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to share a bed with the patient and to take him along with them
wherever they go because it is unsafe to leave him alone even for a
few minutes. If they have no one with whom to leave him their responsibility
is never laid aside and they have no relaxation.
Then too the nurse is not emotionally involved with the patient
as is a wife, husband or offspring. The broken crotchety old man the
wife must watch over may be the former athlete, brilliant scholar,
successful business man and considerate spouse. She must bear the
sadness of comparison between what he is now and what he once was;
she may even be constantly asking herself if she is to blame for his
deterioration. Friends may cease visiting the house because he is a
bore to them, and neighbours complain because he does something
which annoys them.
To the nurse he is just one of a succession of senile old men
whom she has attended; she may not know which were the scholars
or which the illiterate, which the kind and thoughtful, which the
selfish bully. Senility tends to have a levelling effect and to bring
about a pathetic similarity. Bearing this in mind, is it reasonable to
expect a close relative to be able to care for the mentally confused
or senile, with the same detached calm and the same firmness that a
nurse can bring to bear? Yet Doctors and nurses sometimes remark
"He gave no trouble during his stay in Hospital. I cannot understand
why his family cannot manage him at home."
Forty relatives contacted me to say "I cannot cope". Sometimes
the patients were chronic sick who needed lifting, others were
both sick and senile, and caused both physical and emotional strain.
A few were physically fit but mentally confused. These could not be
trusted with gas taps, matches, drugs etc. and were a source of
unceasing anxiety. Advice was given about re-organising the family
life or the allocation of rooms, to ease the problem. Appeals were
made to members of large families who were allowing an unfair share
of the burden to fall upon one member; home safety measures were
suggested such as the fitting of safety taps to gas cookers; and
introductions made to some person willing to spend an evening with
the patient to allow the family to have some recreation. Several were
referred to the Ilford Social Service Association for provision of a
Day Attendant. Others were referred to the Domestic Help Organiser
for some assistance with the housework, or for a Night Attendant to
provide a temporary respite from nights broken by a restless patient.
A few had never consulted a Doctor about the problem and were
referred to their G.Ps. with the outcome that a sedative or some other
medicine brought relief to both patient and relative. There were a