Designated Support vs. Visitor|Exceptions & Exemptions|Know Your Risk / Know Your Role|Continuing Care|End-of-Life| Compassionate Exemptions|What to Expect|Screening & Orientation|Virtual Visitation
Last Updated: April 8, 2021
Due to case rates of COVID-19, community transmission and emerging COVID-19 Variants of Concern, Alberta Health Services (AHS) has made the difficult decision to limit access for designated support persons and visitors at our sites. Patients, residents, family and friends are encouraged to maintain contact virtually. In-person access for the purposes of supporting patients and visitation is limited to the following:
- Critical care, pediatrics and NICU - up to two (2) designated support persons.
- End-of-life - one (1) designated support person at all times in addition to scheduled visitation by other family and visitors.
- All other inpatient areas, including maternity - one (1) designated support person.
- Ambulatory, emergency and urgent care - one (1) designated support person. Patients should maintain the same designated support person for any reoccurring ambulatory appointments.
- Continuing Care - Continuing care facilities operate under an approach to family/designated support and visitation based on CMOH Order 29-2020. See below for details.
Due to the increase in COVID-19 Variants of Concern cases, a confirmed outbreak at a site may require additional access restrictions for designated support persons and visitors. Please contact the service area for the most current access requirements before coming to the site.
Immunized individuals are still required to follow all public health measures, including physical distancing, masking, isolation and quarantine requirements, as well as complete COVID-19 screening before entering a site.
Designated Support Persons & Visitors
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 Facilities
- 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/resident 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/resident 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/residents, 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.
Thinking of Supporting or Visiting a Resident in Long Term Care, Supportive Living or Congregate Living?
Continuing care facilities operate under an approach to family/designated support support and visitation based on CMOH Order 29-2020. All licensed supportive living, long-term care and hospice facilities will follow this Order.
Residents of these sites are at extreme risk if exposed to COVID-19, therefore a safe visitation approach is required.
- Each resident or alternate decision maker may designate up to two (2) designated support persons (over the age of 18) who are essential to maintaining mental and physical health.
- Additional visitors may be given access in specific situations including end-of-life, change in health status or other pressing circumstances (e.g. financial or legal matters, family crisis).
- As announced by Alberta Health on Jan. 20, facility operators may use outdoor designated spaces onsite for outdoor visits with a maximum of five people, including the resident.
- If residents are able to go off-site, they can participate in an outdoor social gathering with up to nine other people.
- In doing so, residents may be asked to use additional safety precautions upon their return.
- Physical distancing must be followed and additional precautions such as wearing a mask at all times during the outing are recommended to protect the resident who is more vulnerable to COVID-19.
- All visits must be pre-arranged. Please contact facility staff in advance to discuss the best option to safely visit your loved one.
- Use the Request a Visit tool to schedule a visit at a participating site. View the Scheduling a visit with your Loved One(s) in Continuing Care Sites infographic for help on booking a visit.
For more information please review CMOH Order 29-2020, Protecting Residents at Congregate Care Facilities and What to Expect, before your visit.
While it is difficult to be precise around when a patient/resident 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/resident 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 CMOH Order 29-2020 and 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 or resident 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 or resident 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/resident 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/resident’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/resident’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: Acute Care & Continuing Care
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/resident 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.