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SOCIAL SERVICES: HELP AND ATTENDANCE AT HOME AND MORE
The provision of and continuing attendance of a home help is probably the most important aspect of keeping a frail and/or mentally confused person at home. A more underrated service (except by the recipients) cannot be thought of. A home help's stated tasks are well known - cleaning, some washing, shopping and making light snacks. These tasks, together with the human contact they provide, mean that countless thousands of people have less lonely and more fulfilling lives. One indicator of their value is that in times of financial constraint or when their numbers are depleted by illness or holiday I have patients admitted to hospital because the lack of that service was the final straw - the home help was the only person keeping that individual from an institution.
Meals on wheels provide the elderly with one hot meal a day. In necessary cases this can be provided seven days a week, and most areas now cater for dietary needs as well as religious preferences. Some areas-charge for home helps, most charge for meals on wheels.
Day centers for the elderly (and often for the elderly mentally infirm) are run by social services and provide some of the benefits of both the meals on wheels service and home helps. A hot meal is provided as well as companionship. Many provide transport and arrange day outings as well as special events within the centre such as recreational, diversional and even medical and legal support. They can cope with some disabilities but not usually incontinence or disruptive behaviour. A long wait to attend is often due to transport difficulties and the most serious failure of all is that they rarely open at weekends, the most cruel time for isolated elderly people.
The problems of some elderly people are very complicated but, often only for a relatively short period of time (just after discharge from hospital, or after bereavement). Most districts now have a specialized group of people (sort of super home helps) trained to go into a person's home at a time of crisis, help them through it and then gradually withdraw. These can have various names - family aids, flying squad, etc. - but they are usually mobilized by social workers and only in especially difficult circumstances. They give a far more intensive input than can be provided by the usual statutory services.
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GENERAL HEALTH
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