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tives who were very indignant that such arrangements could not be
entirely free of cost. Some happy solution was found in each case.
Thirty-six families appealed for advice because of difficulty
in coping with the care of an old person, usually a parent, but in a
few instances an Aunt or Uncle, in one a sister, and in another a
cousin, sharing their home or living alone elsewhere. Senility of
varying degrees was the cause of the problem in most of these
families. Some old active persons were a public nuisance and this
reflected upon the family as a whole; sometimes it led to friction
with neighbours and tradespeople. More than one old person was
taking regular outings on public transport failing to pay the appropriate
fare, being found in trains or buses at termini and being put
in the care of the Police or being escorted home by transport personnel.
Some ordered unwanted goods from local stores; others cancelled
orders for essentials such as bread, milk and fuel. They could
neither be trusted to go out alone, nor to remain alone in the house.
I was able to arrange voluntary help in the way of supervision for
some; I asked leaders of Old Age Pensioners Clubs to accept some
as members, and to arrange escort by other members to and from
meetings and on outings. Some were among those referred to the
Essex County Council Area Welfare Officers and some 1 discussed
with their Doctors. Of the latter, drugs were then prescribed for some,
and a degree of relief resulted. Others were referred by the Doctors
to Goodmayes Hospital and a few admitted. Some were sent into
Private Homes and settled down. Many of these persons were in the
65 — 75 age group. Yet of about 40 persons of 90 years and over
seen by me during the year only 2 or 3 were suffering from a degree
of senile dementia and about 50% were very alert indeed.
The average age of the persons with whom I am involved rises
yearly and is certainly over 80 years. Many are very brave and witty
despite physical disabilities and most of the home visiting is
pleasurable.
The close liaison with the Geriatric Unit, Chadwell Heath
Hospital continued. I visit the unit once weekly and interview
patients with Dr. Dunn. We discuss their medical and social problems;
decide what, if any, services and equipment they will need
at home. What difficulties can be anticipated and how they might be
overcome. When the discharge date is fixed I next go into action by
telephone or in person as the link between the patient and the
Organisers of the various domiciliary services. Within a week to
ten days of discharge, or earlier if the patient lives entirely alone,
I visit to assess the success or otherwise of the arrangements and
to advise generally. I then send a written report to Dr. Dunn. If
there is a relapse in health or some unforeseen problem I contact