The Minnesota Department of Health today released new guidance for long-term care facilities to use in designating family members or others to serve as essential caregivers for residents of nursing homes and other assisted living facilities. People designated as essential caregivers will have expanded access to help ensure that the residents’ full range of emotional, social and physical needs are met.

Since mid-March, visitor restrictions have been in place in long-term care settings to prevent the spread of COVID-19. However, balancing COVID-19 safety and visitation restrictions with the well-being of residents is an urgent priority to limit unintended harms of social isolation. The new Essential Caregiver Guidance for Long-term Care Facilities (PDF) lays out a framework long-term care providers can use to designate people to be essential caregivers, striking a balance between meeting residents’ needs and limiting infection risks.

“Minnesota families have made great sacrifices to control the spread of COVID-19 in our long-term care facilities. I know this has been hard,” said Governor Tim Walz. “But with this guidance, families will be able to reunite with their loved ones while continuing to protect the health of our elderly Minnesotans.”

An essential caregiver could be a family member, outside caregiver, friend or volunteer, who has provided regular care and support to the resident before or during the pandemic. Residents can have more than one essential caregiver for providing emotional support and individualized, person-centered care.

Minnesota Commissioner of Health Jan Malcolm said the new guidance reflects an awareness that even during a global pandemic, preventing disease transmission is only part of what goes into providing quality care in a long-term care setting.

“While preventing the spread of COVID-19 among residents of long-term care facilities has been a top priority since the start of the pandemic, we all recognize how important it is to ensure that the social and emotional needs of residents continue to be met – especially in light of limitations on visits and other activities in these settings,” Commissioner Malcolm said. “By rolling out this guidance for essential care providers, we are helping to build a more robust framework that providers can use to ensure that residents’ full range of needs are met.”

MDH developed the guidance in partnership with stakeholders including Care Providers of Minnesota, LeadingAge Minnesota, the Office of Ombudsman for Long Term Care and other consumer advocate groups.

“One of the most difficult things about COVID-19 for our residents has been the prolonged separation from families and loved ones,” said Gayle Kvenvold, president and CEO of LeadingAge Minnesota. “With the virus still very much a threat in our communities, we can’t throw open wide our doors, but we can take this interim step of welcoming back designated family members and others to our caregiving teams. We remain vigilant in our infection control and prevention efforts and look forward to the day when more widely available testing and other tools can help us expand visitation even more.”

“We know it has been a long four months for our residents and essential caregivers,” said Patti Cullen, president and CEO of Care Providers of Minnesota.  “We hope that this designation will provide the needed support as an interim step until it is safe to resume visitations on a broader scale. We will continue to work with stakeholders on a broader visitation option while carefully looking at COVID-19 outbreak trends.”

According to the new guidance, providers must talk to residents about their wishes to determine whom to designate as an essential caregiver, and facilities should establish policies for identifying and using essential caregivers no later than July 25, 2020. Given that COVID-19 is expected to remain a concern for months to come, caregivers and facilities will need to work together to ensure that infection control procedures are followed closely.

The guidelines require caregivers to sign in and be screened prior to entering the building, just like facility staff. Caregivers must frequently wash their hands and use hand sanitizer and wear all necessary personal protective equipment while in the building (minimally eye protection and face mask). Facilities may restrict or revoke caregiver status if the caregiver fails to follow infection prevention rules. However, facilities are expected to talk to caregivers and attempt to address concerns before restricting or revoking visitations.

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