Continuing Care| End-of-Life|Ambulatory – ED/UCC|Hospital (Inpatient)|What to Expect |Screening & Orientation

Last Updated: August 12, 2020

In response to the COVID-19 pandemic, Alberta Health Services (AHS) has had to make the difficult decision to limit the interactions between patients/residents, families and visitors in order to ensure their safety, as well as physicians and staff providing their care. These decisions have not been taken lightly, and we understand it has been difficult for all involved. We thank everyone for continuing to work together to support all of those in our care. Collaboration is vital to the health of all patients and residents.

Effective Tuesday, August 4, we have enhanced family support and visitation in acute care settings to include updated guidance around outdoor visits, visiting pets, gifts and patient personal belongings. We have also further clarified the difference between Designated Family/Support Person(s) and visitors.

View Family Support & Visitation Guidance - printable version (also available in most Translated Resources).

A Designated Family/Support Person is: Someone identified by the patient as an important support

Someone the patient wants involved in their care and health matters

A relative, legal guardian, close friend or formal/informal caregiver A Visitor is: Not involved in the patient/resident’s health care

Someone whose time with the patient is discretionary and usually temporary

Visiting for purposes that are more social in nature

Physical distancing must be maintained at all times unless Designated Family/Support Person(s) and visitors are living in the same household.

If it is not possible for the Designated Family/Support Person(s) to be physically present with a patient, AHS staff will provide support as needed for virtual connections through phone, video calls or chat apps.

For more information on how patients and their families can stay in contact virtually refer to: Using Technology to Stay Connected with your Loved Ones.

Thinking of Supporting or Visiting a Resident in Long Term Care, Supportive Living or Congregate Living?

As of July 23, continuing care facilities will operate under a new approach to family support and visitation based on the CMOH Order 29-2020. This Order will be followed by all licensed supportive living, long-term care and hospice facilities.

Residents of these sites are at extreme risk if exposed to COVID-19, therefore a safe visitation approach is required.

Indoor visits:

Each resident or alternate decision maker may designate up to two Designated Family/Support Persons (over the age of 18) who are essential to maintaining mental and physical health.

(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).

Outdoor visits:

Up to five individuals, including the resident, may participate in outdoor visits, if consistent with site policy and public health measures.

For more information please review CMOH Order 29-2020, Protecting Residents at Congregate Care Facilities and What to Expect, before your visit.

Book a visit using the Request a Visit tool.

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 at the end-of-life can have a Designated Family/Support Person with them as much as required . Their presence should be coordinated with the care team and reflect the needs of both the patient and their Designated Family/Support Person.

. Their presence should be coordinated with the care team and reflect the needs of both the patient and their Designated Family/Support Person. Other support persons/visitors may visit as long as the visits are pre-arranged with the site/unit.

Children under age 14 may visit if accompanied by an adult.

If the room is large enough for social/physical distancing to be maintained, up to three individuals may be permitted at the same time.

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.

For more information please review CMOH Order 29-2020 and Family Support & Visitation Guidance - printable version (also available in most Translated Resources).

Thinking of Supporting or Visiting a Patient in a Hospital?

All Ambulatory Clinics (including Emergency Department/Urgent Care)

Patients may identify one Designated Family/Support Person to accompany them while accessing ambulatory, emergency or urgent care services in AHS facilities.

to accompany them while accessing ambulatory, emergency or urgent care services in AHS facilities. There may be circumstances where physical distancing with other patients within clinic areas will not allow for the Designated Family/Support Person to be present. In this case, staff will communicate this to the patient and their family/support person, and discuss options based on patient need.

All support persons must be over the age of 14 for adult clinic visits. If visiting the Alberta Children’s Hospital or the Stollery Children’s Hospital, the Designated Family/Support Person must be 18 years of age or older.

All Inpatient Settings (Admission to Hospitals)

Patients may identify two Designated Family/Support Persons while admitted to an inpatient unit in an acute care facility. If the room is large enough for physical distancing to be maintained, both Designated Family/Support Persons may be permitted at the same time. If not, they must attend one at a time.

while admitted to an inpatient unit in an acute care facility. If the room is large enough for physical distancing to be maintained, both Designated Family/Support Persons may be permitted at the same time. If not, they must attend one at a time. All facilities will have a screener greet Designated Family/Support Persons to conduct the health screening and verify if the person is authorized to enter the site.

