ELIZABETH DIACON: Why should I deny someone younger a hospital bed?

Two weeks ago I was handed a letter, along with other residents in my care home in Wiltshire, and asked to sign it. It stated that if I fell ill, I agreed that I did not want to be taken to hospital.

No-one put me under pressure to sign it, but I did.

Why? Because, aged 97, I feel that, with our hospitals so terribly overstretched by the coronavirus epidemic, somebody younger than me should have the benefit of a hospital bed or, if I needed it, a ventilator.

I would hate to think that I was taking away resources from someone, who because of their age and general good health, would have a better chance of survival.

I spoke to my family before I signed and they supported my decision. And that was that.

At my age I know what I want: I may be frail in body but my mind is strong.

In the war, I was in the WAAF – Women’s Auxiliary Air Force – and I worked at Bletchley Park – where the Enigma codeCJK was cracked – as a signals intelligence officer.

Of course, signing the letter was merely an expression of my own decision – and I certainly don’t believe other people should be forced to do the same.

I’m also fully aware that the care in my local hospital – which I’ve visited just twice in the past three and a half years – is very good.

But in the past weeks, many of the wards have been hit by coronavirus and staff are understandably rushed off their feet.

Hospitals are difficult places to be in at the best of times, especially if you are blind, as I am. The staff are brilliant but they don’t know you, and it’s stressful and noisy. I dread to imagine how chaotic it is now.

Whereas here, in the care home, I know my way around, I know the staff and they know me. I am very lucky: I have my own private room, talking books from the Royal National Institute of the Blind. And, of course, the carers – despite being underpaid – are wonderfully patient and charming.

All of which means I’d much rather stay here than be sent to hospital.

That said, if I did need to go to hospital for a heart or a hip operation then I definitely would. 

But if it was because I was infected with coronavirus, then I would rather remain where I am. I signed a DNR (Do Not Resuscitate) form years ago, so this is not all that different.

It’s simply the truth that I am not afraid of dying – though I am slightly afraid of how I might die. Quite naturally, I’d rather it were quiet and peaceful, with palliative care if I need it. That is far more likely to happen here than in a busy hospital. 

Though I do worry that this places a huge responsibility on the carers here, many of whom are very young.

Yet all staff in the care home are trained in end of life care and there is always someone available for me to call upon. And if necessary the nurses could always call in the paramedics and review my situation.

I know that not everyone feels this way but signing that letter offers a degree of comfort.

For as long as I have the choice, I would much rather die in my own bed.

This brutal ageism would have appalled my grandfather: Wiston Churchill’s granddaughter EMMA SOAMES says it is wrong to prioritise young people over the elderly in coronavirus crisis

One can only imagine what my grandfather Sir Winston Churchill would have thought of the decisions being made about the treatment of the elderly during this coronavirus pandemic.

My abiding memory of him is as a man who was always working, right up until his death at the age of 90, and indeed it is salutary to think just how much he achieved in later life.

When he first became prime minister in 1940, he was 64, an age when most of us are happily looking forward to retirement. By the time he was re-elected in 1951, he was 77.

Nobody would have dreamed of writing him off and yet in our supposedly more enlightened times we are in danger of condemning many thousands of people to death, simply because they are elderly.

I am 70 and yesterday came a double blow for those who, like me, like to imagine that their lives are important and that their wishes matter.

First, as the Mail reported, we learned that care home residents with coronavirus are being kept away from hospital.

Guidelines published by the Department of Health, Public Health England and the NHS, instruct care managers to ‘assess the appropriateness of hospitalisation’ if residents become seriously ill with the virus.

One GP from the Brighton and Hove Clinical Commissioning Group reportedly went so far as to tell a care home manager that ‘none of your residents over 75 will be admitted to hospital’.

Meanwhile older people across the country are being pressured to sign ‘Do Not Attempt CPR’ forms. CPR refers to ‘cardiopulmonary resuscitation’ and once a patient has signed such a document they become subject to a DNR (Do Not Resuscitate) order signed by a doctor that means no attempt will be made to revive them should their heart stop beating.

In my view, the guidelines issued to the hospitals amount to euthanasia by the back door, especially at a time when our hospitals still have some spare capacity. As for the pressure to sign Do Not Attempt CPR forms, it is simply outrageous.

Of course I’m not suggesting that hospital is always the best option. I recently lost a friend in her eighties who was in no state to make decisions about her care but was allowed to die peacefully at home when she finally reached the end of her race.

Undoubtedly the right choice for her, it was made by a triumvirate of her family, her carers and the local GP. That is exactly how such decisions should be made and I share the Alzheimer’s Society’s concern that stretched and exhausted health and care workers will misinterpret such guidelines and ‘inadvertently prevent access to critical care to people who need it’.

When it comes to Do Not Attempt CPR forms, I have no problem with any individual choosing to sign such a form. Indeed, I have signed one myself. It was one of the first things I did after following government advice and putting myself into self-isolation, both because of my age and because I suffer from a condition which puts me in the vulnerable category.

When I depart this world, I would like to have my family around me and, if I fall ill for any reason, the thought of being rushed to hospital and then dying on one’s own behind a plastic curtain in an intensive care unit is not very appealing.

I am also reluctant to put the NHS to the bother of spending a lot of time, trouble and expense on me. I would rather they spent it on somebody younger. But that is a decision for me to make and it’s shocking to think that these forms are being sent to groups of elderly and vulnerable people across the UK.

In one example quoted by Age UK, an 85-year-old woman who has several long-term health problems but still enjoys life was called by her GP, who asked if she would sign a Do Not Attempt CPR form. ‘She felt mortified and was extremely upset when she received a letter with a form in a few days later,’ reports the charity.

Elsewhere, a GP surgery in Wales asked patients with ‘significant life-limiting illnesses’ to sign a Do Not Attempt CPR form in case they contracted coronavirus. Meanwhile, care home staff are being given responsibilities way beyond their pay grade. Often underpaid and overworked, they have quite enough to cope with as it is, working as they do in a social care system which remains unfit for purpose, despite enquiries commissioned by government after government.

It’s partly because care homes are underfunded and overcrowded that coronavirus has been able to rip through them in the first place.

Let’s not compound those failings with policies which lump the elderly together. Just as there was only one Winston Churchill, so we are all individuals with medical needs every bit as varied as the personalities, talents and experience which mean we are still invaluable members of society and make a nonsense of such brutal ageism.

Emma Soames is a former Editor of Saga Magazine