The coronavirus pandemic is forcing medical professionals into making decisions no one wants to make.
The right to a bed or a ventilator has now become a series of calculations. Who will benefit the most? How many years of life will we save? And what quality of life will that be?
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In the charity sector, plans have been thrown into disarray and funding is disappearing fast, yet the need for our work is greater than ever. At Independent Age, we’re evolving our services in response to this crisis situation, so that we can continue to meet older people’s needs throughout this worrying period.
Older people’s needs are being put aside
In these fast-moving and economically pressured times, it can be easy to put aside humanity in favour of efficiency.
And in this situation, as so often, it appears that older people are the ones are having their needs, agency and wishes put aside.
In recent weeks, we have seen too many incidents when well-meaning but overstretched individuals and organisations have fallen into this trap. Other times, the trap has been loudly stepped into by deliberately provocative pundits.
One situation in the first camp is a GP surgery in Wales that recently wrote to some of its older patients. The letter – received by patients with medical issues like cancer or Motor Neurone Disease – asked the recipients to fill in a ‘do not resuscitate’ form.
It listed the ‘benefits’ of filling in such a form. It promised it would not abandon patients, but needed to be “frank and realistic”. It said the recipients would be unlikely to gain admission to hospital if they contracted Covid-19, and “certainly will not be offered a ventilator bed”.
As I said, these are hard decisions. But reading that letter, posted on social media, made me feel deep anguish for the people on the receiving end. The GP surgery later apologised for the letters.
‘Worthless and disposable’
Is it so necessary to communicate such a message, which is likely to devastate many recipients, in such a clinical, hard-headed way? Is there no way to ask patients to consider difficult access questions while not making them feel worthless and disposable?
It is far too easy to discount the way that tone and narrative can impact a person.
Although there is no evidence that older people are more likely to catch Covid-19, they do appear to be at greater risk of becoming seriously ill or dying from coronavirus, particularly those over 70 with underlying health conditions.
However, the daily death statistics have shown that this is a virus that can tragically affect young and old alike. The social distancing measures we are all undertaking are designed to protect us all.
But we are all more than our demographic. Who we are is made up of our life experiences, our families, friends, our interests and passions, our past, present and hopes for the future.
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‘Older people become an age’
In the current debate, older people sometimes appear to simply become a chronological age, rather than a person with a life story of their own. It can be easy to reduce them to a series of risk factors and thus feel comfortable putting pressure on them to sign a do not resuscitate order.
But they are not disposable. They are people with a lifetime of knowledge, experience and love to offer, who would also leave a massive void in the lives of those who love them.
I cannot praise and thank enough the extraordinary efforts of our health and care workers. We recognise their struggles, and the tough decisions they have to make every day. It must be unbearably difficult at times.
But older people are going through an unprecedentedly difficult time too. They are dealing with the stress of knowing that they are at a higher risk, without their normal social support systems. Many – more than two million over-75s – live alone. Many are not confident internet users.
I believe it is incumbent upon all of us to do what we can to mitigate those stresses. Where difficult messages have to be communicated, they should be communicated compassionately, and with a degree of thought about how the person receiving them will feel.
‘Rights-based decisions’
Last week, I signed a joint statement with other older people’s charities and organisations, which called for priority treatment for Covid-19 to not simply be made on chronological age, which we know is a poor proxy for health. We need to make rights-based decisions that we can feel proud of after this crisis is over.
Older people are more than just a demographic and certainly more than their health conditions – they are who we will all be one day, if we are lucky. It’s imperative that we don’t lose sight of our societal values and the gains we have made at overcoming discrimination at this time of crisis.
Surely, in fact, we need to hold on to them now more tightly than ever.
Deborah Alsina is CEO of national older people’s charity Independent Age
