ELDERLY PEOPLE

Otago Daily Times, Issue 26917, 1 November 1948, Page 6

ELDERLY PEOPLE

NUMBERS INCREASING SPECIAL REQUIREMENTS INFLUENCE ON MEDICAL PROFESSION Special Correspondent WELLINGTON. Oct. 31. More than one in eight of New Zealand's population is over the age of 60, and probably one in every five electors is 60 or more. A , , ■ These figures are quoted as the basis of a paper on old people in New Zealand. their medical and social requirements and their part in the structure of New Zealand society, written by Mr Mr Harold Palmer, of the Department of Psychiatry,* Dunedin Hospital and Otago Medical School, and published in the New Zealand Medical Journal. Western civilisation has produced conditions , favouring survival into old age to the extent that in New Zealand old people now constitute 14 per cent, of the population—probably the highest figure in the world, Mr Palmer says. The family is no longer considered to be an. efficient biological unit, and this is tacitly admitted by most modern States. As a consequence, old age is now subsidised, and community existence is dependent on the younger people who constitute 60 per cent, of the population. The practice of medicine is now influenced in a critical manner, says Mr Palmer, by the adsorption of medical set-ups up to as much as 45 per cent, by the care of old people. The care of old people has therefore become a compelling study. Here are some of the chief points Mr Palmer makes in an extensive survey of the subject:— 1 In 1944 old people (over the age of 60) constituted 13.6 of New Zealand's population, and by now are at least 14 per cent. In 1944 the figure for the United States was 12 per cent, of the white population, and for Britain 13.3 per cent. There is ample evidence that the proportion of old people in Western communities will continue to grow. 2. There may be many causes of this increase, though it may be true to assume that the simplest explanation is that more ways of curing disease have been discovered. On the other hand, it may be that people's modes of life and surroundings are a consideration, and that hereditory factors conducive to longevity may favour economic survival under industrial conditions and thus influence reproductive rates. 3. The actual causes of death as they affect old people occur in the following order: Disease of the heart and arteries; cancer; and respiratory infections. It does not seem likely that any considerable increase in ability to affect the rate of death from the first of these causes will be achieved, and there may not be much significant progres concerning the third cause. Should there ever be discovered, however, a cure for cancer, it is certain that it would have a tremendous effect on the balance of the population in favour of the old people. 4. Assuming that the production of wealth in the community is performed by people between the ages of 18 and JO, it is found that these constituted 997,628 in 1944 out of a total population of 1,575,451. The wealth of the community was therefore dependent on 62 per cent. Moreover, as the proportion of old people grows the amount of .younger people’s energy diverted from production to the care of the aged increases. 5. Old people are absorbing more and tiiore services and more and more wealth, and at the same time, playing a less and less effective part in the total economy of the .community. Under rural conditions the old person often finds a very useful niche for himself, but under industrial conditions the old person tends to be “ in the way.” A similar consideration applies to the very young. 6. It is of compelling medical interest that people aged 60 and over occupied 25 per cent, of the mental hospital occupied beds as at 1944, and probably 20 per cent, of general hospital beds. , 7. According to a leading authority, in relation to those abilities which intelligence tests measure, the peak of performance is achieved at 18 years of age, after which a slight deterioration sets in, which does not assume significant proportions until the age of 40, after which the deterioration may be more rapid. In general, there is much more rapid deterioration after the age of 70. It is suggested that over the whole age range there can be allowed 6 to 12 months’ loss off " intellectual age ” for each decade of chronological age. It is important to realise, however, that different persons are affected differently,. An analysis of famous men and artists indicates maximum capacity between the ages off 30 and 40, and all studies indicate that old age is a period characterised by a desire for security and a shift of human interest in the direction of philosophy, religion and culture. 8. It is a curious paradox of the present age that as the age of survival has increased, the age of pensionability has decreased, so that whereas in these modern days there are plenty of people who are vigorous and alert at 70, the community now accepts that at 60 years of age people are entitled to become, pensioners. In the middle ages the almshouse was regarded not only as an asylum where old people could rest, but as a place where the old person could retire to dedicate himself to a new type of work: the service of God, and in particular, in many instances to offer prayers as a form of intercession for the soul of his benefactor. To a spiritually-minded culture this was a most valuable form of work, and such people were thought of as continuing to contribute towards community welfare. Almshouses were set in the centre of the towns which they served, and by the very beauty of their architecture and charm of atmosphere created precinctual qualities.

With the onset of industrialism, old people are now removed to special hospitals outside the limits of the town, spiritually and materially divorced from community life. Old people must be brought back into the wealth-producing and spiritual system of communities. There should be a system affording encouragement to old people to do productive work suitable to their abilities and capacities.

9 Taking Dunedin City as a typical population group, it is found that of a total population of 95,000 at May 1, 1946, and an electoral roll of 59,774, the number of people aged 60 or over was about 12.00§: At May 1, 1948. it is estimated that 50 per cent, of Dunedin’s 247 available private hospital beds were occupied by persons over 60, and 30 per cent, of the 395 available public hospital beds were occupied by people of this age. Adding the number of beds at the Talboys annexe, it is found that the proportion of old people in public hospital beds is 45 per cent. It is clear, therefore, .that one of the most urgent needs where hospital building and organisation is concerned in a modern city is for the provision of beds for old people. 10, Mr Palmer believes that there are two practical contributions which can be made to the problem of old people. The first is that a resolute attempt should be made to make contact with employers of labour to see if smjae scheme can be devised whereby old people can have a niche created for them in suitable forms of employment. The second is that there should be Old People's Welfare Councils, which should integrate the medical profession with various social agencies, particularly the churches, with a view to establishing "Darby and Joan ” Clubs and interesting themselves in the problems of the aged in general. Astonishing success in this way has been achieved in Great Britain, An excellent club has been established in Dunedin, but there is a most urgent need for a very much larger set-up which should continue to function in the centre of the city.