Table 1.
Recommended Nursing Home Visitor Policy and Access for “Family Caregivers”
| Domain | Recommended Policy |
|---|---|
| 1. Defining an “family caregiver” | • Residents, substitute decision makers and their families must retain the authority and autonomy to determine who is essential to support them in their care and designate their own family caregivers.4 |
| • Governments, public health authorities and homes must not define who is a family caregiver, especially on the basis of either an individual’s caregiving involvement and role prior to the pandemic or by identifying those individuals providing services that would otherwise require a private duty caregiver. | |
| 2. Allowable number of designated family caregivers | • A resident may designate at least two family caregivers. • Similar to guidance from Alberta Health Services, a resident may identify a temporary replacement family caregiver if the primary designated family caregivers are unable to perform their roles for a period of time; the intent is not for designates to change regularly or multiple times but to enable a replacement, when required.36 |
| 3. Allowable number of family caregivers in the nursing home at one time | • One family caregiver per resident should be allowed in the home at a time. • Under extenuating circumstances (i.e., end-of-life), this allowable number should be flexible. |
| 4. Allowable locations within the nursing home | • As essential partners in care, family caregivers should have access to areas both outside and inside the home (similar to staff members) but must maintain physical distancing from other residents and staff. They should be provided with an individualized caregiver identification and/or badge, and must abide by all IPAC and PPE requirements and procedures concerning staff members of the home.17,18 |
| 5. Allowable access during a COVID-19 outbreak | • In order to promote relational continuity and meet the ongoing needs of residents, family caregivers should still have access to the home during a COVID-19 outbreak, as long as the following conditions are met: |
| - The family caregiver attests that they understand and appreciate they are entering a home under outbreak and that they may be at increased risk of COVID-19 infection | |
| - They must be trained in IPAC procedures and the proper use of PPE and abide by all outbreak-related policies that apply to staff members of the home. | |
| 6. Allowable frequency and length of time for family caregiver presence | • No restrictions as long as it does not negatively impact the care of other residents or the ability of other family caregivers to provide care and support. |
| 7. Screening and testing requirements | • As partners in care, family caregivers should be subjected to the same COVID-19 screening requirements as nursing home staff. If asymptomatic COVID-19 testing is recommended, family caregivers should be provided with the same access to testing as staff members of the home. |
| 8. IPAC and PPE requirements | • As partners in care, family caregivers should receive an orientation and be educated and trained to follow the same IPAC and PPE requirements and procedures as staff members of the home, including remaining masked at all times.3 The Ottawa Hospital has designed a PPE training video specifically for family caregivers: www.youtube.com/watch?v=GkAYc5wcn0c&feature=youtu.be |
| • Homes must maintain ample PPE supply to enable family caregivers’ participation in care. | |
| • Failure of family caregivers to comply with these procedures could be grounds for loss of their rights to participate in care as family caregivers, which should be appealable. |