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Group B. Rising Systolic Pressure, Anaemia, Respiratory and Circulatory
Diseases:
Systolic blood pressure 160-199;
Haemoglobin 30-69;
Respiratory, heart, and arterial diseases.
Group C. Multiple Disabilities, Rising Diastolic Pressure, and Obesity:
Three or four diseases;
Diastolic blood pressure 100-109;
Obesity.
Group D. Malignant Hypertension:
Diastolic blood pressure 120-159;
Systolic blood pressure 220-299.
Groups A and B are related to systolic blood pressure; Groups C and D to
diastolic blood pressure. It is possible that dietary deficiencies may be the cause
of some of the disabilities in Groups B and C.
We cannot but be impressed with the need for preventive services when
we see the vast amount of disability which results when nine out of 10 of these
elderly people have something wrong with them. As always the first requisite
is ascertainment. I believe we need clinics for the elderly just as we do for
babies, where they can be medically examined, their disabilities ascertained,
incipient diseases put under control and deficiencies corrected. In these clinics
watch would be kept for signs of anaemia, so common with the dietary deficiencies;
and for the excessive weight which some women tend to put on after
middle life through disregard of well known dietary principles; the clinic
would provide education in weight control. For those who could not afford
private chiropody, the clinic, in co-operation with the voluntary organisations,
could provide it. When the patient had some disease or disability needing
treatment he would be referred to his practitioner who would deal with that
aspect of it.
The great lesson of the baby clinics is the importance of education in
parentcraft for mothers who, for the most part, are exceedingly ignorant of
the principles of child health through not having been taught them. The
same applies to the elderly, the reason most of them are disabled in one way
or another is through ignorance of the principles of healthy living. The clinics
would keep them on the right lines. The greatest difficulty amongst so many
of them seems to be the inability to provide themselves with an adequate diet
rich in protein, minerals and vitamins. We ought to determine the best diets
for the elderly and then by education encourage old people to feed themselves
properly. It is essential that they should know the importance of proper food
and how to cook it. For those who cannot get about, the meals on wheels service
should be extended.
I should not be surprised if the clinics for elderly people would be a sound
economic proposition. If they kept the elderly healthy and prevented the
deterioration which becomes such a burden to relatives, prevented many of
them having to go to hospital and kept them fit and working, then in the
long run we should have provided the country with many more useful working
lives and have saved a great deal of misery and preventable nursing and the
time and energy of the many relatives who have to look after them.
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