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Then as far as direct effects in mental illness are concerned many cases of senile
dementia in the elderly tend to become worse because the patient loses touch with
reality, and contact with the outside world and tends to become forgetful and absent
minded and may need hospitalisation if this becomes too severe. The home help can
help enormously by talking and listening to the patient, and thus helping to keep her in
touch with reality and in contact with every day affairs, she can also help by overlooking
shortcomings including those little difficulties which come from extreme forgetfulness
from which the senile dement so often suffers.
b) Maternity
Next I would like to consider the maternity cases. This occupies 11% of cases.
The demand for this service has reduced slightly. The object of a pregnancy is to
produce a healthy infant. The pregnancy itself, though we tend to talk about it as a
normal physiological process, produces physical and mental stresses on the mother to a
variable extent. It is by relieving the mother of the physical burden of housework and
lessening her problems of domestic worries that the home help can be of invaluable
assistance, and her influence may well effect the outcome of the pregnancy. The toxaemias
of pregnancy are examples of a medical condition where the home help can be
invaluable; the toxaemia may be mild or severe, and the home help can help to secure for
the mother, if she is a mild case, and is considered not to be in need of hospital care,
that essential rest which is very important in the recovery of the toxaemic case. If on
the other hand, the mother has to go into hospital, the home help can, by being there
in the home to look after the needs of the rest of the family, alleviate a good deal of mental
worry on the part of the mother.
Other complications of pregnancy such as heart disease bring their problems and
in the case of heart disease or heart failure in pregnancy the home help service may make
all the difference between recovery and invalidism. When early discharge from hospital
after a normal confinement takes place, as it is beginning to do in some cases on the third
or fourth day, the part played by the home help may be absolutely vital.
c) Tuberculosis
I do not propose to say anything about tuberculosis because as far as we are concerned
this is a lessening need, although the home helps still make a valuable contribution
in these cases.
d) Other (i) mentally sick and mentally sub-normal
I would like to say something about the mentally sick and the mentally sub-normal
because I think this is something of importance for the future of the service in Great
Britain. The value of the home help is almost inestimable in this particular field, it
can be so important that it can make all the difference between recovery and deterioration.
We believe that mental illness is a result of environmental and hereditary factors, possibly
more environmental than hereditary, and that on the environmental side we get both
physical and mental factors coming into play. The extent and degree of mental
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