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member of the chest clinic medical staff and general practitioner. The occupational
therapist of the London Borough of Brent also visits the hostel.
If their medical condition allows, residents are encouraged to find employment.
Care of the Elderly
The health department staff are experiencing some difficulty in placing old people
in need of residential care, who therefore have to be cared for by the domiciliary
services who at best can only give very short time cover. It is too early to evaluate hard
statistics in this context yet. The result may be that the old person is left alone for
many hours or days and certainly at night.
Most of these are the elderly people, who come between Scylla and Charybdis:
(A) They are not considered suitable for hospital admission because (1) they are
not infirm enough, or more likely (2) there is not a bed available for them.
(B) They are not considered suitable for a welfare home because they are not
sufficiently mobile.
Many of them are not willing to leave their own homes and their care therefore
falls on the family doctor in collaboration with the domiciliary services.
If nursing care is required, then the district nurse does invaluable work, often
outside her normal scope of duty.
Much more frequently the problem is the old person, living alone, often in untidy
circumstances, who needs someone to look in daily, to make a meal, to do the shopping,
the rudiments of cleaning and washing and even more important, to be someone to talk
to. Meals on Wheels are excellent, but they can only come twice a week. The home
help service is quite inadequate to deal with the demand. There are not nearly enough
home helps to go round. Conditions in the home may be so filthy, the house in such a
decrepit decorative state and the old person so cantankerous that, quite understandably,
it may be difficult to get a home help to go in to do the work. If the older person is
to be supported in the community then sufficiently adequate home help services should
be provided before conditions get too bad. In view of the national shortage of domestic
workers, then vocation training and monetary incentive is needed to make the job
worthwhile. (See page 43 —Home Help Service).
Loneliness, lack of social contact, with resultant deterioration in habits and health,
affects elderly people regardless of social class or income. There may be many cases not
known to the health department, so some system of notification of all people reaching
retiring age would be helpful. Immediate action would not necessarily be indicated,
but help should be forthcoming at the earliest realization of difficulties.
Old people who are cared for by relatives, or more particularly a single relative,
can be a tremendous burden. Theoretically, if they are mobile, then the welfare services
can arrange short term care, but accommodation is limited. If they need nursing care,
a small number have in the past in the Richmond and Barnes areas only, been taken
into hospital for a short term stay to enable relatives to have a holiday. This scheme
does not apply to the Twickenham area. There is clearly a need for this scheme to be
extended as and when possible.
Old people being discharged from hospital to adverse home circumstances could
be greatly helped by provision for purely social therapy, i.e. food, shelter, and buildingup.
While this short term rehabilitation is going on provision could be made to have
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