- Email: [email protected]
Disabilities
872 tion. The British Red Cross Society and other voluntary bodies which had undertaken the management of the homes had cooperated wholeheartedly with the hospital authorities and the Fund in all the preliminary work. This was essentially a pilot scheme, with two objects : to give some of the old people who must otherwise be hospital cases more home-like care, and at the same time to get the beds in the hospitals free for others who too often cannot obtain admission. Sir EDWARD PEACOCK, treasurer, said that during the year ;f;230,OOO had been spent on ordinary expenditure, and S92,000 on capital and non-recurrent items, whereas the disposable sum upon which the Fund could rely was some ;f;300,OOO a year or a little more. A further 100,000 had been received from the Nuffield Trust for the Special Areas, and was being added to capital. The late Lord Wakefield had made the Fund one of the residuary legatees of his estate, with an instruction that any sum received should be treated as capital; and ;f;200,OOO had recently been received. Sir ARCHIBALD GRAY, chairman of the distribution committee, speaking of the nine homes now being provided for the aged sick, said that the Fund was anxious to emphasise that they were intended, not for the completely bed-ridden, but for " frail ambulants " who could enjoy the attractive gardens and other amenities of the houses.
Disabilities 57. OLD AGE
WHEN does old age start’? I feel inclined to extend the normal three score and ten to 75. Life today is longer and, granted reasonable health and mental freshOf ness, no-one should feel really aged before then. course, when no more than five-and-forty, a man with " a family growing up may remark, I am getting on." This, however, is a pose ; and the next day, to prove his fitness, he will take a twenty-mile walk. After 60 he may, as a precaution, take things easier, but this without a trace of certain symptoms which will appear later. He may escape serious accident or illness and be spared one or other of those bodily visitations which call for drastic surgical treatment. Yet sooner or later there comes a day when he realises that age is upon him. Yes ! And suddenly he feels a wave of intimate sympathy with the frail, for whom previously he had a lordly pity. The first warning is often ignored. Probably the patient has neglected to be perfectly frank with his There has been a momentary shock ; but doctor. equilibrium is restored, and in the absence of any perceptible change he proceeds on his journey. Years may pass before another red light appears. My own came at about the 75 contour line while I could still carry on normally. What is the reaction when deterioration can no longer be ignored ?‘ I leave on one side the question of bodily or mental collapse. Also I accept as normal the slow response of muscles and the hesitancy of functional organs. The man I have in mind is still mentally vigorous, still full of life, with a steady hand and good eyesight, who knows clearly that, now, he is old. Secretly he resents it. Intelligence, imagination, enthusiasm, capacity for work, all are there ; but (and it is a big but) control is waning. This applies to head and limbs alike, for these are in mutual sympathy. Firstly, in respect of the head : there may be no sudden vertigo ; but there is a precautionary reluctance to turn round or stoop down. An upward glance or a sharp turn of the head provokes momentary giddiness, while a downward bend to pick up something reveals a lack of correlation between head and knee-muscles. The worst trial of all is to stand still indefinitely while a lady discourses at large on the movements of her
relations. This question of balance is interesting because of its contradictions. Rough hilly ground would not disconcert me ; walking a 9-inch plank over a running stream would not unnerve me ; over a wooden or a wire fence I could climb without hesitation. But give me a streak of ice on a wintry road, set me on a chair without a supporting hand-hold, and I should shirk it ; some conspiracy between head and limb would warn me. To a doctor one does not communicate this kind of Can determination overcome it ? childish weakness. Or is it wiser to capitulate gracefully ?f Then, on the physical side, there comes awareness that exercise of any kind produces tiredness, and this is emphasised by shortness of breath. There may be no pain and no stiffness in the muscles, but just a wearied inclination to get out of the way and rest. And when the brain is active again you resent this ; you are still nursing the unconquerable hope, still clinging to the delusion, that you are not old. It is long since you felt an inclination to run ; but you do hope for fitness to walk without threat of faintness. But that hilly bit of road over the bridge, that flight of steepish steps, that parcel of books you are carrying, that window you wish to open, that table you want to move! Tackle all or any-and some obscene little demon laughs in your ear. It is here, too, that the mental side comes in. From ordinary mental overwork a man may seek refuge in physical exercise; but on reaching the stage when physical work is beyond him, where can he turn for recreationIt is easy to suggest : read, write, or resort to chess or bridge ; but at 75 or 80, with little capacity for physical exercise, can the mind be rested by mental exertion greater than it had to bear between the ages of, say, 20 and 70 ?‘l Ordinary business or professional pursuits provide a routine which eases the strain ; but in retirement routine is swept from the daily schedule. Companionships might do much to stimulate, but environment changes as age approaches. Contemporaries drop by the way, and if retirement has involved a change of scene new companionships are not quickly acquired, nor are they quite so intimate. Thus age has often to be passed in comparative seclusion. Apart from trifling lapses of memory or moments of absent-mindedness, a man of 80 may feel in full possession of all his former mental faculties and yet be honest enough to ask himself : how far is this justified, and how much is mere wishful thinking ?If he attempts to write a book or an article, or to deliver an address, will the impression left on reader or hearer be that of virility or senility ?‘ He cannot tell, but the secret dread of disillusionment is ever present. My own experience of men is that even in age the capacity for study, research, concentration, analysis, and interpretation may remain unimpaired. At 80 a man may show an inclination to suspend judgment on matters of the moment, but in thought he may have much to contribute. Where weakness may emerge is in yielding to mental restlessness-this at least in the case of one who has led a very active life and who chafes at enforced inactivity. Restlessness, too, unless combated, may easily develop into impatience and possibly depression ; and as the man is usually aware that his blood-pressure is above normal he is conscious that impatience reacts on bodily as well as on mental fitness. Age presents many problems, but to the old man whose mind remains active the greatest is this. At his desk, fully occupied, he feels fit, calm, and contented. He needs recreation, however, as well as rest. When the body can no longer provide the exercise that would afford the needed recreation, is there any other compensation ?" ,
** * This
article concludes Disabilities. We are hoping to them in book form.-ED. L.
