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179
Since 1965, usable geriatric beds in the Greenwich District Hospital
have been reduced from 207 to 179, the average number of
long-stay patients has increased from 115 to 147, and the number
of beds available for active use has declined from 92 to 32.
Besides being a reflection of present government policy which
is to reduce the number of geriatric beds in hospitals and to restrict
finance for local authority homes, this results in greater pressures
on the local authority and its supportive services. Whilst there
can be no objection to the aim of prolonging an elderly person's
independence it must be realised that the longer elderly people
are sustained in their own homes by supportive services, the greater
is their disability or incapacity when this becomes impossible.
Furthermore, if the provision of local authority homes is
repeatedly restricted then the more serious cases will become
"bed-blocking" patients in hospital and will restrict its ability to
act as a true "rehabilitation" unit. As a result and after a lapse
of time the local authority home will find itself becoming a
geriatric "hospital" with a substantial quota of bed-bound cases.
The advent of such a vicious circle will be brought much nearer
if, for economic reasons, domiciliary services and qualified staff
are not expanded in time to meet the coming "deluge". A welfare
authority home has no choice regarding its residents and is constrained
to take the recluse, the frailest and the most anti-social,
give them devoted service and weld the whole into a successful
establishment. We must see to it that the staffs of these homes
have our fullest support and confidence. However, their burden
is likely to be eased only by an efficient and enlightened domiciliary
geriatric service.
Waiting lists for welfare homes are already long and are likely
to get longer and the period between acceptance for admission
and the taking up of residence is becoming more prolonged. In
the meantime, the physical and/or mental condition of a prospective
resident is bound to deteriorate. Here, surely, is a situation
which demands a "day centre" scheme whereby, during the
interim period, the elderly could be kept from progressive
impairment and, in many instances, family harmony, often a
casualty in such a situation, would be restored.
In the main, admissions to welfare homes concern those living
alone for couples, no matter how old or frail, usually seem able
to support one another throughout all their infirmities. Because
future residents will tend to be older, more frail and vulnerable,
new homes will have to be designed accordingly, bearing in mind
also that two out of every three places will be filled by women and
some adjustments may be needed to provide for this eventuality.