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Dental inspections are carried out by the area dental officer, who attends the centre
monthly for this purpose. There are no facilities for treatment at the centre; patients
are advised and encouraged to consult their own dentist. Where a patient has no
dentist of his own, a local dentist has agreed to accept patients at his nearby surgery.
Ill-fitting dentures have been the main finding; many of the patients were found to
have been wearing the same set for fifteen years or more.
Treatment
Drugs, dressings, or injections ordered by the practitioner can be given by the
nursing staff at the centre.
A physiotherapist is employed for two mornings weekly, and at each session she
sees all patients who need physiotherapy. We knew that in providing physiotherapy
for this type of patient there was an inherent risk of producing physiotherapy addiction.
The patients eventually accepted that physiotherapy was not an indefinite process
but only a part of their general treatment given for a limited time. Apart from the
physical benefit of this form of treatment, it has certainly helped greatly to restore
the morale of the elderly arthritic, who was enabled to feel that something practical
could be, and was being, done to alleviate his disability. The physiotherapy equipment
at the centre includes two beds each equipped with a Balkan frame, an infra-red
lamp, a faradic battery, and a wax bath. A platform with three steps up and down and
a hand-rail, constructed in the department, has proved useful for re-education in
walking.
The occupational therapist attends for five sessions a week. The work includes
basket-work, embroidery, weaving, stool-seating, and leather work. Simple carpentry
is also available for the male patients, and a set of bookshelves has been made for
the centre's day room by the patients themselves. A specially designed gas cooker
has been obtained from the gas board at a nominal rent for rehabilitating the handicapped
in simple cooking.
A chiropodist is employed by the Association and attends for one session a month
at which all new patients are seen.
General Management
First place among the measures for general rehabilitation must be the companionship
provided both between the patients themselves and between patients and staff.
A midday meal is provided by the meals-on-wheels service, which in Ealing is
shared by the British Red Cross Society and Women's Voluntary Services. Meals
are brought to the centre already cooked and are served out in the centre's kitchen,
where any additional warming can be done. All meals are cooked without added
salt so that they are suitable for most cardiac patients, and in addition to the standard
meal a 1,200-calorie meal is supplied for patients who are on a reducing diet. Diabetic
diets can also be provided.
The centre is equipped with a 'Vogue Harmony' bath, which has been kindly
loaned by the British Bath Company (fig. 2). This is low and is equipped with a hoop
handle and hand rails. A swivel seat fixed into the floor at the side enables the patient
to be trained to get in himself by swinging his legs over the side and lowering himself
on to a plastic seat within the bath and thence into the bath itself. Experience with
different types of baths may lead to the development of a suitable standard type which
could be installed in council houses and easily adapted to the needs of old people.
The bathing is carried out by the nurses and, although time consuming, has proved
generally popular with the patients.
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