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to be essential. It is also helpful to make regular visits if only for
the purpose of advising the old people themselves or assisting
relatives to cope with the day-to-day problems of management that
arise where a patient is housebound and, perhaps, incontinent.
Reports are given below on representative problem cases which
have been encountered during the year.
(a) An old man of 82 was constantly visited over a period of
eighteen months. He lived in a tiny back room and
became very dirty in his habits, rarely going out mainly
because of his difficulty in getting about. He rarely, if
ever, used the lavatory but burned his excreta on the fire,
causing great distress to other occupants of the house.
Visits were made by the Administrative Officer, a male
nurse from the District Nursing Association, and the
Medical Officer of Health, all with the object of persuading
him to enter a home where he could be cared for, but their
attempts were of no avail. Subsequently, he was admitted
to an institution, after a Committal Order had been made,
and he died there after having been confined to bed for
some weeks.
(b) After a number of visits to Mr. C., aged 87, arrangements
were made for him to be bathed regularly and for meals
to be provided. He was also supplied with clothing and
the service of a home-help was obtained. There was
difficulty in getting him to pay for meals and his reluctance
to put money in the gas meter or to pay for coal caused
some distress to the various home-helps who called. At
one stage he tore pieces off the floor covering to provide
fuel for heating water. A daughter visited him occasionally
but she said her father was a very difficult man and he had
always been very independent. Every effort was made
to persuade the old man to enter a home but without
success. He later became ill and was removed to
hospital where he died shortly after admittance. It was
only after his death that various relatives enquired to ask
what had been done for him.
(c) Mr. and Mrs. P, aged 79 and 83 respectively, were
rehoused under a clearance scheme and were visited
regularly because it was found that their flat was only
sparsely furnished and that bedding was scarce. Various
pieces of second-hand furniture were supplied and a grant
for extra comforts was obtained from the Mayor's
Contingency Fund. The old lady seemed ailing and
unhappy and it was not until she became very ill that it
was learned she had not been allowed to share her
husband's bed for a number of years but had had to sleep
on a chair. She was visited by her doctor and the
District Nurse and her last few days were made comfort-