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visitors and, with the Council's long-standing schemes for mealson-wheels,
luncheon clubs and cheap food supplements, the
numbers now at risk are minimal.
There is, however, one aspect of modern life which is developing
to the nutritional disadvantage of the older and one-person
household. It is the growth of the supermarket. Unlike the small
shopkeepers, these emporiums are not geared to cater for the
smaller quantities of comestibles needed or that come within the
budget of the retired person. Whilst such a situation persists it
would seem reasonable for small groups of elderly people to combine
to buy the larger packetings for eventual division, in order to
produce a more varied and economical diet for the participants.
Enquiries into conditions such as malnutrition and hypothermia
in the aged open up a much larger field for investigation. There
is growing concern about the need to assess physical and mental
disability in the elderly and to diagnose and treat the underlying
disease processes. Recent events have shown that there is a
clamant need for medical, paramedical and nursing personnel to
be trained in modern geriatric practice. With the growing numbers
of elderly persons the serious shortages of staff in this field
become even more evident and this has a crippling effect upon
the rehabilitation of the older citizen whose ability for improvement
seems sadly under-rated. Whenever staff is in short supply
the geriatric services are among the first to suffer but appointing
more social rather than health workers will not retrieve the
situation. It is at this point that a genuine divergence of opinion
arises.
A recent Office of Population survey has indicated that some
70% of the handicapped of Great Britain are elderly. Perhaps, in
this revelation, the Social Services see grounds for augmenting
their establishments but, logically, theirs is not the prime problem.
Clearly, prevention or rehabilitation is the first priority and only
after these avenues have been fully explored to produce the maximum
improvement does the need for the social aspect become
paramount. No one doubts but that the social and health services
are facets of the same endeavour to improve the quality of life.
However, successful prevention depends upon surveillance of the
whole field at risk and not upon a restricted and narrow prospect.
It was this "all-embracing" concept that led to the introduction in
Greenwich of the geriatric visitors who, inter alia, are qualified
health visitors.
During the early 1950s, when first contemplating the need for a
geriatric service, "the Council, after considerable deliberation, came
to the conclusion that a specialist health visitor was the best