Report of the Commissioner of Public Health / Western Australia.

  • Western Australia. Public Health Department.
Date:
[1961]
Catalogue details

Licence: Public Domain Mark

Credit: Report of the Commissioner of Public Health / Western Australia. Source: Wellcome Collection.

    16/94 (page 14)
    of old people’s settlements which includes old people’s homes for the able-bodied, homes for the frail and hospitals for the sick and bedridden. This system involves the isolation of the aged into cantonments apart from the general population. It is an expensive method of dealing with the problem, it can never meet the whole problem and it tends to make old people still more introverted and withdrawn from general community activities and from playing their part in the general social structure. The British method with accent on shared responsibility puts the main responsibility for the care of the aged on the family but gives the family and the family doctor extensive assistance to carry out this function in the way of health visitors, day hospitals and a guarantee of a hospital bed for specific periods to meet the convenience of the family. There is, of course, both in Britain and the Continent an intermingling of both systems and that undoubtedly is the manner in which the problem must be tackled. The extent to which Shared Responsibility or Old Age Cantonments is developed and intermingled will depend on the size of the problem, the money available and the willingness of the family to share the problem. It is often said that the social structure of Australia is not very suitable for the care of the aged in the family and that Australian families desire to get rid of their responsibility in this matter. This, however, need not be true where a proper system of shared responsibility has been introduced and there is every indication that Australian families can carry this responsibility if given the proper support from an organised system. Method.—Social centres for the still healthy old people. Social workers or health visitors to keep in contact with elderly persons living alone to see that they avail themselves of the resources the community provides and that unnecessary deterioration does not take place. Assessment and treatment facilities in the form of out-patient and in-patient units in major general hospitals. Rehabilitation units, physical, mental and social, attached to major general hospitals. Day hospitals attached to or working in co-operation with major general hospitals to assist in early discharge from hospital and to maintain treatment. Day hospitals also play a part in Shared Responsibility by taking the patient out of the family during a considerable part of the day. Geriatric hospital beds for non-rehabilitable cases, long stay cases and for periodic use in the system of Shared Responsibility. Sufficient beds of this type are probably already in existence in Western Australia. A system of contact between hospital and home, involving health visitors, domiciliary nurses, home helps, meals on wheels, etc. A transport system between the home and day hospital. As geriatrics requires the co-operation of many specialties and involves not only the physical and mental assessment and treatment of the patient but also the investigation of his social background and the remedy of defects therein, it stands to reason that the full investigation and treatment of geriatric patients is a time-consuming and specialised task for which most medical practitioners have insufficient time. Practised as a specialty, it is time-consuming and with little financial reward. It is therefore clear that a co-ordinated geriatric service can only be successful if at the specialist clinical level it is developed and controlled by salaried medical practitioners having suitable qualifications in this field and an enthusiasm which amounts to dedication for this type of work. Such specialists in charge of geriatric departments in General Hospitals are in a position to supply the family doctor with the assistance he requires in the diagnosis and care of his elderly patients. W. S. DAVIDSON. Table 1 BEDS OCCUPIED IN METROPOLITAN AREA BY AGED (70 YEARS AND OVER) Metropolitan Public General Homes for Aged (Beds occupied per 1,000) “ C” Class Population (Hospital Beds Hospital (Beds Total (70 and over, occupied occupied (per 1,000) in 1,000’s) per 1,000) per 1,000) Male. 8-8 12-8 61 39 112-8 Female 14-8 8-9 67 64 129-9