Attitudes and practices of the primary health care team towards assessing the very elderly.

This paper investigates the attitudes and practices of members of the primary care team towards assessing the very elderly in the community. Using self-completion questionnaires 47 general practitioners, 24 health visitors and 22 community nurses in the Bath health district were asked if they felt over 75 year olds should be assessed, and if so who should do it, and what the assessment should include. A majority of all three groups of professionals considered it important to assess the over 75 year olds and that this should be done at home. They felt that such an assessment should be functionally oriented, that is, should concentrate on the activities of daily living rather than medical problems. None of the groups felt assessment was their sole responsibility but should be undertaken by a combination of members of the primary health care team with the health visitor playing a prominent role. Although 89% of all the respondents felt that health visitors should be involved in assessing the elderly, half of the health visitors felt their work should be mainly concerned with 0-5 year olds. In the absence of any general policy few assessment schemes exist in the district. An overall policy is required and this should be reflected in the training of each of the professional groups.