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and local authority services.
In relation to this Department's services, such problems have
been minimised by its insistence on an accurate initial assessment by
a skilled geriatric visitor and by the appointment of Dr. Boyd, the
Consultant Geriatrician to St. Alfege's Hospital, as the Council's
Geriatric Adviser. Our relationships with the local hospitals' geriatric
services, already close and cordial, have thereby been further
improved and we are more nearly at the point when we can say we
have 'the right patient in the right bed'.
Our experience, locally, convinces us that the majority of the
elderly wish to remain independent in the familiar surroundings of
their own homes and our supportive services, therefore, are organised
and directed towards that end.
Admissions of the aged to hospitals or residential homes can
often be avoided, with consequent economic advantages, by better
nutrition. Indeed, a case could doubtless be made out for the
appointment to the department of a dietitian whose duties, inter alia,
would include nutritional advice to the elderly. Response to a
proper diet is often dramatic in elderly people and many an old
person with mental infirmity has made a remarkable recovery when
regular, balanced meals have been forthcoming. Support of this
principle is evident in the Department's 13 luncheon clubs and a
5-day per week 'meals-on-wheels' service with emergency arrangements
for weekends. Recipients of meals-on-wheels are carefully
selected for it is recognised that attendance at luncheon clubs has
not only a nutritional but a therapeutic value. The clubs entice the
elderly from their homes and, in doing so, maximum benefit is
derived from the effort of dressing and titivating and the energy,
both physical and mental, involved in mixing with others. In addition,
encouragement is given to our elderly citizens to make use of
the 55 old people's clubs and so avoid the devastating effects of
loneliness.
As yet, notification to the department by general practitioners
of elderly persons at risk is not obligatory but there is extremely
good liaison and regular contact with local doctors, officers of the
Ministry of Social Security, clergymen and other voluntary bodies
which enables our services to be brought to bear on many of the
day-to-day problems of elderly people. Our present combined
health and welfare department ensures the closest co-operation of
geriatric visitors with the district nurses and home helps which, with
appropriate use of the department's supportive services, not only
makes domestic life for the homebound a feasible proposition, but
reduces demand on the Council's residential accommodation.
The proportion in the population of residents over the age of
65 years is rising and with this increase comes the additional need
and demand for domiciliary services. Future planning and