Elderly coronavirus patients ‘should talk to families about whether they want hospital treatment’

Elderly people should discuss with their loved ones whether they want to be treated in hospital if they develop coronavirus, an NHS doctor has said.

Dr Rachel Clarke, a palliative care specialist, warned on Friday that some Covid-19 patients were spending their final hours and days alone in busy intensive care units despite having no hope of survival.

The Oxford-based clinician advised all families to have an “advanced planning” conversation to ascertain elderly relatives’ wishes if the virus strikes.

She told BBC Radio 4’s Today programme: “The disease can take you over in a matter of hours. If you are very elderly and you have lots of underlying diseases, it may never be appropriate for you to be put on a ventilator.

“That means the risk of being rushed into hospital is that you are rushed into an environment where nobody you know and love is there and, if you had had the conversation in advance, you may have concluded you would rather have been at home.”

Dr Clarke spoke on the day the official UK death toll from coronavirus reached 759. Data from Imperial College London shows a nearly nine per cent mortality rate among those aged 80 and over, with just over five per cent mortality among those aged 70 to 79.

Figures are also showing that a higher than expected proportion of patients ill enough to require hospital treatment end up in intensive care and on ventilators.

Because of infection control, loved ones of Covid-19 patients who are deteriorating are usually forbidden from being with them as they die. Stories have emerged in recent days of clinical staff having to pass on final messages from family members.

Dr Clarke, an author on compassionate dying, said Skype and WhatApp are being widely used on tablets and smartphones to say goodbye during the outbreak, which has so far hospitalised at least 4,300 people in England.

“It’s heartbreaking,” she said. “We know in palliative medicine that although physical symptoms such as pain are very important, and we have wonderful drugs to manage those, so too are the psychological aspects of facing the end of one’s life.

“Patients will very often be frightened and very lonely, and that means one of the most import medicines in palliative care is not morphine on tablets and smartphones – it is the sheer value of another human presence up by the bedside at the end of their lives.

“One of the desperate cruelties of Covid-19 is its denying patients who are dying, or at risk of dying, the presence of the loved ones at the bedside.”

The warning came as a new survey suggested two-thirds of older people are struggling to get enough food to meet their daily needs as they self-isolate during the coronavirus pandemic.

The charity Independent Age said 64 per cent of 489 adults over the age of 65 were unable to buy enough food, while 60 per cent struggled to get household supplies.

The poll, carried out by Opinium between March 20 and 24, also found that 58 per cent reported struggling to purchase enough toilet paper, while nearly a third had difficulty getting medicine and healthcare supplies.

Around 29 per cent of those struggling to get supplies said they were having difficulties getting basic toiletries such as soap and shampoo.

Deborah Alsina, the chief executive of Independent Age, said: “Older people, particularly those aged over 70, are at higher risk from Covid-19, so the levels of anxiety being experienced are certainly very understandable.

“It’s incumbent upon all of us to do what we can to reach out to our older friends, family and neighbours – a simple phone call can make a remarkable difference in lifting someone’s mood and getting them through the day.”

More than 500,000 people have this week offered to join a volunteer army to protect the NHS by helping vulnerable people self-isolate for 12 weeks as the coronavirus outbreak spikes.

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