Considering the Aged

Abstract

MANY institutions and many programs are feeling the pinch of greater and greater demands on their facilities by older people. At the Peter Bent Brigham Hospital in Boston, for example, 7 percent of the patients during 1913-18 were 61 years of age or older as compared with 20 percent for the 1938-43 period. At present, the ratio is well above 20 percent and may approach 30 percent. Unpublished records from the Massachusetts General Hospital in Boston, as another example, show that the average age for all medical admissions, excluding pediatrics, rose from 35 years in 1912 to 60 years in 1949. In the visiting nurse programs, too, the caseload has become increasingly weighted with older and chronically ill persons. Some estimate that approximately 50 percent of the visiting nurses' time is spent with these patients. In a rehabilitation clinic for the crippled and handicapped, my final example, the ratio of approximately 5 children to 1 adult a few years ago is now nearly reversed. It is not surprising, therefore, that anyone engaged in public health work or private medical care finds himself a practicing gerontologist. The public health practitioner, more than ever, must be prepared and willing to accept the new responsibilities imposed on him by an aging population and to find new ways of working with other professions concerned with the same problem. The seeds of chronic illness are planted early in life, perhaps before birth, necessitating a continuum of services throughout life, from infancy on, and not abruptly at the onset of old age, when chronic illness is most prevalent. The multiplicity of services and organized community efforts required by patients with chronic illness makes the health of older people everybody's business. To provide, effective community response to the increased importance of socioeconomic factors, the resources of many agencies and people need to be pooled. Of course, the demands of the chronically ill and aged are in competition with other insistent matters such as radiological health, air pollution control, accident prevention, and the traditional concerns of the community. Thus, consideration of the older person's needs must be balanced with the needs of all members of the community, regardless of age or status.