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two courses of action open for the treatment of their problem, viz.
institutional care or home care.
Not unnaturally, it is generally agreed that old people are
infinitely better off in their own homes especially when infirmity
rather than illness seems to predominate but the usual assumption
that this is also economically sound is rather open to question.
It has been estimated that short-term acute hospital cases
could cost from £25 to £30 per week but that in the long-term stay
so often met with in geriatric wards, the weekly cost may be as
low as £10, a figure which is usually augmented by a contribution
from the patient's pension.
On the other hand, effective home-care demands a high standard
of co-operation at all levels from all the various agencies
concerned with the wellbeing of the aged. In effect, this involves
home nursing, home help services, meals-on-wheels, bathing and
laundry services, pharmaceutical services and National Assistance,
the overall costs of which are likely to outstrip the cost of a place
in a geriatric ward and, moreover, it is doubtful whether such
arrangements make the most economical use of personnel.
However, the salient fact in all these deliberations is not the
cost in terms of money and personnel, important though it may
be, but the happiness of the aged in the twilight of their lives.
Undoubtedly the person most fitted to exercise an overall control
and watching brief is the Medical Officer of Health. Environmental
health, which plays a vital part in maintaining the moral of the
aged, is his prerogative and his department, being the centre of
a collection of loosely-knit organisations, is likely to be able to
ascertain very early on whether a break-down in home-care is probable
and if so, what methods can be expected to provide a satisfactory
solution.
So often one finds, in this connection, that the nearer one
approaches the home the less enthusiastic are the people who have
to bear the burden of caring for the old folk. This formidable
obstacle of "family strain", so inimical to the maintenance of a
smooth-running home-care system must be surmounted and a family
genuinely seeking to do its best for its older members deserves
our full and continued support. With this aim in view and with the
co-operation of the Geriatrician at St. Alfege's Hospital, short-term
admissions are arranged for the elderly to enable relatives to take
a well-earned holiday.