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173
ever the reasons, which are many and varied, the problem of our
elderly not only remains but is literally burgeoning.
An analysis of admissions to the acute wards of a large teaching
hospital during September of the current year revealed that 70%
were over the age of 60 years and 40% over 75. Furthermore, it
is well known that approximately 60% of all psychiatric beds in
this country's hospitals are occupied by persons over the age of 60.
It would be no exaggeration to say that over one half of all
hospital beds, which number almost 500,000, are occupied by those
of 60 years of age and over. Leaving aside the humane elements
of the problem, any reduction in this proportion, however small,
would bring enormous financial benefits and a release of vital
personnel and equipment.
Such an exposition, however, is far from disclosing the full
extent of the geriatric problem. In this country it is traditional
for medical treatment to be based on the self-reporting of illness,
a method known to be largely ineffective in the case of old people.
Investigations have shown that more than half of all disabling
conditions in elderly persons are unknown to their respective
doctors. Since 95% of all old people live and die at home, the
total amount of undisclosed disability must be substantial, much
of which, however, is preventable.
An appraisal of the preceding two paragraphs will establish
the inescapable fact that illness, although not the only problem,
is by far the most important in old age. Recently, a great deal
of attention, perhaps an inordinate amount, has been given to the
purely social aspects of the "elderly persons" situation but, no
matter how desirable this may be, it cannot solve their present
problems arising from ill-health. How, then, is improvement in
this field to be achieved?
Notwithstanding that, in this instance, there can never be a fully
satisfactory solution, nevertheless, apart from the practical effects
of relieving pain and suffering there are sound economic advantages
to be gained from adopting a more positive approach and
greater emphasis on preventive medicine. Unfortunately, preventive
medicine has a low rating in medical priorities and, in medical
training, only lip service seems to be paid to its importance. Its
application to the aged tends to be even more remote. In this
respect and vital though their contribution is, hospitals can hardly
be expected to improve upon existing efforts for not only are they
already working to capacity but the number of geriatric beds is
officially being reduced. Moreover, hospitals deal only with those
referred to them, namely, patients with overt diseases or persons