View report page

GERIATRICS
Dr. R. V. Boyd, Consultant Physician in Geriatrics, Greenwich District Hospital
(Dr. P. Meisner, Consultant Physician in Geriatrics, Lewisham
Hospital, was in the United States of America at the time of
compilation of this report.)
It is common knowledge that the population of the United Kingdom has increased
rapidly over the last hundred years, and the term "population explosion" has many
times been applied to this increase. What is not so often realised is that within the
general population explosion has been a disproportionate growth in the number of
elderly persons. A hundred years ago the population of England and Wales was
22,700,000 with 1,750,000 over-65's (4½%); in 1971 the population of England and
Wales was 48,600,000 with 6,350,000 over-65's (13%).
Not only is there this vast increase in the number of elderly but there have also
been complex changes in social structure and habits. The elderly are surprisingly
resilient, however, and only one in twenty of the over-65's lead an institutional
existence in hospital or old people's home, the vast majority continuing to live
in the community. It is highly important, both on humanitarian and on economic
grounds, that every effort be made to support the elderly so that they can remain
in the community. A large factor in attaining this end is the preservation of health,
by high social standards (including housing, food, clothing, heating, and social
contacts and personal interests) and early detection of illness so that permanent
disability can be prevented or minimised.
Concerning the early detection of illness, there are difficulties because the elderly
tend not to seek medical help but to accept limitations as being due to old age and,
therefore, untreatable. It is tragic when problems which are treatable are not
diagnosed, and sometimes gross disease is accepted as "old age" and left to become
irremediable. The speciality of geriatrics has shown that the ageing process itself
does not cause gross disability, and such symptoms as inability to walk, incontinence
and confusion are due to diseases—and many of these diseases are treatable.
In working with the elderly, one is impressed by the support that relatives and
neighbours give to the disabled elderly. It is commonplace to say that people
neglect their responsibilities to the elderly nowadays, but studies from different
parts of the country show that this, as a generalisation, is untrue. Rather the
opposite; those in contact with the elderly often give considerable help to an extent
that is remarkable. There are now many people concerned with helping the elderly
both in local authority departments and in the National Health Service, but where
many people are involved, co-ordination of services may be difficult to organise.
There is an awareness of possible overlapping of services (or of possible gaps);
liaison is already taking place, and it is to be hoped that co-operation will continue
and progress.
22