The agencies entrusted with the care of a couple found dead in a house with no heating in Northampton could not have done more to save them, a report found.
A review looked into the deaths of Jean and Derrick Randall after their bodies were found at their home in Kingsthorpe on 7 January in freezing conditions.
Mr Randall, 76, died from pneumonia and lung cancer, while Mrs Randall, 79, died from a heart attack.
The seriousness of their conditions had not been known, the report said.
The couple were found in their home in Birch Barn Way by police after a nurse who came to give Mrs Randall an injection failed to get an answer.
She alerted the authorities and the bodies were found after police went into the house.
Her Majesty's Coroners Office said in a statement: "No inquest will take place. The deaths are of a result of natural causes and there are no other suspicious circumstances present."
The results of the Safeguarding Adults Board review were published on Monday.
It said: "Several offers of interim care, which could have been implemented quickly, were made to the couple.
"However, these were refused as the couple decided to pursue accommodation in care for Mrs Randall."
The report concluded that "different actions by local agencies would not have avoided the couple's deaths".
However, the report did recommend that there should be a review of how agencies respond when people refuse their offers of help.
Northamptonshire County Council offered its condolences to the Randall family and acknowledged the difficulty of accepting that adults are entitled to refuse offers of professional help.
The independent review involved local GPs, Age Concern, Northamptonshire County Council and Northamptonshire NHS.
The review revealed Mrs Randall had only partially recovered from a broken hip in 2007.
In December 2009, Mr Randall told his GP his wife's condition was deteriorating and the couple were contacted by the district nurse, and referred to social services, the report said.
"The couple chose not to accept the offers of services but did agree to advice being provided by Age Concern about the possibility of residential care," the report said.
A neighbour had also tried to get the couple help from the social care service and Age Concern, while their local MP also wrote to the director of Adult Social Care Services.
"This resulted in a manager attempting to contact Mr and Mrs Randall by telephone on 7 January," the report found.
It also said both were judged fully capable of making decisions regarding their care needs on different occasions by different professional staff.
Northamptonshire County Council's corporate director of health and adult social services Charlie MacNally said: "It can be difficult to accept that adults who have sound mental capacity are entitled to refuse professional help or services, as was the case here."
He said steps were being taken to implement recommendations from the report.