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COVID-19: End of life care in older people
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This page brings together resources and information for any clinician or carer who finds themselves faced with providing care at the end of life during the COVID-19 pandemic.
COVID-19 has moved death and dying to the centre stage. While end of life care has always been an integral part of care for older people, the acute and rapid nature of COVID-19 changes the pace and focus of that care. Clinicians and carers will need to give both the best physical care possible and also provide the human contact and comfort to older people who are dying - ideally provided by those they love.
Person-centred care has never been more necessary, including sensitive advance care planning conversations and best interest decisions -communicated clearly with compassion, symptom control, support of family and friends from a distance, and crucially care of yourselves and colleagues.
We care for older people across sectors and support for, and solidarity with, our fellow workers in social care is crucial. Just as we face new challenges in our own clinical settings, our colleagues in the community, social care and charitable sectors will be facing their own challenges.
Careful and compassionate communication between sectors has become more important than ever. Below is a set of resources to assist you. It is not exhaustive and needs to be adapted to your situation.
The current COVID-19 crisis is likely to be the defining moment of all of our careers. We will face huge professional as well as personal challenges during this time and need to support each other.
National guidance
- NHS Clinical Guide for Management of Palliative Care in Hospitals during the coronavirus pandemic
- RCGP coronavirus resource hub
Includes an end of life section covering changes to death certification, symptom control.
- The Ambitions End of Life Partnership Charter on ethical community practice during COVID-19
Scottish Guidelines
Advance Care Plan conversations
- Difficult Conversations - Why we need to talk about dying - NHS Education for Scotland
- Why plan ahead? End of life care - NHS
Communicating sensitively from a distance
- Quick telephone consultation tips for primary care - eGPlearning
- Top Tips for video consultations for the beginner - Wessex LMCs Podcasts
Symptom control
- Symptom management - elearning for Healthcare, NHS Health Education England
You will need to be registered using your NHS login to access these slides and accompanying algorithms for symptom management.
- Guidance on the management of symptomatic patients dying from COVID-19 - RCGP elearning
- COVID-19: End of life care and dementia - British Geriatrics Society
Community focused
- BMJ Learning
Modules on pain assessment, breathlessness, and end of life care in hospitals and the community.
- Clinical guidance for managing COVID-19 - RCN
Scroll to section on palliative care.
- COVID-19 rapid guideline: managing symptoms (including at the end of life) in the community [NG163] - NICE
COVID-19 Rapid guideline managing symptoms in the community including fever, breathlessness and delirium and anticipatory medications.
- COVID-19: Managing the COVID-19 pandemic in care homes - British Geriatrics Society
Supporting friends and family
- Supporting informal carers during the COVID-19 pandemic - RCGP
Guidance for clinicians on supporting carers.
- Caring for your dying relative at home with COVID-19 - Hospice UK
Guide on Caring for a relative dying at home with COVID-19.
Care for ourselves
- COVID-19: Health and care staff wellbeing - British Geriatrics Society
- Stress, Coping and Resilience - NHS Education for Scotland
- Caring for Yourself & Others During the COVID-19 Pandemic: Managing Healthcare Workers’ Stress - Schwartz Center for Compassionate Care (Webinar)
