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GERIATRIC SERVICES
The problems of the elderly in Haringey give increasing cause for anxiety. Owing to shortage of
staff the Health Visiting Service is barely able to cope with its commitments regarding young children,
and has great difficulty in fitting in visits to needy elderly people. Although well-equipped to
look after sick old people in their homes, district nurses are being forced more and more to engage
in preventive care, which although desirable in itself, is not the most effective way of using
already hard-pressed staff.
Organisation has been employed to a growing extent to compensate for the deficiencies in provision.
A Geriatric Co-ordinating Committee has been formed to deal more effectively with the problems
of old people in crisis situations, or on the verge of becoming so. Under the chairmanship of
the Deputy Medical Officer of Health, it includes in its membership the Superintendent Health
Visitor, the Supervisor of Home Nurses, the Deputy Chief Mental Welfare Officer and a representative
of the Welfare Department. This group has often proved successful in ameliorating the problems
of older people when an officer working alone might have found himself baffled.
"Problem" is perhaps the most appropriate word that could be applied to a high proportion of the
individuals who are discussed at its monthly meetings. Thirty-seven were referred during the
year, of which five went into homes and three into hospital. One died and no further action was
taken in the case of three.
Often living in squalor, under-nourished and in poor health, they have little insight into the gravity
of their positions and refuse most or all of the help offered. Often the best that can be done is
to maintain friendly contact until the old person recognises the truth himself. One hopes that
this will not come too late; but this Committee is reluctant to force any of them to do anything
against their will. People have a right to live their own lives, even if others may not approve
of the way they do it; and the fact has to be faced that even if the conditions are so filthy as to
seem repulsive to neighbours and relatives, such old people often manage to live lives which are
quite satisfying (to themselves if not to others) for many years. Only in the most extreme
circumstances would action be taken to remove an individual from home against his or her will.
This was considered necessary only once during the year, when, after months of fruitless persuasion
it was decided to recommend action under Section 47 of the National Assistance Act 1948, against
an old lady who was incontinent and living in indescribably filthy conditions. Members of the
Health Services Panel visited the premises and agreed that the Council should bring the matter
to court. However before this could be done the old lady had a fall and had to be admitted to
hospital, where she has remained since.
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