Guidance for essential caregiver visitation for long-term care facilities

LINCOLN -Friday, Dec. 4, Governor Pete Ricketts announced that the State of Nebraska issued new Directed Health Measures (DHMs) to align with CDC recommendations to shorten the length of quarantine required for persons who’ve had close contact exposure to the coronavirus. The updated DHMs took effect Dec. 3, 2020 at 5 p.m.

Gov. Ricketts also announced new guidance for longterm care (LTC) facilities to designate “essential caregivers” for their residents. These caregivers may be family members, friends, or volunteers who provided regular support to the resident before the pandemic. By recognizing them as essential caregivers, LTC facilities can allow these folks to have more regular interactions assisting residents during this time of enhanced restrictions.

The Governor was joined by Becky Wisell, Interim Deputy Director of Health Licensure and Environmental Health for the Division of Public Health in the Nebraska Department of Health and Human Services (DHHS). She outlined guidance for LTC facilities to follow with their essential caregiver program. Jenifer Acierno, CEO of LeadingAge Nebraska, talked about the many ways essential caregivers benefit residents in long-term care.

Becky Wisell: Essential Caregiver Guidance

• The Essential Caregiver Guidance document is intended for nursing homes and assisted-living facilities that decide to designate Essential Caregivers in their facilities.

o An Essential Caregiver is a person who was previously actively engaged with a resident or who is committed to providing companionship and/or assistance with basic activities of daily living.

• The guidance is important because: o It provides long-term care facilities with the opportunity to supplement their limited staffing with valuable volunteers who are willing to provide care for residents; and

o It provides family members and other outside caregivers who have worked with these residents an opportunity to spend more time with them.

• Essential Caregivers have an important role in providing care for residents in nursing homes and assisted-living facilities.

o Because of their relationships with residents, Essential Caregivers can observe and communicate important details about changes in a resident’s condition or behavior;

o Caregivers provide emotional support to residents and honor the residents’ personal values and preferences of care; and

o Most importantly, Essential Caregivers help promote quality of life for residents.

• LTC facilities must establish policies and procedures for how to designate and utilize an Essential Caregiver. This will take time for facilities to develop; the policies won’t immediately be in place.

• Nebraskans should consult the facility’s administrator, Director of Nursing, Social Services Director, or other designated facility staff to help determine who meets the criteria of an Essential Caregiver.

• The resident must be consulted about their wishes to determine whom to designate as the Essential Caregiver.

• The Essential Caregiver Guidance also includes necessary precautions to prevent the spread of coronavirus such as screening Essential Caregivers prior to entering the facility, requiring PPE and frequent hand hygiene, and limiting the number of Essential Caregivers in a facility at one time.

• The Essential Caregiver Guidance for Long-Term Care Facilities can be found on the DHHS website at dhhs.ne.gov/Documents/COVID-19-Long-Term-CareEssential-Caregiver-Guidance.pdf.

Jenifer Acierno: Essential Caregiver Guidance

• Thanks to DHHS for seeking out options to keep our LTC residents in Nebraska connected the best we can during this challenging time.

• During the pandemic state and federal guidelines have been put in place to protect residents, who are among the most vulnerable to the coronavirus.

• Typically, we like to engage residents with social activity, and we encourage it. But we recognize that these times are not typical.

• Isolation has taken a toll on LTC residents physically, mentally, and emotionally. This program allows for an Essential Caregiver provider to help maintain resident health across that spectrum.

• Essential Caregivers will help to reduce isolation for LTC residents while helping LTC staff with basic activities of caring for a resident.

• The program is voluntary. It allows providers to assess their specific situation and implement the program when it makes the most sense for their residents and their facility. Decisions on if and when to implement a program take account of community spread, availability of staff for screenings, as well as availability of necessary personal protective equipment (PPE). Some LTC facilities may be able to implement an Essential Caregiver program in the next few weeks. Others may have to hold off until a later date.