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Mental Health Aspect
As the numbers of old persons in the community continues to
expand so inevitably the proportion of cases of senile mental
disorder will increase.
This condition which responds poorly to present forms of treatment
starts with a gradual deterioration of personal standards and
confused and forgetful behaviour. The course of the disease is
progressive. There is a tendency for persons with this disease to
wander about often travelling long distances from home, where
they can get lost and stranded and may not remember where they
live when eventually rescued by the Police. Such persons particularly
when living alone may become the object of derision and
persecution by thoughtless children because of deterioration in
personal hygiene, a tendency to bizarre attire and eccentric
behaviour. Eventually they need constant supervision and care
which may only be obtained by certification, a step always reluctantly
undertaken, but often necessary on account of the degree
of mental derangement present. Such patients cannot be expected
to co-operate in arrangements for their care and their consent to
attempts to gain admission to an institution voluntarily often
cannot be obtained. Because of their age certification is resorted
to only in the last resort, and in fact the tendency often is to postpone
this step until it can no longer be resisted. It is during the
period, often lengthy, between the development of symptoms, but
before compulsory admission to an institution is felt justifiable or
secured that the patients intractable habits can cause much distress
to their families and friends and when living alone, concern to our
staff.
The special homes in residential areas envisaged by the Mental
Health Act 1959 might well cater for this type of patient when they
become available, and so avoid mental hospital admission for a
common terminal illness of old age.
Discharge from Hospital
Information about the discharge or imminent discharge from
hospital of patients who are likely to need Local Authority Services,
e.g., Home Nursing, Domestic Help, Sick Room Equipment, etc.
should be given to the Medical Officer of Health of the area in which
the patient resides. There are sometimes social obstacles to be overcome
before a patient can be properly looked after at home.
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