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30
The health department during the year continued to take a
detailed interest in the work for old people generally and remained in
the closest touch with the Lewisham Old People's Welfare Association
(LOPWA), which Association has offices in the department. LOPWA
is, so far as the borough council's work for old people's welfare is concerned,
the main body in the area and has affiliated to it the various
other bodies to which the Council makes grant. LOPWA is responsible
for the meals-on-wheels service to housebound old people.
The laundry service carried out by the borough council for the
small number of old people living at home whose infirmity is such as
to make them incontinent of urine or faeces was continued and
expanded during the year, over 41,000 articles being cleansed. The
service was highly appreciated; it can only be used, however, where
section 122 of the Public Health (London) Act applies.
Admission of old people not acutely ill to hospital or home
Prior to 1948 there was not much difficulty about the admission of
old people who were found to be in need of medical care to hospital or
Home, as even if it were difficult to obtain immediate admission to a
hospital the relieving officer in collaboration with the district medical
officer could arrange for the patient's admission. The offices of relieving
officer and district medical officer ceased to exist in 1948 and since then
it has, in many parts of the country, become more and more difficult to
obtain admission of old people requiring institutional care. Under the
National Health Service there has been a greater demand on hospital
accommodation and at the same time there has been a continuation of
the difficulty, through lack of personnel, of staffing hospital wards. For
one reason or another, more particularly perhaps because of the
increasing number of old people in the community, there has also been
a greater difficulty in getting suitable old people into Homes, and this
in spite of the fact that in London, at least, quite a number of smalltype
residential Homes have come into being.
The tendency for some years — and this perhaps has been
accelerated since the advent of the national health service — is for local
geriatric units to be formed in Hospital Management Committee areas.
The advantage of a geriatric unit is that it enables specialist help and
consideration to be given to the problems of old people, and one of the
better developments is that a greater number of old people can be taken
into hospital for short stay and then allowed to return home after they
themselves and perhaps their home conditions have been improved.
This part of the work is sometimes called rehabilitation. Apart from this
there are what are called " half-way houses," which are usually
administered by a voluntary organisation or a local welfare authority
and sometimes by the hospital authority direct, but even where the
administration is not with the hospital authority that authority pays
towards the maintenance of old people therein. These half-way houses
are primarily for old people who are not really ill enough to be admitted
to hospital, but are too ill or frail to be regarded as suitable for