Caregiver says directive for long-term care plays ‘Russian roulette’ with people’s lives

·4 min read

A Hamilton caregiver is concerned that the province is potentially exposing residents of long-term care to COVID-19 in its latest rules for testing.

Barbara Gallant, whose husband resides at Extendicare Hamilton, disagrees with a directive from the Ministry of Long-Term Care that lets caregivers enter resident rooms before they know the results of their COVID tests.

“Why are you playing Russian roulette with these people’s lives?” she asks.

By March 15, Ontario long-term-care homes switched to rapid antigen tests — which provide results in minutes — instead of other COVID tests that are processed in labs.

That transition came with new requirements from the ministry, including that caregivers take rapid tests two to three times a week in areas with high COVID spread, including those in the yellow to grey provincial zones. That goes for both indoor and outdoor visits.

Alternatively, they can take one polymerase chain reaction (PCR) test and one rapid test on different days within a seven-day period.

The new rules say that if a caregiver takes a rapid test, and passes screening questions and temperature checks, the facility “may allow the caregiver to proceed to the resident’s room with appropriate personal protective equipment ... and following infection prevention and control practices pending the antigen test results,” the ministry says. The rule applies only to homes without active outbreaks.

The reason for relaxing the rules? Vaccines.

“Long-term-care homes are now one of the safest places for people to be,” said ministry spokesperson Aslan Hart in an email, pointing to high uptake for vaccine among residents, staff and caregivers.

But while Barbara and her husband are both vaccinated, she doesn’t think homes should take chances.

“It makes no sense that they’re allowing people in when the variants are more deadly than the original (virus),” she said, noting she always waits for her negative result before her daily visits.

Extendicare, which operates homes across Ontario, said it has had conversations with Barbara and that the Hamilton facility heard opposite “complaints” from other caregivers asking to access resident rooms before receiving the test result.

“It’s always a balance to follow directives and apply them on a home-by-home basis, based on the range of needs of the various family members in each home community,” Extendicare spokesperson Laura Gallant said in an email.

She added that the home ensures caregivers follow PPE requirements “for the full duration of their visit” and that rapid tests are “an additional layer of protection,” noting results arrive within 15 minutes.

The ministry says it updated its directive in response to “changes to testing guidance and feedback from homes.”

“They are minimum requirements,” spokesperson Aslan Hart said in an email, noting individual homes can choose to make visitors wait for results or be tested more often.

Other local homes have opted to wait.

At St. Peter’s Residence at Chedoke and Idlewyld Manor, both operated by Thrive Group, essential visitors must wait in the home’s testing area for their results “before proceeding to a unit.”

In an email April 22, senior administrator Renee Guder said despite the ministry’s permission to let caregivers inside, Thrive Group decided to make them wait due to “the rapid spread of the virus, and high number of cases in Hamilton.”

Grace Villa, which had Hamilton’s worst outbreak to date, also said caregivers must wait for their results.

“If they test negative, they are then permitted to enter the home,” said Mary Raithby, CEO of operator APANS Health Services, in an email.

Both Guder and Raithby noted rapid testing requires more resources. Grace Villa “partnered” with outside agency staff to provide testing seven days a week so the home’s staff can “remain focused on resident care,” Raithby said.

Chartwell Willowgrove, on the other hand, lets caregivers proceed without their results.

“Should a negative test arise, staff would immediately notify the visitor and ensure an immediate and safe departure from the home,” said an email from Sharon Ranalli of Chartwell Retirement Residences.

The vice-president of marketing and communications said it takes up to two full-time staff to perform the tests, order supplies, track results and promptly follow up.

“Residences have adapted to these requirements ... but it continues to challenge limited resources,” she said.

Asked how the ministry responded to staffing concerns, Hart said “anyone with appropriate training” can perform antigen tests and the ministry offers a directory of providers who “agreed to charge a reasonable price.”

“Supervised self-swabbing” is also allowed, Hart added, noting homes are allowed to expense costs associated with the tests to the ministry.

Maria Iqbal, Local Journalism Initiative Reporter, The Hamilton Spectator