The Problem of the Aged in Mental Hospitals

THE problem of the aged in Mental Hospitals is universal, and is becoming more acute as time goes by. Mental disease is a tragedy at any time of life, but coming on in the later years it presents a particularly saddening picture. The majority of these patients have led a busy and useful existence, and those who were once the props and pillars of their age and generation are now a burden on the backs of their younger brethren. The aged patient is considerably different from the average inmate of a mental hospital. No other type of patient, with the exception of the acutely ill, requires so prolonged and continuous supervision. Uncontrollable factors, such as incontinence, confusion, and memory impairment, make it impossible for the aged to get along without considerable physical help from the nursing staff. Occupational therapy is limited, especially for those suffering from senile and arteriosclerotic dementia, and the useful output from such a department is so small that it presents a serious drain on the resources of the mental hospital. Looking after such patients constitutes the most monotonous and least glamorous type of nursing, and a year of care of the aged patient is probably equivalent to at least two years care of any other-the acutely mentally ill excepted. This communication deals briefly with patients of 60 years and over in the six mental hospitals of Northern Ireland in general, and Purdysburn Hospital in particular. The basic age of 60 years rather than 65 years was taken to conform with the statistical requirements of the Geriatric Service. To give some idea of the amount of accommodation required for these patients, the following table gives the return from each of the mental hospitals.