View report page

PREVENTION OF ILLNESS, CARE
AND AFTER-CARE
Clinics for Older People
There are two clinics for older people. Dr. Joan Ferreira reports
on the clinic at Amity Grove as follows: —
Our main problem during the year was to meet the demand for
new appointments and to make provision for the patients who are
returning for re-examination and advice. It became necessary to hold a
second weekly session in November.
We try to carry out as thorough an examination as possible and
do certain screening tests. This is, however, only the basis.
We are not so much looking for disease as for health, and hope
that patients may achieve the maximum well-being of which they are
capable. At the same time we try to identify the more vulnerable and
to recognise their special needs. This is a new and mainly unexplored
field of work for the health visitor.
There are several quite important ways in which our patients
can be helped. Some are overweight and many do not realise that
ideas on diet must change as life progresses. Others are potentially
lonely and depressed and will become more so unless this is recognised
and treated appropriately. Some have chronic anxiety (this is not
surprising when one hears the traumatic childhood histories which
reflect the social and medical conditions of the beginning of the
century). Supportive therapy from interested and skilled health
visitors can be of great benefit.
Mild high tone deafness is common and may result in certain
difficulties in the patient which are misinterpreted by him and may
also lead him to appear to his family and friends as absent-minded,
impolite, or stupid. We are trying to develop methods of education of
the slightly hard of hearing to prevent the isolation which can ensue.
Many of the patients have osteo-arthritic symptoms which worry
them not so much because of the inconvenience and discomfort, but
because they fear a general worsening and ' seizing up '. The subject
can be discussed and put in perspective.
On the whole the obvious hazards to health seem to be the most
difficult to eliminate. We have a number of patients who continue to
smoke, despite the known risk of developing cancer of the lung,
chronic bronchitis and an aggravation of heart disease.
As people live longer it becomes more important to promote
health in the older age group. This type of clinic should ideally be
run in a group practice where the patient's main medical records are
available and where his own doctor, or another in the practice especially
interested in health education, can work with the health visitor.
Patients in this age group presenting in surgery with vague complaints
could then be studied further in the clinic, and it could cater for
those older members of the community who do not consider they have
particular symptoms, but would appreciate examination and advice.
47