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Council, or perhaps by the Government through the Medical Research
Council. I believe such an institute, properly equipped and staffed
and maintained even at some considerable expense would be well worth
while, and might eventually save huge sums of money in medical and
social services in the long run.
Health Education
We need to extend our health education. First to medical
students in the universities, for it is generally admitted that
there is very little preventive medicine in the present day curriculum.
Second we must try to educate our medical colleagues who
may have had little opportunity of studying the problems of preventive
medicine in the aged. Finally we need to teach the general
public the principles of correct medical, social and economic welfare
for the elderly, so that many mistaken practices may be
avoided and better attitudes engendered.
Employment.
Many times have the men and women attending my clinic said they
wished they could continue their employment instead of having to
retire. Most of these people are perfectly capable of doing work
within their strength and ability. This is not the same as saying
that they should continue their previous work at the former speed,
pressure and wage; but it is possible to find work at a slower
rate, with less demand on brain and muscle, and yet having some
value, which will keep these people occupied and happy and provide
a certain amount of income. In Finsbury there is an experiment in
which elderly men and women are employed for two hours each day at
1s 6d. an hour on light industrial tasks in a workshop given over
specially to the needs of the elderly. This experiment has shown one
way of how to do it. I would like to see something similar started
in this Borough.
Case Finding
In the infant welfare and school health services we know where
to find our cases because we receive notifications of every birth
by law and we know what children are in the schools. But we cannot
say this of the elderly because for some reason unknown to me we
cannot get notifications from the Ministry of Pensions and National
Insurance. Our aim is the prevention of deterioration. The causes
are noti-necessarily only medical: there are difficulties over income,
housing, relatives, social relationships, habits and often
ignorance. This last maybe ignorance of the principles of healthy
living, but also of where to obtain the information of services
available. If we try to immitate the infant welfare services by
sending round health visitors to call on the elderly we must know
who and where they are and we need some sort of register system as
we have for children.
At present there is no organised system for determining the
progress of the deterioration in an elderly person. After each
illness trivial or severe, there is a residue of disability slowly
increasing. The burden of attention and nursing falls mainly on
the relatives. In time the stress can become very severe and almost
intolerable. This produces unhappiness in the home. Alternatively
old people living alone without supervision and attention
get to the stage where they cannot manage and break down. A system
of geriatric clinics could cater for the assessment of deterioration.
Each clinic could become the centre for receiving information
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