A health visitor affects the problems others do not reach

Difficulties associated with old age that were previously unknown to the general practitioner were detected by a health visitor attached to a general practice for 2 years and given a case-load of 296 people aged 70 years or more. Previously unknown conditions included physical and mental illnesses and social difficulties related to the patient's environmental setting or to the person (carers) who looked after the patient regularly. Most of the severe illnesses were known to the general practitioner but many minor ailments and other aspects of old age were not. Even though the practice had a policy of encouraging doctors to visit the elderly in their homes, the health visitor was more successful at obtaining a complete picture of old people's home circumstances and the consequences of them.