[Elder people in institutions - Problems concerning health and hygiene (author's transl)]

On the basis of our earlier studies on the hygienic, health and social situation of old people living in their own flats, we investigated the conditions in all 12 larger old people's homes of a big city in the Rhine-Main area, as well as 100 selected subjects of a defined socio-economic group within these homes. We checked the existence of pathogenic germs and the total number of germs on a total of 247 air culture plates in as many rooms and 669 impression preparations; additionally, we evaluated 35 examinations of members of the staff. We classified our findings according to the following typical areas: flats, recreation rooms, corridors, bathrooms, toilets, tea kitchens and main kitchens as well as washing and ironing rooms. - In all the homes we found with a single exception up to eight samples with Staphyl. aureus and, occasionally, E. coli, Proteus mirabilis and other pathogens. A typical localisation for these groups was not found. In contrast, a clear "graduation" was found to exist with respect to the average figures of the colony size, with the kitchens and laundries revealing the best figures, the living and social rooms - these usually less frequently used - intermediate, and bathrooms, toilets and corridors, and especially the tea kitchens, the most unfavourable figures. In view of the disinfection measures which are often of a merely symbolic nature, carried out in old people's homes, our figures emphasize the necessity for intensive education and counselling. As regards personal hygiene and cleanliness, formerly acquired habits and patterns of behaviour were influenced by the home only insofar as help and surveillance eliminate all gross forms of deficient care. The establishment of clinical findings and the detailed questioning on anamnestic and social problems confirmed the significance of the multimorbidity and the degree of seriousness of the diseases to which the occupants of old people's homes are exposed despite good medical and nursing care.