BC Seniors Advocate pushing for essential visit improvements in LTC, eager to see widespread rapid test use

BC Seniors Advocate Isobel Mackenzie understands the province had to act quickly to respond to the rapid spread of the Omicron variant but says it should be easier for residents to have an essential visitor.

“I am frustrated,” Mackenzie says. “I would have thought by this point in time we would have acknowledged that every resident in this province is entitled to designate a person as their essential visitor, full stop.”

The Seniors Advocate says essential visitor guidelines are interpreted differently depending on the facility, and essential visitors shouldn’t be decided by the care homes, but by the residents.

“They are hearing things such as it’s only if your loved one is palliative – that’s not true,” she says. “It’s only if you are the only person who can provide these services and we’ve deemed that we can keep your loved one comfortable. And that’s not really, in my opinion, what this is intended to be.”

According to current guidelines on the B.C. government website, essential visits include visits for compassionate reasons, such as end-of-life care or those essential to a resident’s care and mental well-being. The site also advises readers to contact the long-term care facility to find out if they qualify as essential visitors.

Speaking to CFJC Today, BC Care Providers Association CEO Terry Lake says once the visitor designation is approved, long-term care residents can have more than one essential visitor on their list. But only one of those essential visitors can be there at one time.

Mackenzie says she has no qualms about reducing the number of visitors during heightened COVID-19 spread but wants residents to be able to easily choose their own essential visitors, and have facilities be able to use rapid testing with those frequent, essential visitors.

“At the end of the day, it’s fairly straightforward,” Mackenzie says. “Every resident is entitled to name a designated essential visitor.”

Testing in B.C.

Meantime, as rapid tests are used across the province this month, Lake says rapid testing has been a topic of conversation for well over a year now.

“We know we have an inventory of rapid tests sitting in a warehouse in Vancouver,” Lake says. “For some reason, Dr. Henry does not like this particular type of test, and yet we have been using it in our own office for months. And it’s simple to use and certainly would work well in a residential care home.”

This week, rapid testing kits are being sent to care homes around the province, and Lake wants to see those kits used immediately.

“We understand that new kits are being shipped,” he says. “About 180 homes have received them so far and hopefully all homes will receive them by the end of the week.”

Care providers and the Seniors Advocate also want more frequent testing implemented so there’s a better chance of identifying asymptomatic staff cases or asymptomatic residents who are coming back into a facility from acute care.

When asked on Tuesday whether Interior Health residents who are leaving acute care are required to be tested for COVID-19 before returning to their living facility, Dr. Henry reiterated that this is now the expectation.

“That is the protocol. Normally when residents are transferred back to a facility from a hospital or if they’re in an alternative level of care and they’re awaiting placement in a care home that they are tested prior to returning to that facility, yes,” she says.

However, according to Lake, testing has not been consistent, and he’s heard of instances where asymptomatic residents are not tested before being transferred back to their living facility.

“The mantra always seemed to be if someone is not showing any symptoms, then they’re not tested,” Lake says. “But when you put that person into the most vulnerable setting possible, it just seems like a no-brainer. When they’re coming from a hospital where testing is easily done, why wouldn’t you take that precaution?

“I can tell you that we have had outbreaks from residents being transferred from hospitals without being tested. Despite what anyone else may say, this has happened, and it should not have happened.”

Mackenzie says she can’t speak to how consistently testing is used now under updated protocols. However, in an October 2021 report released by the BC Seniors Advocate office that analyzed previous outbreaks under the previous protocols, Mackenzie notes that not every resident discharged from a hospital was tested before returning to their living facility or community.

“But I can tell you that certainly in the review we did, most hospitals did not test people,” Mackenzie says. “And in fact, policy was people were not tested when they were admitted into hospital and people were not tested prior to transfer to long-term care. Some long-term care homes would test people on arrival. Not all.”

Mackenzie notes the policy at the time was to isolate arrivals for 14 days. Looking back, the Seniors Advocate thinks testing could have been used more strategically to reduce isolation for seniors.

Going forward, Lake hopes the rapid testing will be implemented quickly so care providers can tackle problems in other areas of long-term care.

“There’s no question that we have to address the critical staffing shortage in seniors care in the short term but also in the medium and long term. And so we look forward to working with the government to see how we can make that happen,” he says.

by Dylana Kneeshaw

BC Seniors Advocate pushing for essential visit improvements in LTC, eager to see widespread rapid test use

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