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63
Aged, Infirm and Physically Incapacitated Persons.—
Public Health Departments are in constant contact with problems
of old age, many of which are either difficult to overcome or incap—
able of permanent solution.
In 1949 the percentage of the population of pensionable age
was 13.5 and it has been estimated that this will rise to 18.8% in
1979—a proportion which will almost equal that of children under
15 years.
It is to be expected, therefore, that there will be a consequent
rise in the number of persons who are no longer capable of fending
for themselves, especially where no practical help is forthcoming
from relatives.
Questions of retirement age, size of pensions, etc., have received
nation-wide publicity : not only do these fall outside the scope of
local administration but the publicity has tended to focus attention
on those elderly persons who are able to lead fairly normal lives.
It is the health and well-being, however, of the infirm, decrepit and
incapacitated which are the greatest concern to a Medical Officer
of Health and his Department.
In a general way, the aged can be classified as follows :—
(a) The Elderly—those who are sufficiently healthy and
active to manage small homes of their own.
(b) The Elderly and Infirm—those who suffer from the
disabilities of age but not from extreme
frailty or chronic disease.
(c) The Elderly Sick :—
(i) Acute sick—those for whose treatment the normal
hospitals will provide.
(ii) Long-term sick Those whose treatment
(potentially and prospects of recovery
remediable) are the responsibility of
(iii) Irremediable— the Geriatric Unit.
In normal circumstances the local Geriatric Unit is called upon
to deal with persons in Category (c). In sub-divisions (i) and (ii),
the aim is to investigate, treat and rehabilitate so that in due course
these persons may be discharged, either to their own homes or,
after consideration, to other appropriate accommodation.
Regarding those classified under (iii) of (c) above, it is necessary,
in order to avoid blocked hospital beds, to see that the persons
finally classified as ' irremediable ' (subject to periodical review)
should be passed to long-stay annexes but still under the direct
supervision of the Geriatrician.
Relations between Dr. A. J. Mester, (Geriatrician of the
Greenwich and Deptford Hospital Group) and this Department are