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26
WELFARE OF THE ELDERLY
BY DR. A. L. WYMAN PHYSICIAN SUPERINTENDENT FULHAM HOSPITAL
The welfare of our old people is causing great concern to the community today,
Inflation affects the retired and pensioned more than the younger working population, and
illness brings in its train social consequences to the old which often transcend in
importance its physical effects. In the last few years such problems have been increasingly
prominent in the work of the Medical Officer of Health, Divisional Medical Officer,
L. C. C ., the General Practitioner and the Hospital Physician Reasons for this are not
hard to seek Though the population of the Borough has been decreasing, the proportion
of people over the age of 65 has increased.
Population
Males
Age 65
Females
Age 65
1931
151,200
4,403 (2.9%)
6,842 (4,5%)
1951
122,400
5,500 (4.49%)
8,500 (6.94%)
The young women of the household, even if married, go out to work to a much
greater extent than in the past so that there may be nobody at home all day to look after
an elderly relative. Again the younger members of the family tend to leave the Borough
for new housing estates or new towns while the older remain behind without relatives near
at hand to help them in their days of distress.
What leads to the actual breakdown so that an independent old man or woman needs
help from the community, and what help can be given?
The loss of independence may come gradually and insidiously with declining physical
and mental powers. For a time, the stronger partner, in the case of a married couple,
may be able to take over all the household duties, the washing the cleaning and the
shopping, but eventually the burden may become insupportable. Or more suddenly, the
illness or death of one partner leaves the survivor deprived of help and unable to manage
alone. A single person may be helped by kindly friends or neighbours, but there comes a
time when this is insufficient or the friend herself becomes ill or has to go on holiday
or for some other reason has to withdraw the aid offered.
Difficulties may arise after recovery from apparently acute illnesses. After
an attack of pneumonia or heart trouble, an old person may find the range of his activity
limited. A stroke may leave so much disability that an independent existence becomes
impossible.
What help can be given? As far as possible, an attempt is made to keep the patient
in his own home where among familiar surroundings and in the neighbourhood of friends and
relatives free from the restrictions of an institution, he should be at his happiest.
If this is impossible, the next choice would be a small home either private or run
by the various organisations. The Borough for example has a small home on Putney Hill.
Application may be made for L. C. C, Part III accommodation. For these homes, people have
to be in relatively good health, ambulant and able to look after themselves, although of
course, cooking, cleaning and shopping are done for them.
If an old person has some chronic sickness and needs nursing and medical attention
then admission to hospital may become inevitable.
Fulham Hospital has only 87 beds for the chronic sick and has to serve part of the
Borough of Hammersmith. These beds are always fully occupied so that some selection has
to be made and the most urgent cases must take priority. When an application is made
for a chronic bed, an assessment is made both on medical and social grounds.