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Priority is given to applications for help in the following order:
(i) Maternity cases.
(ii) Cases of acute or chronic illness.
(iii) Aged, infirm or blind persons.
(iv) Households where there is a mentally subnormal person or a large number of
children under compulsory school-leaving age.
The majority of requests for assistance come from general practitioners and hospital
almoners.
Patients' relatives who give up paid employment to look after them are allowed, in exceptional
circumstances and at the divisional medical officer's discretion, to act as home
helps if an official home help cannot be provided. They are paid for this service in accordance
with the home help organiser's assessment of the needs of the case. This arrangement
can be particularly useful when the patient is tuberculous and it is difficult to obtain a
volunteer from the ordinary staff to work in the household.
Old people—The great majority of the cases provided with home help are the aged and
chronic sick (83 per cent. in 1959). Many of these old people require simply a helping hand
to enable them to maintain their independence but others are in the care of a doctor and
perhaps a home nurse.
In some cases failing physical and mental powers may create a more difficult situation,
as they have done with Miss P., an old lady living in the basement of a four-storied building,
formerly the family house but now empty and dilapidated. A borough council health
inspector appealed to the home help service to see whether anything could be done for
Miss P. who, it had been suggested, might have to be removed under a court order. Miss P.
was visited and her home found to be covered in cobwebs and littered with accumulated
rubbish. She was sleeping in an old armchair because her bed had two mattresses on it and
she could not climb up. After some persuasion she consented to accept some help. It has
not, unfortunately, been possible to break the hoarding habits of the old lady, who is
adamant in refusing to throw away any article however old and dirty and useless; every
empty tin and bottle is retained and she even manages to collect other rubbish, going out
with a push-chair to collect the discarded ashes from a local school. She is a pleasant old
soul, however, determined to stay in her own home and is causing no nuisance to anyone.
Although little visible progress has been made, her bed has been adapted for use and she
now occupies it on most nights, and she looks forward to the visits of the home help who
comes three times each week to do the little sweeping and tidying which Miss P. will permit
her to carry out.
Tuberculous cases—Home helps who attend tuberculous patients have all been Mantoux
tested and X-rayed before being allowed to take on the work, and a regular X-ray check
is maintained thereafter. In addition to these precautions a special leaflet is issued to
home helps working with tuberculous patients advising them on cleaning and ventilation,
laundering the patient's linen and other points which can eliminate any unnecessary risk
of infection.
Uniform and protective clothing—Home helps do not wear uniform but they are provided
with cotton floral overalls for wear when doing housework on duty; the home helps who
appear in the photographs facing page 68 are wearing these. Hand-towels are also issued and
rubber gloves and aprons can be supplied on loan where necessary. Stocks of cleaning
materials and household utensils are kept at home help offices for use where proper
equipment is not available in the patient's home.
Specialised services
Although specialised services are needed in only a small proportion of the total
households helped, the part played by these services in ensuring that individual needs are
met makes them indispensable if a complete home help service is to be provided for those
in need in the community as a whole.
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