MEMORANDUM DATE :January 5, 2021
TO: All Staff, Volunteers, Board of Directors/Committee Members, Physicians, Visitors
FROM: Dr. Glenn Maddison, Medical Director
Larry Lafranier, Executive Director
Kelly Chartrand, Director of Residential Care
DATE: January 5, 2021
RE: VISITORS TO HOSPICE - Directive #1 for Health Care Providers and Health Care
Entities – Revised March 30, 2020, Issued under Section 77.7 of the Health Protection and Promotion Act (HPPA), R.S.O. 1990, c. H.7
As you are aware, the COVID-19 virus is on the rise in our community and we are taking necessary precautions. Your health and the wellbeing of your loved one is very important to us. Based on the directives from the Ministry of Health and Hospice Palliative Care Ontario, we are taking steps to protect our residents, visitors, and our health care team. Our Visitor Policy is reviewed frequently, responding to the evolving COVID-19 situation in the community. We are seeking your cooperation in managing the risk of the spread of COVID-19. Here’s how you can help:
- Effective immediately, we must limit designated visitors to only one (1) per resident. The designated visitor remains the same for the duration of the resident’s stay. As the resident approaches end-of- life (days to hours to live), we will make provisions for one additional designated visitor, named at admission, per resident.
- We are asking that designated visitors limit their visits to two (2) per day to minimize the risk.
- We ask that all visitors and staff practice social distancing when visiting Hospice (keeping a distance of two (2) meters from others and avoiding non-essential outings), wearing a mask when interacting with individuals outside your immediate household and frequent hand washing.
- All visitors will be screened at each visit.
- If you are experiencing any respiratory symptoms such as a cough, difficulty breathing, sore throat or fever, you must notify us immediately and stay at home.
- Please encourage family members and friends who are not able to visit to stay in touch by phone or video calls. Hospice staff are available to assist with video calls.
- We will no longer be able to offer treats, coffee or tea to our visitors in our Great Room or Kitchen area. We ask that you bring your own, if needed, in sealed containers, that can be left in the resident’s room.
- We ask that you refrain from accessing our Great Room area and other common areas.
This is an unprecedented time that calls us to act in a way that is outside of our typical Hospice philosophy of care. We recognize this is a difficult time for you and your circle of support and it is with great compassion that we extend our sincere gratitude for your understanding and cooperation at this time. The above is subject to change, as per directed by legislation.
TO: All Staff, Volunteers, Board of Directors/Committee Members, Physicians
FROM: Larry Lafranier, Executive Director
DATE: December 23, 2020
RE: COVID-19 Update
Due to the province-wide shutdown effective December 26, 2020 at 12:01 a.m. and Public Health Directive O. Reg. 82/20, as of Thursday, December 24, 2020 at 4:30 pm, the Resource Centre will be closed to the public.
- There will be no volunteers in a supporting capacity in the Resource Centre and the Residence.
- Resource Staff will be deployed on a rota basis in support of those areas where volunteers provide support, i.e. Reception, Kitchen, as required.
- Even though the Resource Centre is closed to the public, all operations remain business as usual with the exception of onsite Supportive Services who will provide virtual support.
- The current visitor policy for the Residence will remain in effect.
If you have any questions, please contact me.
Resident Visitor’s Guidelines
As of August 24, 2020
Visitor guidelines are provided to ensure the safety and health of all staff, residents and visitors also to address the needs related to COVID-19 by minimizing physical contact and exposure for all individuals working in, visiting, or making deliveries to the Hospice Residence. These guidelines will be assessed on a case-by-case basis during the resident’s stay, ensuring the vision of supporting the whole person with respect, compassion, and empathy are considered in all decisions.
Upon admission, the resident and/or Substitute Decision Maker (SDM) must identify up to no more than five (5) designated visitors.
- A Designated Visitor is an individual who has played a significant role in the resident’s life, may include immediate family, significant others, close friends or colleagues, and is identified by the resident and/or their Substitute Decision Maker (SDM) as such.
- The name(s) of the individual(s) will be added to the Visitor Attendance Log for those attending the Reception Desk who will be able to identify authorized designated visitors. Each designated visitor must sign a waiver stating they understand the Resident Visitor’s Guide that has been communicated at the time of admission.
- Designated visitors are to supply their own mask (cloth or surgical); if not, a cloth mask will be provided for them, subject to availability.
- Waiver – see the attached Visitor Waiver to be signed by designated visitors stating the understanding of the Resident Visitor’s Guidelines that were communicated to them at the time of admission.
- We will not “switch out” individuals on the visitor list - the five (5) individuals originally identified will remain on the designated visitor list for the duration of the resident’s stay.
