Continuing Care

Continuing care facilities operate under an approach to designated support and visitation based on CMOH Order 16-2021.

Review the Alberta Health Visiting Policy and Fact Sheet for more information. Learn more about quarantine requirements for fully, partially and non-immunized individuals returning from outings or moving facilities.

Request scheduled visits with loved one(s) in continuing care sites operated by AHS, CapitalCare, Carewest and Covenant Health.

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.

Exceptions & Exemptions for Designated Support Access at Acute Care Sites

• 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
• Pediatric Inpatient: In consultation with the unit manager/charge nurse on a case-by-case basis, other support persons (e.g. disability support worker) may be permitted in addition to the two (2) designated support persons. Parents/guardians under quarantine/isolation for COVID-19 may be able to be present with their child.
• NEW - EFFECTIVE APRIL 8: Sibling visitation can be considered for long-stay pediatric patients in consultation with site leadership and IP&C. An adult must accompany children under the age of 14.
• Maternity: An additional designated support person may be considered by unit leadership or designate to meet the needs of some birthing circumstances (e.g., for infants born via surrogate and situations involving adoptive parents and guardians). In these cases, the infant may have a designated support person after birth.
  Maternity CMOH Exemption: a designated support person under quarantine/isolation may access in accordance with CMOH Exemption: Designated family & support person for obstetrical patients.
• Dependent Adults: Dependent adults can have one (1) designated support person. A person quarantined or isolated because of COVID-19 who has an adult-dependent may be eligible to accompany or visit the adult-dependent patient requiring medical care.
• 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. All persons considered to be end-of-life can have one (1) designated support person who can be present as much as the patient requests. Visitation at a patient’s end-of-life continues to be supported at all sites including for faith leaders, elders and traditional knowledge keepers. End-of-life is the only circumstance when visitors are allowed as requested by a patient or their decision maker. Please see below for details on end-of-life.
• UPDATED - 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 the guidance.
• UPDATED - Outdoor Visitation: Outdoor visitation is not encouraged at this time and will remain under review.

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

On May 13, the Chief Medical Officer of Health (CMOH) announced Order 22-2021 which clarifies mask exceptions for those with certain medical conditions.

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

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.

The attending physician, in consultation with the unit manager/charge nurse, determines if the patient's condition is considered end-of-life. End-of-life guidance applies to individuals in hospice, from the time of admission. The enhanced guidelines also recognize unique end-of-life considerations for Indigenous individuals.

The following applies to End-of-Life:

• End-of-life is the only circumstance when both a designated support person and visitors are allowed site access;
• All persons considered to be end-of-life can have one (1) designated support person who can be present as much as the patient requests;
• Additional visitors need to pre-book seeing the patient with the site/unit;
• Community-based religious/faith leaders, elders, elders’ helpers and traditional knowledge keepers can pre-book visitation with a patient;
• Scheduled time between visitors to avoid queueing;
• Visitors should leave the site as soon as their visit is complete;
• 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 end-of-life and 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 either federal and/or provincial 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.