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27
Frequent snap checks at unorthodox hours might lead to improved
conditions but are undesirable in other ways, and would create bad
relationships. Chief complaint, which comes too frequently and consistently
to be attributed to senile memory loss and the possible
unreliability of the evidence of old persons is about inadequate
meals. Indeed my views are not founded entirely upon reports as
several persons have been served with very unsuitable and meagre
meals while I have been visiting them. Last meal of the day at
4.30 p.m. and breakfast at 9 a.m. is not unusual. Unappetising food,
lacking in vitamin content, and unreasonable restriction of fluids
because of the problem of incontinence are common. Toilet facilities
lacking privacy are sometimes mentioned, and bed linen that is not
changed when rooms are re-allocated. Persons unable to get into a
bath unaided have spoken of not being offered assistance with their
toilet. Some homes have no lounge and the occupants live cloistered
lives in bed-sitting rooms, sometimes overlooking uncultivated
gardens where rubbish is dumped. Many have no visitors and never
see a newspaper or television. Charges average eight guineas
weekly. It is easy to offer excuses that old persons appetites are
small, that they do not like the sort of diet that is correct for their
needs and that they dislike each other's company. Of many this is
true, but in Local Authority Homes old people are successfully persuaded
to eat a suitable diet, and to use communal dining rooms and
lounges; and those who upon admission do so unwillingly become
quite happy after a short period of adjustment. Local Authorities
are also encouraging their residents to dress fully and to take a
pride in their appearance. In some Private Homes they sit about in
grubby dressing gowns with their hair unkempt and do not wear their
dentures, hearing aids and spectacles. Some, in fact, lack a necessary
appliance. A really interested Proprietor would look into these
needs but in some places the Proprietor is seldom seen, and does
not reside at the premises.
Of the total number of cases dealt with, 160 subsequently died,
95 in Hospiital and 65 at home. Many of these persons were very ill
indeed when referred and the reason for my being requested to see
them was that various services and general advice as to their care
were required. Loan of sick room equipment and laundry service was
arranged in most cases.
Of the 65 who died at home a few were listed for admission to
Hospital but in most cases the family preferred to nurse the old
person at home and the old person wished to remain there.
I spoke to a few organisations during the year as follows: —