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required no further services from society but slightly more than
this wanted more financial security. About one third came into contact
with other people, apart from shopping, and the rest watched
television, read, wrote or rested. Because of the degree of immobility
most hobbies were those which could be carried out at
home.
Re-organisation
It is learned with regret and not a little trepidation that, under
the new Social Services Act, many of our services for the elderly,
so painstakingly built up over the past 25 years, are likely to be
placed in other and less experienced hands.
Our undoubted success in the past with the geriatric problem
in this Borough has been largely due to an insistence that initial
visiting be undertaken only by persons with a nursing qualification
and health visiting experience. In this way accurate assessment
of the physical and mental condition of the elderly is made at the
earliest possible moment namely, at the first visit, and the problems
of incapacity, disability, nutrition, insanitary conditions,
housing and other social circumstances are promptly and effectively
met. Regular visiting with efficient assessment is the essence
of prevention and the basic philosophy of our policy. Many difficulties,
previously considered insoluble in the case of aged
persons, have been tackled and solved by the patient application
of expertise and skills accumulated over a quarter of a century.
Because many of these skills are the products of years of empiricism
they are often indefinable but none the less essential in the
successful prosecution of a comprehensive geriatric service—they
are neither transferable nor capable of statistical analysis.
One other disturbing fact likely adversely to affect the situation
is the attempt to introduce bonus incentives in connection with
personal health services. What havoc will be wrought to our
elderly community if their baths, laundry service, chiropody treatment,
etc., are to be subjects not of our care, consideration and
attention to need but of pecuniary advantage? Is this not pursuing
management techniques to absurd, nay, destructive lengths?
Future Prospects
Our present geriatric services are directed towards practical
and material support with the declared intention of delaying the,
as yet, irreversible processes of ageing and maintaining our elderly
people more happily in their own homes so that, if or when,
hospitalisation becomes necessary, it will be of short duration. In
this connection, there is the closest of liaisons between this