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as a service exclusively for the elderly and we must avoid this attitude, but we must not
shut our eyes to the fact that a high proportion of cases which the home help deals with
will be elderly chronic sick, 76% as I have said were those dealt with in 1960.
I am influenced in my approach to the problem of the elderly in my own experience
in a clinic which I have been running since 1957 where I attempt to keep the elderly
as fit as possible and make them as independent as possible. It is very difficult
to attempt to separate out the various factors in the health of the elderly but I like to look
on them as divisible into physical and mental and into direct and indirect factors. The
terms physical and mental are self explanatory, direct and indirect are not so obvious.
By direct I mean medical as such, and by indirect those which are outside the scope of
direct medical treatment, such as the relief of loneliness in the prevention of deterioration.
One of the first things which springs to mind in the physical field as an indirect
factor is the provision of adequate food; this can of course both prevent and cure illness
and the film strip which I will show later on is one we made in Dagenham to illustrate
the effects of wrong feeding on the health of the elderly, and in it you will see the home
help providing a good meal for the old lady, and thereby preventing deficiencies due to
wrong feeding.
The direct effect of the home help on the person's health can be illustrated by the
picture I will show you where the home help is seen administering the medicine to a
patient. This she does at the request and under the supervision of the home nurse, another
one will be seen putting drops in the patient's eyes and this she does again at the instigation
and under the instruction of the home nurse. These have a direct effect on the
physical health of the patient, the drops cure the eyes, the medicine to cure the cough,
and certainly many a home help bandages an old lady's leg if a bandage has come undone
and is needed for the treatment of an ulcer of leg, and this would be direct in its effects
on the patient's health.
On the mental side of the old person's make up, the home help can exert indirect
effects by her mere presence which may, and in fact does, in so many cases, prevent loneliness.
How many of us have heard or perhaps how many of us have not heard, the
stories of the old people who suggest to their home help that she should not bother about
doing the work but sit down and have a cosy chat and a cup of tea; and which of us
can say that a cosy chat, and particularly a listen, what one has heard called therapeutic
listening, is not as effective a therapeutic weapon as anything any psychiatrist ever
achieved. How many of us can say that this is not more valuable to the patient than a
scrupulously clean household ? This, of course, is not to suggest, and I dare not suggest
in front of an audience of this type, that I would encourage the home helps not to do the
cleaning in a household, but it is to suggest that this is a point of view worth taking into
account.
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