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8
The Geriatrician based at Kingston Hospital is responsible for
the care of the chronic sick who require admission to hospital. She has
the services of a Health Visitor who supervises those awaiting admission,
and is in a position to report on improvement or deterioration.
A number of chronic sick hospital beds are occupied by elderly
patients who have improved with treatment and who could be trans'
ferred to welfare accommodation if only places were available. Again,
the waiting list for admission is increasing, and although a desperate
case is invariably admitted quite quickly, other cases requiring admission
must often wait lengthy periods under very difficult conditions.
There is a group of elderly patients who form a very real prob'
lem. They are old people who suffer from increasing senile mental
degeneration. They are confused, often incontinent, unable to do
much for themselves, and not amenable to treatment. They are usually
ambulant and not suitable for a chronic sick hospital bed. Many
such patients occupy welfare accommodation, but generally they have
deteriorated since admission some years previously and it has not been
possible for them to be transferred elsewhere. The mental Hospitals
will not willingly admit such patients since they do not respond to
treatment, and also because these hospitals are suffering severly from
shortage of staff. There is an urgent need for special accommodation
for these patients. Every effort is made to provide assistance through
the domicilliary services. A very effective District Nursing Service is
maintained, but increasing difficulty is experienced in recruiting suitable
women to the Home Help Service since work in light industry is
more attractive and quite easy to obtain.
Much good work is done by the voluntary services, and full
support should be given to any proposed expansion.
National Assistance Act, 1948, Section 47.
National Assistance (Amendment) Act, 1951, Section l(1).
Perhaps one of the most difficult problems is how to deal with old
people who are living alone, neglecting themselves and their accommodation,
and who resent any interference. Every effort is made to
persuade them to accept the services available. When this is successful
the old person gradually begins to appreciate the help given, and often
begins to improve both physically and mentally.
Sometimes the old person refuses all offers of help, and is quite
unwilling to enter a Home or Hospital. In these cases it becomes
necessary to apply to the Court or to a Magistrate for an Order for
the Compulsory Removal of the patient to suitable accommodation.
Two such cases occurred during the year. The first was an old lady
aged 97 who lived alone in a house which was neglected and dilapidated.
She had had the gas supply disconnected, there was no power,
and she cooked on an open fire. She refused all assistance. In January