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172
GERIATRIC SERVICES
In 1870, those persons in England and Wales aged 65 and over
numbered slightly more than one million, equivalent to 4½ of the
then enumerated inhabitants. If to today's figure of 6½ millions
(13%) one adds those women 60 to 64 years, this combined total
of approximately 8 millions represents 16% of the existing population
of England and Wales.
Making due allowance for those persons receiving full time
education and for those married women who remain primarily
housewives, we are left with a working population of some 23
millions to provide all the resources for the remainder. These
amount to 26 millions of whom one-third are of retirement age—
not an inconsiderable responsibility. Aggravating the problem is
the fact that improvements in medical care and environmental
conditions over recent years have enhanced the chances of people
reaching retirement age and beyond. Moreover, there has been a
decline in the size of the "producing" groups, a trend which is not
likely to be reversed until the final decade of this century. Furthermore,
even at the present time in this country, there are countless
elderly people suffering from loneliness among the 1½ million old
persons who live alone, over 300,000 of whom are subject to conditions
so appalling that it is estimated that 90,000 die every year
from the cold. All of which adds up to a serious "elderly persons"
situation which will almost certainly prove to be the biggest and
probably the most important of all the social problems to be met
by the nation during the next 20 years.
Some 25 years ago, a new branch of medicine was established
which, by accurate diagnosis and active methods of treatment, was
to revolutionise the care of our aged and infirm. It was called
"geriatrics". Whilst it cannot be denied that, nationally, some
improvements have been seen, the high hopes previously entertained
for this specialised service have not been realised. Indeed,
today, the term "geriatric" is often used pejoratively to indicate
inadequate care and less than satisfactory medical attention. Why
should this be so? Perhaps it is the sheer size of the problem and
its financial implications in a period when cost effectiveness has
become of paramount importance. Or maybe that, as the chances
of complete recovery are heavily weighted against the aged, this
becomes such a disincentive to the medical and nursing professions
as to leave the geriatric branch of medicine seriously understaffed.
Again, it may well be that, as a nation, we prefer to
allocate a greater proportion of our resources to the more glamorous
advances in therapeutics such as transplantations, etc.