WHERE TO GET HELP: SOCIAL SERVICES

This part of the local authority provides many of the basic essential services necessary to keep many elderly people at home. The key workers in social services are the social workers. This group of professional people either works out of a central head office or increasingly is in new neighborhood centers where they also may work with specialists in housing, etc. Some social workers are also based in hospitals. Social workers can have unqualified staff working with them called welfare assistants.

In many ways a social worker can be seen as a person's advocate (someone who will do the best for that person, fight their battles when they are unable to do so). In many cases social workers offer advice that is then taken up by the person or their relatives. When someone is alone, however, and maybe frail, elderly or even illiterate, then it is the social worker who many turn to for practical help as well as human contact. It is obligatory that a person in hospital has access to a social worker.

Social work falls into two main areas. There is the practical side of arranging meals on wheels or a home help, or advising where to go and how to obtain benefits. Their other less publicized work involves helping individuals and families cope with bereavement, serious illness and advising with complicated dilemmas such as an elderly frail person needing to move to an old people's home. These tasks require great skill.

Most social workers possess these skills; what they don't possess is the time needed to work with the elderly and their carers. Much of their time is devoted to sorting out the horrendous problems surrounding the very young (child physical and sexual abuse) and very little time is left for elderly people, except in crisis situations. One of the main reasons for this is that there is a lot of legislation concerning the welfare of children and hence social services have a legal duty to respond. There is no such legal requirement when it comes to the old, and it is one of the scandals of our time.

Any confused elderly person and their carers should have access to a social worker. Increased help and supervision at home may prevent an admission to hospital and a worsening of the confusional state. Some episodes of illness may take longer to recover from than others, and in some cases the acute illness will be overcome only to reveal an underlying long-term confusional state like Alzheimer's disease. In all these situations the link between the person affected, their carers and social services is vital.

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GENERAL HEALTH