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6
would be wrong, however, to pursue this too far. Where there is
no competent relative or neighbour to give some care and attention
it is unreasonable or quite uneconomic to try and replace
institutional by domiciliary care of the bed fast patients. Such
patients living alone must either be left unattended for most of
the 24 hours or covered by paid help at a total cost exceeding
the rate in a suitable hostel or hospital. Continuous day and
night cover with home helps and sick room attendants costs over
£20 per week, and can be a temporary measure only while hospital
admission is obtained. The importance of keeping in close touch
with geriatric units allows admissions and discharges to be regulated
so that the best use is made of all facilities. A scheme
was drawn up to employ a home nurse (a S. E. A. N.) to ensure that
patients rehabilitated by the geriatric unit do not relapse to a
bed fast state on discharge from hospital. This is very likely
to happen without skilled supervision and constant encouragement.
Preparations were also made for establishing a small laundry service
to assist the Home Helps. Work with problem families continued
mainly as a responsibility of health visitors and selected
home helps and is covered under the section dealing with the
latter's duties. Home Help services were also extended to deal
with family care over longer hours than usual, where this would
prevent the admission of many children to children's Homes.
While thus mentioning some special aspects of the work of
the Department I would emphasise that other sections have been
equally active and on the whole it has been a busy year.
I welcome this opportunity to thank the members of the Committee
for their continued encouragement and mention with appreciation
the help given by other Departments of the Corporai-iAn,
and members and officers of the hospital and general ^pracoiifing
services.
My thanks are also due to members of my staff for their work
and help in the preparation of this report and I wish to pay
tribute to Mr. Rush, the officer chiefly concerned in its production,
who retires after 36 years service with the Department.
I am,
Yours faithfully,
S.L. WRIGHT,
Medical Officer of Health