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107
years in advance and so lay foundations for a fresh pattern of life.
This is no easy task but, once accomplished, it enables them to
develop new skills and cultivate fresh interests and friendships
which will counter the detrimental effects of loneliness so commonly
met with in those who have no contacts outside their work.
Furthermore, during this period when earnings are still being made,
with some encouragement to use a little forethought many repairs,
adaptations and alterations such as provision of hand grips to
baths, rewiring and re-siting of switches, replacement of stoves or
geysers, etc., could be executed in the home with a view to anticipating
retirement problems.
Comes retirement, then the most promising situation is to be
found where elderly couples, well and active, are living in their
own homes. In these circumstances only minimal support will be
required from the community but, where there is some loss of
physical mobility, then all the domiciliary services should be
directed towards maintaining or improving the status quo. In cases
where retirement has been reached alone, we must provide companionship
in the home through voluntary organisations (and here,
I feel, is a fertile field of service for religious bodies) or take steps
to see that interests in community activities are promoted and
sustained.
At this juncture it cannot be over-emphasised that, in all cases,
a very great deal will depend upon the conduct of the first visit by
the local authority's representative and the subsequent accuracy
with which the needs of a particular case are assessed.
In considering this aspect of assessment there is an unmistakeable
need for some form of geriatric clinic attached, perhaps, to
a "day club' where members could leisurely discuss with a doctor
personal problems in relation to their environment. If necessary,
and with the concurrence and co-operation of the patient's own
physician, some degree of physical and maybe mental investigation
could be carried out over a suitable period to ascertain more
accurately his or her needs which could then be dealt with accordingly.
Benefits from the introduction of physiotherapy would be
two-fold. It would have the direct effect of helping old people to be
more active and would be a method of attracting them from their
homes and inducing them to enter some form of community life.
But, it is clearly not sufficient to organise out-patient clinics for the
aged in an effort to prevent invalidism or to provide specific
intensive treatment if, fundamentally, they are suffering from
malnutrition, inadequate amenities and unsatisfactory social conditions.
In such circumstances, the value of a precise initial assessment
becomes self-evident.