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wise require admission to a long stay bed. The atmosphere is friendly and optimistic,
and we are fortunate in having voluntary workers who entertain the patients regularly
at two social afternoons per week.
The incidence of physical diseases is high, and again we get much assistance from
our general medical and geriatric colleagues at St. Andrew's Hospital.
The Outpatient Clinic for Psychogeriatric Patients has increased its activity during
the year. Both new referrals and follow-up appointments have been more than in 1965.
In addition, the amount of domiciliary work, has increased steadily. Both aspects of outpatient
work present problems of organisation. The most obvious feature of psychogeriatric
referrals is the urgency with which an opinion is requested, and this often places
great demands on the service. In the out-patient clinic the demand for appointments
often fluctuates markedly, and the clinic is difficult to organise as patients arriving
by ambulance are often latei. The time required for the assessment of a new patient varies
more than that required for younger patients.
Domiciliary consultations are rightly regarded as a very valuable part of the service,
but they are time consuming, and often have to be done late at night. It may be difficult
to find time for an urgent domiciliary visit as I am only available in East London three
days a week. This only emphasizes the geographical difficulties of psychogeriatric care
at St. Clement's. Relatives have to travel 20 miles to visit long stay patients at Long
Grove Hospital, Epsom. It is difficult to run an efficient community service 20 miles
across London, and I would like to reiterate the need for more local long stay beds for
old people as a matter of priority.
I would like to thank all those who have been involved in this work, for their
contribution to the welfare of the elderly of the East End.
STATISTICS
Statistics relating to the Mental Health Services appear on pages 113 - 115.
52.