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76
(of the elderly) to a proper diet is often dramatic" and many an
old person with mental infirmity has made a remarkable recovery
when regular balanced meals have been forthcoming.
For the old people, this country is not yet a Welfare State;
many family doctors are far too busy to spare much time for the
elderly and hospital accommodation for them is hopelessly inadequate.
It is well known that it is extremely difficult for anyone
over 75 years of age to get into hospital except as an "acute" case.
Nevertheless, there are some one hundred special geriatric units
in being, attached to hospitals which are attempting to provide for
the special needs of the elderly and, in this field, they are achieving
an unexpected measure of success in restoring many to normal
health and reducing their hospital stay to a minimum. These
beneficial advances can so very easily be lost and it is essential
for the geriatric unit to be assured that, on discharge, the patient
will return to conditions most likely to lead to his or her re-establishment
in life. Information of this nature is usually in the hands of
the Medical Officer of Health which could be made readily available
to the geriatrician and which should form the basis of their
co-operation.
In order that the problem shall be seen in its true perspective
it must be stated that, not withstanding these geriatric successes,
hospital care of the elderly is an enormous burden which can never
be borne alone by the existing services and much, therefore, must
be accomplished in the home. It is here the environmental health
services should assume responsibility.
When considering the role which local authorities must play
in the general scheme it should be made quite clear that, admirable
though modern and well equipped institutions may be, old people
are infinitely better off in their own homes, especially as infirmity
rather than illness seems to predominate; such a situation demands
the best of co-operation at all levels between the various authorities,
agencies, organisations, etc., concerned with the well-being of the
aged.
Accepting the view that old people are better off in their own
homes, there is no doubt that many an old and frail person could
remain in his or her home with very little domestic help, but only
about four old people in every hundred are receiving this kind of
assistance. This position is no reflection on the Home Help Service
for it is performing splendidly with very limited resources. The cost
of such a service is high, something more than £9,000,000 is
involved, but residential care, whilst being less satisfactory, is much
more expensive.
Again, a mobile meals service is invaluable to the homebound
and the B.R.C.S., the W.V.S., and others are performing wonders