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Reports to Practitioners
If the general practitioner has not visited his patient during the first two weeks,
a preliminary report on the investigations and treatment is sent to him. This enables
him either to visit the centre or to give instructions over the telephone about the
further management of the patient. If the practitioner is visiting the centre and supervising
treatment, then this report is of course unnecessary.
As soon as possible after the patient has been discharged the practitioner is sent
a summary of the patient's investigations and treatment.
Discharge
It was originally planned that patients should attend daily for up to a month;
but after the opening of the centre some patients were allowed to stay longer, and it
became apparent that this longer stay was often more appropriate to their needs.
At present therefore the average length of stay is about two months, which allows
a reasonable time for the completion of investigations and treatment.
The possibility of readmission at the request of the patient's own doctor was taken
into account when the centre was planned, and this has been done with four patients.
This possibility is always mentioned at the time of discharge in order that the patient
should not feel that interest in him ceases when he leaves the centre. Before a patient
leaves, the opportunity is always taken to discuss his needs at home and to ensure
that, if they are required, the various services provided by the local authority are
made available to him. These particularly include the meals-on-wheels service, the
provision of a home help, assessment of suitability for work-centre employment, and
contact with social clubs.
Follow-up
The health visitor in whose area the patient lives is told of his discharge and is
given all relevant information, and arranges to visit within a week. There is a great
need for follow-up after leaving a centre of this sort if the improvement achieved is
to be maintained. But, owing to the shortage of health visitors a permanent regular
visiting service is not feasible, and the ideal system—namely, that the general practitioner
who initially referred his patient to the centre should be responsible for the
follow-up—may prove difficult by reason of insufficient time for frequent follow-up
visits.
Benefits
Experience has shown over the year that comparatively simple measures may
produce a great deal of benefit. For example, the provision of a hearing-aid or
reading-glasses can make a pronounced difference to patients' lives when they return
home, merely by enabling them to hear the wireless again and to read without strain.
Such is the apathy of many old people that unless there is an organisation of this sort
to take the initiative they themselves tend to accept their disabilities and the restriction
that these entail.
All those who work with old people know how appreciative they are of congenial
companionship, how quickly they become acclimatised to social life, and how grateful
—sometimes absurdly so—they are that someone is taking an interest in them.
Discussion
As the centre was not running to capacity during the early months it is difficult to
estimate the cost per head during the first year. We hope that during the second
year the cost of keeping a patient in the centre will be about £4 10s. a week.
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