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Total number of dentures 19
Number of treatment sessions 287
Geriatric Services
Dr. W.T. Orton
The Retirement Advice Clinics continued to perform within the confines of their very limited role, unable
through lack of staff to exert their supportive and preventive capabilities in the field, and used by only a small
minority of older people. An encouraging development at the end of the year, however, was the appointment of
the Borough's first two Geriatric Visitors, fully qualified nurses who devote the whole of their working time to
the promotion of the health of the elderly. It is intended that they shall take an increasingly important part in
the running of these clinics, where their knowledge of the home backgrounds of the clients will be of considerable
value.
Another important advance during the year was the formation of a co-ordinating committee attended by the
Consultant Geriatrician at St. Anns and North Middlesex Hospital, a senior medical social worker and representatives
of the Health and Social Service Departments. A general practitioner has recently joined the Committee and
invitations have been extended to two psychiatrists. The committee meets bi-monthly and discusses means of
using the resources of the various agencies concerned to the maximum advantage. It has proved a valuable means
of increasing mutual understanding of the problems encountered by each service and the extent of need. The
members have together studied ideas on the future pattern of health and social services and their co-ordination,
and are closely following the development of the role of the geriatric visitor as a link between home and
hospital.
As it seemed only right to give this committee the name of "Geriatric Co-ordinating Committee" it became
necessary to qive another title to the other committee which had been using it for some years. It was decided
to give it the description of "Committee for the Elderly at Risk", as being a more appropriate definition of its
function, which is to support and guide older people who are in a state of crisis or on the verge of it. Implied
in this is the committee's aim to increase the independence of the elderly individual by offering, through field
workers, services which she is willing to accept, and the determination to do everything possible to avoid
compulsory action.
The situation of an elderly person alone and in some danger is liable to evoke an emotional response from
outsiders. On the one hand we are told that we should intervene immediately and, ignoring the protests of the
individual, place her in a home or a hospital where she will be more secure. But the piece of legislation under
which we are required to perform this task-Section 47 of the National Assistance Act, 1948-sets out certain
criteria which must be satisfied, yet leaves them obscure enough to cause difficulties of interpretation in
individual cases. Occasionally we do it—though not in 1972, fortunately—and in such circumstances we
could perhaps be described by some as "bureaucrats", a term sometimes applied to those who are required by
society to carry out some unpleasant tasks which it would rather not know about. But perhaps it might be
worthwhile reminding them that the act of depriving a helpless old person of some of her liberty is not without
cost, emotional and spiritual, to those obliged to put it into effect; and no application is ever made to the
court without great heartsearching. On the other hand people may be horrified to find elderly people known
to us who are living in squalor or at possible risk from death by fire. But the problem.is that although we have
offered to remedy such situations, the old folk themselves may think that we are being fussy. It is a fact that
some not only tolerate but enjoy their squalor—and who are we to deprive them of their happiness? With
such cases we could no doubt fill all the available old people's homes several times over; and perhaps a case
could even be made for forcibly removing middle-aged and young people who live in equally dangerous
circumstances.
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