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178
GERIATRIC SERVICES
How old is old?
Although at the beginning of the century the average man could
be expected to live to 50 years of age it would seem that life
expectancy for today's child may well be 80 and perhaps 90
years. Indeed, many gerontologists feel that a life span of 100
years is within sight.
What is it, then, that ages people? If any single process is
responsible for ageing, science has yet to learn of it. Certainly
heredity plays an important part and, without doubt, metabolism
is influenced by environment, but how long a body can endure
when not subject to illness or mishap is still obscure.
Experts are agreed that life can retain its vigour to quite
advanced ages and as still more diseases become controlled and
more is learned about the ageing process so will man approach
closer to his theoretical life span without major physical and
mental debilitation.
Why do not more people reach the century mark? Undoubtedly
a great deal depends upon the following of a sensible diet, proper
exercise, rest and recreation and the avoidance of excesses but it
is evident that deterioration of the body and its functions is due
not so much to age but to the results of disease or accident. It
is with these aspects that the local authority is more intimately
concerned.
Promotion of health and the prevention of disability are the
logical approaches to a problem which is clearly going to grow
and become more difficult of solution. Unfortunately, bad habits
acquired in early life persist into old age and are difficult to
break and. furthermore, although a doctor can bring all his skills
and training to bear on a patient's behalf this can occur only if
the patient makes the first approach for only he can decide how
ill he really is. There is ample evidence that more than half of
all disabilities occurring in elderly persons are unknown to their
general practitioners because of this system of "self-reporting".
How, then, is the hidden disability in the elderly to be revealed
and countered? By far the most effective method is regular
"preventive" visiting by suitably qualified visitors, a practice
which has always been actively pursued by this department.
Regrettably, with increasing numbers of elderly, shortage of suitably
qualified staff and the present financial stringency this type
of visiting is having to give preference to urgent and emergency
cases which merely amounts to a "holding" exercise while the real
problem continues and becomes exacerbated.