- Three (3) of the designated visitors are allowed in a resident’s room at one time. If the resident is actively dying (24-48 hours), this compliment of three (3) may be increased up to five (5) designated visitors, unless the resident becomes COVID-19 positive, in which case only one (1) designated visitor will be allowed with full PPE as required.
- Designated visitors are to only visit the resident who has named them as “Designated” and avoid visiting other residents and common areas. Designated visitors may be asked to leave the resident’s suite during care. In that case, designated visitors can either wait in the hall or in the Great Room until care is complete.
- If a designated visitor should come into contact with someone who has tested positive with COVID-19 or are experiencing symptoms, they are asked to report this immediately to the Executive Director or designate, and refrain from entering the Hospice Residence.
- If a resident is a primary care giver of a designated visitor who is under the age of 16, special allowances for visitation will be permitted and will be coordinated through the Executive Director, in collaboration with the Physician and Clinical Care Team.
- Visiting hours for designated visitors are 24/7.
- Designated visitors may have overnight stays.
- Outdoor garden area visits for residents are restricted to only the five (5) designated visitors identified upon the resident’s admission. At all times during outdoor garden area visits masks must be worn and social distance guidelines must be adhered to.
Any person who is outside of the five (5) designated visitors, as determined by the resident or SDM, will be deemed a non-designated visitor. Non-designated visitor(s) will be allowed window visits between 8:00 am and 1:00 pm. Upon arrival, non-designated visitor(s) must check in with Reception/Care Team to determine if the resident is able to have a window visit at that time. When non-designated visitor(s) window visits are permitted, visits are limited to 30 minutes. Four (4) visitors at a time are permitted, and visitors will provide their own mask(s), to be worn at all times. Children under 16 will be allowed to have a window visit provided they are accompanied by an adult and wear a face covering.
NOTE: Window visits are not allowed at the same time as a scheduled garden area visit with the resident and garden area visits take precedence over window visits.
Admission Protocols, Visitor Access and PPE Requirements
- Admission - All residents admitted to the Hospice Residence must be determined negative for COVID-19 upon admission. In the event a negative test result has not been determined upon admission, the resident will be swabbed and placed on Droplet and Contact Precautions until a negative COVID-19 test result has been received.
- Awaiting COVID19 Test Result - Only one (1) designated visitor will be permitted in the Hospice Residence (resident’s room) while awaiting a COVID-19 test result. The one (1) designated visitor will be required to wear full PPE including surgical mask, gloves, gown, and shield/goggles for visits conducted, provided by Hospice, until such time as a negative result is received. If it is determined that a resident is actively dying (within 24-48 hours) without test results available, the resident will be allowed three (3) designated visitors who will be required to wear full PPE (gown, gloves, procedure mask with eye protection and be asked to practice hand hygiene), provided by Hospice.
- Negative COVID-19 Test Result Confirmed - Once a negative COVID-19 test result has been received for the resident and they remain asymptomatic, an additional four (4) designated visitors will be allowed in the Hospice Residence (resident’s room), three (3) at a time who must be within the same ‘bubble’ or household. Designated visitors outside that household or “bubble” must visit at alternate times. After a negative COVID-19 swab test is received, all designated visitors of residents will continue to wear a mask for the remainder of the visits conducted. If circumstances warrant, due to extenuating circumstances, alternate visitation guidelines will be coordinated by the Executive Director in collaboration with the Physician and Clinical Care Team.
- If a Resident becomes COVID-19 Positive – NO visitors will be allowed unless it is determined the resident is actively dying (within 24-48 hours), at which time the resident will be allowed one (1) designated visitor. This determination will be made in collaboration with the Executive Director, Physician, and Clinical Care Team. The one (1) designated visitor will be required to wear full PPE (gown, gloves, procedure mask with eye protection), provided by Hospice.
- ALL individuals who need to enter the Hospice Residence will be screened – there are no exceptions. This includes all staff and volunteers working or conducting business at the Hospice Residence, visitors, priests/clergy, persons making deliveries, and persons arriving from funeral homes.
- ALL visitors arriving at the Hospice Residence will go to the Residence entrance and initially be screened over the intercom. If they pass the initial screening questions, they will be allowed to enter the building, have their temperature taken, and be asked to sanitize their hands.
- Visitors will be reminded that masks must always remain in place in common areas, outdoors and in the resident rooms. Visitors must enter and leave through the front doors. No other exits are to be used when leaving the building.
NOTE: Visitor guidelines are subject to change due to any directives/guidelines received from the Ministry of Health and/or Public Health.