing symptoms of COVID-19 so they can provide you with the care you need.

End-of-Life

While it is difficult to be precise around when a patient is at end-of-life, this generally refers to the last four to six weeks of life.

Supporting patients at end-of-life:

• End-of-life is the only circumstance when designated support persons and visitors are to be accommodated by all clinical areas;
• All persons considered to be at end-of-life can have two (2) designated support persons who can be on site as much as the patient requests;
• Visitors need to pre-book seeing the patient with the site/unit;
• Schedule time between visitors to avoid queueing;
• Advise visitors before they come of site access requirements;
• Visitors should leave the site as soon as their visit is complete;
• Community spiritual/religious care providers, Indigenous elders and traditional knowledge keepers can schedule time to visit, or to perform end of life ceremonies, rituals and rites as requested by the patient;
• The maximum number of designated support persons and visitors with the patient at one time is three (3), space permitting;
• Physical distancing is required unless designated support persons and visitors are from the same household;
• Children under the age of 14 may visit if accompanied by an adult; and
• There are Federal and Provincial Compassionate Exemptions from quarantine for the purposes of visiting a patient at the end-of-life and/or during critical illness.

For more information please review Family Support & Visitation Guidance - printable version (also available in most Translated Resources).

Compassionate Exemptions from Quarantine

Alberta Health and AHS have established a process for persons seeking exemption from quarantine to visit a patient who is receiving critical care for a life-threatening illness or imminent end-of-life care at an AHS, Covenant or continuing care facility or in a home setting.

To request a visit with a loved one in one of these settings, follow these steps.

What to Expect as a Designated Support Person

To support and visit a patient you must:

• Know your risk of exposure and transmission of COVID-19 and your role as a support person or visitor before you enter an AHS site.
• Ensure the patient has identified you as a designated support person, and wear designated support identification.
• Be feeling well on the date/time of your visit.
• Follow all required site policies and public health measures.
• Complete health screening prior to entering the facility.
• Continuously wear a mask that covers the nose and mouth.
• Remain in the patient’s room as much as possible and minimize movement within the facility.
• Perform hand hygiene (hand washing and/or use of hand sanitizer) when entering and leaving the facility and when entering and leaving the patient’s room.

Screening & Orientation for Designated Support Persons & Visitors

Facilities will have a screener greet each person to conduct the health screening and verify the designated support person is authorized to attend as per the above. AHS units and teams will be responsible for providing an orientation to patients and their designated support persons including:

• Communicating the risks, requirements and responsibilities of being in the service area.
• Providing appropriate Personal Protective Equipment (PPE) to designated support person(s) and/or visitors and instructions on how to use PPE, hand hygiene and other infection prevention and control precautions for the service area.
• View Screening Questionnaires: Daily Designated Support Person & Visitor Screening Questionnaire For Acute Care, Ambulatory, Emergency & Urgent Care

Virtual Visitation

We are encouraging virtual visitation at all healthcare facilities.

If it is not possible to have an in-person visit, staff will communicate this to the patient and their designated support person, and discuss options based on need. Staff will do their best to support virtual visits by phone, video calls or chat apps. For more information on staying connected virtually, refer to our virtual visitation tools and resources.