Visiting Pets in Acute Care

Effective August 4, one pet is permitted to accompany a Designated Family/Support Person or other visitor for outdoor visits, subject to health and safety precautions and the ability of the site to accommodate.

The pet must be in good health, have up-to-date immunizations and must not come from a household with high risk of exposure to COVID-19.

A disposable or washable barrier (e.g. a blanket or a bed sheet) should be provided by the animal handler and be placed between the patient and the animal (e.g. on the patient’s lap).

In extenuating circumstances, if a patient is unable to have an outdoor visit, a manager or supervisor may approve indoor visits with a pet on a case-by-case basis (e.g. end-of-life).

Gifts and Personal Patient Belongings

Designated Family/Support Person must check with the site/facility prior to bringing gifts and personal patient belongings to the site.

The site/facility may require that items be cleaned and disinfected. Please check with the site prior to drop off.

Outdoor Visits in Acute Care

Admitted inpatients may participate in outdoor visits with their Designated Family/Support Person(s) or others, where the site can support access to green spaces.

A maximum group size of three (3) people is permitted, including the patient.

A child under the age of 14 is permitted at an outdoor visit but must be accompanied by an adult.

No COVID-19 positive or COVID-19 suspected patients will be permitted to have an outdoor visit.

Patient Off-Site Passes

Off-site pass may be granted if they are required as part of a patient’s treatment plan. This includes patients with an Alternate Level of Care designation, patients in dedicated rehabilitation programs and Addiction and Mental Health patients.

If a pass is deemed an essential part of the patient’s treatment plan by their care team, weekend, overnight, and day passes must be ordered by a physician or designate.

The facility, home environment and any destinations the patient plans to attend while out on pass, must not be on outbreak.

Maternity/Postpartum

In consultation with the unit manager/charge nurse on a case-by-case basis, other support persons (e.g. surrogate parent or Doula) may be permitted in addition to the two Designated Family/Support Persons. Designated Support Persons on a maternity ward must be 14 years of age or older.

Special consideration may be given to a symptom free Designated Family/Support Person who is under quarantine or isolation. See Obstetrical Screening and Visitation Guidance for more information.

Pediatrics/NICU

Two individuals may be Designated Family/Support Persons.

A child age 14 years and older can visit an admitted patient in addition to one designated family/support person.

Children under 14 years of age are currently not permitted to visit. However, for compassionate reasons (such as at the end-of-life) and on a case by case basis, exceptions will be considered in consultation with the unit manager/charge nurse.

Breastfed infants are able to accompany their mother.

Parents/guardians under quarantine or isolation for COVID-19 may be permitted to visit. See Acute Care Guidance for Parents/Guardians Accompanying Children for more information.

See Acute Care Guidance for Parents/Guardians Accompanying Children for more information. Ambulatory areas remain restricted to patients being accompanied by one Designated Family/Support Person 18 years of age or older.

Adults with Disabilities

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 Designated Family/Support Persons.

A person quarantined or isolated because of COVID-19 who has an adult dependent requiring medical care may be permitted to accompany or visit the adult dependent. See Memo: Clarification: Exemption – Quarantined and isolated persons who have adult dependents that require medical care for more information.

End–of-Life Situations

Two Designated Family/Support Persons at a time can be present if the room is large enough for physical distancing to be maintained between individuals.

at a time can be present if the room is large enough for physical distancing to be maintained between individuals. The attending physician, in consultation with the unit manager/charge nurse, determines if the patient condition is considered end-of-life.

View Family Support & Visitation Guidance - printable version (also available in most Translated Resources).

What to Expect

To support and visit a patient or resident you must:

Understand the risk of exposure to COVID-19 for yourself and others, the risk tolerance at a site, as well as follow all required site policies and public health measures.

Ensure the patient/resident has identified you as a Designated Family Support Person, and wear Designated Family Support identification.

Be feeling well on the date/time of your visit

Be 14 years of age and older OR accompanied by an adult. For pediatrics (Alberta Children’s Hospital and the Stollery Children’s Hospital), children under the age of 14 are not allowed to visit. For continuing care, children under 18 years of age must be accompanied by an adult.

Complete health screening prior to entering the facility, including a temperature check for fever over 38 degrees Celsius and a questionnaire.

Sign in and out of all visits.

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/resident’s room.

Screening & Orientation

Facilities will have a screener greet each person to conduct the health screening and verify the Designated Family/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 Family/Support Persons including: