NIA Releases 10 Recommendations to Support the Safe Reopening of Long-Term Care Homes
As first and second dose COVID-19 vaccinations rates in Canada continue to rise, it is time for long-term care (LTC) homes to safely loosen restrictions and improve the health, well-being, and quality of life of LTC residents and their loved ones.
With 96.7% of LTC residents, and between 62%– 91% of LTC staff, being partially or fully immunized against COVID-19 by mid-April, 2021, it has become both safe and essential to begin reopening Canada’s LTC homes. Given that significant restrictions have been in place in LTC homes across the country since March 2020, many have come to realize the negative impacts of social isolation. This includes what has been described as ‘confinement syndrome,’ which has also likely been devastating in these settings. As vaccination coverage in the general population continues to rise, restrictions on visitors should also be reassessed.
To support LTC homes to reduce restrictions and return greater balance to residents’ lives, the NIA recently released a new guidance document — After the Shot: Guidance Supporting the Re-opening of Canada’s LTC Homes Following COVID-19 Vaccination — to help more quickly guide the safe reopening of Canadian LTC homes while ensuring a safe environment for residents, staff, essential caregivers and visitors is maintained. In this report, the NIA identifies 10 recommendations designed to improve the health and well-being of residents while balancing the ongoing risks posed by the pandemic.
The NIA’s 10 Recommendations to Support the Safe Re-Opening of Canada’s LTC Homes:
1. Resuming Visits with General Visitors: Residents should be supported to resume regular, frequent, and routine social visits, both indoors and outdoors, with appropriate precautions.
2. Expanding Access to Essential Family Caregivers: No restrictions should be placed on the number of essential/family caregivers that a resident can designate and a minimum of two should be able to visit at a time without restrictions, regardless of vaccination status.
3. Removing Restrictions on the Frequency and Length of Visits with Family and Friends: Visits should be as frequent and long as possible, with limits only put in place where necessary to prevent negative impacts on the care and well-being of other residents.
4. Allowing Essential/Family Caregivers Access to their Residents During a COVID-19 Outbreak: Essential/family caregivers should continue to have access to LTC homes during a COVID-19 outbreak, as long as they can attest that they understand the risks and are trained and abide by the required COVID-19 safety measures.
5. Screening and Testing: Essential/family caregivers or general visitors should be subject to the same COVID-19 screening requirements as LTC home staff if visiting or providing care.
6. IPAC and PPE Requirements: Essential/family caregivers and general visitors should be trained in and follow the same IPAC and PPE requirements and procedures as staff members of the LTC home.
7. Resuming Communal Dining within Cohorts: It is recommended that LTC homes place residents in groups based around their floor or residential unit to enable communal dining. Residents in the same group should be able to resume sitting together at dining tables without the need to wear masks, use physical barriers, or physically distance themselves if cohorting residents is feasible.
8. Resuming Group Social Activities within Cohorts: It is recommended that LTC homes place residents in groups based around their floor or residential unit to enable social activities. Residents in the same group should be able to interact without the need to use physical barriers or physically distance themselves, but should, when possible, continue to wear a mask when engaging in group activities.
9. Supporting Non-Essential Absences and Outings: Fully vaccinated residents should be able to leave their LTC home for outdoor social outings and return to the home without requiring testing or isolation, unless exposed to COVID-19 or proper protocols/public health guidance have not been followed. Fully vaccinated residents should also be able to spend time indoors and engage in overnight stays or absences with other fully vaccinated essential/family caregivers, family members and friends.
10. Adopting a Post-Vaccination LTC COVID-19 Outbreak Definition: Homes should adopt a revised COVID-19 confirmed outbreak definition that reflects the added protection provided by the near universal achievement of resident vaccination.
Allowing residents to visit openly and safely with their families and friends is of the utmost importance. While necessary during the first and second waves of the pandemic, prolonged restrictions have had negative impacts on the physical and mental health, cognition and overall well-being of many LTC home residents. The benefits of safely reopening LTC homes are significant, and it is now possible for homes to safely reduce restrictions in accordance with current public health guidelines.
While the sector is taking much-needed steps to relax visitor restrictions, support the resumption of communal activities, and permit resident outings, clear and evidence-based guidance is needed at national, provincial/territorial and local levels.
The re-opening of LTC homes provides a powerful example of the role a comprehensive National Seniors Strategy could play in meeting the needs of older adults across the country. The NIA has long advocated for a coordinated national plan to provide federal leadership and promote greater equity for older adults. Learn more: nationalseniorsstrategy.ca.
By Samir Sinha, Director of Health Policy Research, Natalie Iciaszczyk, Policy Analyst, and Cameron Feil, Research Coordinator