our
present series
publish
a
on
selection from
Disabilities 57. OLD AGE
WHEN does old age start’? I feel inclined to extend the normal three score and ten to 75. Life today is longer and, granted reasonable health and mental freshOf ness, no-one should feel really aged before then. course, when no more than five-and-forty, a man with " a family growing up may remark, I am getting on." This, however, is a pose ; and the next day, to prove his fitness, he will take a twenty-mile walk. After 60 he may, as a precaution, take things easier, but this without a trace of certain symptoms which will appear later. He may escape serious accident or illness and be spared one or other of those bodily visitations which call for drastic surgical treatment. Yet sooner or later there comes a day when he realises that age is upon him. Yes ! And suddenly he feels a wave of intimate sympathy with the frail, for whom previously he had a lordly pity. The first warning is often ignored. Probably the patient has neglected to be perfectly frank with his There has been a momentary shock ; but doctor. equilibrium is restored, and in the absence of any perceptible change he proceeds on his journey. Years may pass before another red light appears. My own came at about the 75 contour line while I could still carry on normally. What is the reaction when deterioration can no longer be ignored ?‘ I leave on one side the question of bodily or mental collapse. Also I accept as normal the slow response of muscles and the hesitancy of functional organs. The man I have in mind is still mentally vigorous, still full of life, with a steady hand and good eyesight, who knows clearly that, now, he is old. Secretly he resents it. Intelligence, imagination, enthusiasm, capacity for work, all are there ; but (and it is a big but) control is waning. This applies to head and limbs alike, for these are in mutual sympathy. Firstly, in respect of the head : there may be no sudden vertigo ; but there is a precautionary reluctance to turn round or stoop down. An upward glance or a sharp turn of the head provokes momentary giddiness, while a downward bend to pick up something reveals a lack of correlation between head and knee-muscles. The worst trial of all is to stand still indefinitely while a lady discourses at large on the movements of her
relations. This question of balance is interesting because of its contradictions. Rough hilly ground would not disconcert me ; walking a 9-inch plank over a running stream would not unnerve me ; over a wooden or a wire fence I could climb without hesitation. But give me a streak of ice on a wintry road, set me on a chair without a supporting hand-hold, and I should shirk it ; some conspiracy between head and limb would warn me. To a doctor one does not communicate this kind of Can determination overcome it ? childish weakness. Or is it wiser to capitulate gracefully ?f Then, on the physical side, there comes awareness that exercise of any kind produces tiredness, and this is emphasised by shortness of breath. There may be no pain and no stiffness in the muscles, but just a wearied inclination to get out of the way and rest. And when the brain is active again you resent this ; you are still nursing the unconquerable hope, still clinging to the delusion, that you are not old. It is long since you felt an inclination to run ; but you do hope for fitness to walk without threat of faintness. But that hilly bit of road over the bridge, that flight of steepish steps, that parcel of books you are carrying, that window you wish to open, that table you want to move! Tackle all or any-and some obscene little demon laughs in your ear. It is here, too, that the mental side comes in. From ordinary mental overwork a man may seek refuge in physical exercise; but on reaching the stage when physical work is beyond him, where can he turn for recreationIt is easy to suggest : read, write, or resort to chess or bridge ; but at 75 or 80, with little capacity for physical exercise, can the mind be rested by mental exertion greater than it had to bear between the ages of, say, 20 and 70 ?‘l Ordinary business or professional pursuits provide a routine which eases the strain ; but in retirement routine is swept from the daily schedule. Companionships might do much to stimulate, but environment changes as age approaches. Contemporaries drop by the way, and if retirement has involved a change of scene new companionships are not quickly acquired, nor are they quite so intimate. Thus age has often to be passed in comparative seclusion. Apart from trifling lapses of memory or moments of absent-mindedness, a man of 80 may feel in full possession of all his former mental faculties and yet be honest enough to ask himself : how far is this justified, and how much is mere wishful thinking ?If he attempts to write a book or an article, or to deliver an address, will the impression left on reader or hearer be that of virility or senility ?‘ He cannot tell, but the secret dread of disillusionment is ever present. My own experience of men is that even in age the capacity for study, research, concentration, analysis, and interpretation may remain unimpaired. At 80 a man may show an inclination to suspend judgment on matters of the moment, but in thought he may have much to contribute. Where weakness may emerge is in yielding to mental restlessness-this at least in the case of one who has led a very active life and who chafes at enforced inactivity. Restlessness, too, unless combated, may easily develop into impatience and possibly depression ; and as the man is usually aware that his blood-pressure is above normal he is conscious that impatience reacts on bodily as well as on mental fitness. Age presents many problems, but to the old man whose mind remains active the greatest is this. At his desk, fully occupied, he feels fit, calm, and contented. He needs recreation, however, as well as rest. When the body can no longer provide the exercise that would afford the needed recreation, is there any other compensation ?" ,
** * This
article concludes Disabilities. We are hoping to them in book form.-ED. L.
our
present series
publish
a
on
selection from