Editorial

Much has been published recently about the “revolving door” effect of many of the programs designed to care for the mentally ill. It has therefore occurred to me that psychoanalytic workers might be interested in a program currently in operation that could be further expanded to provide broader care for the chronically ill, especially the elderly, who have no family or friends interested in their welfare. I am referring to a home-care plan for the mentally ill which in recent years has had some success, as indicated by reports emanating from Europe and various communities in our own country. If the principles of such home care are effective on a small scale, they may very well prove rewarding on a larger scale, provided there are adequate preparations in the planning stage and that unequivocal safeguards are instituted against possible misappropriation of funds.

There are many persons with small social security benefits or on public assistance rolls who are finding it exceedingly difficult to “make ends meet.” These people might be willing, given the opportunity, to increase their income by caring for a patient in their own homes. For an income of some several thousands of dollars per year, they would be responsible for the care of one person who might otherwise have to be cared for in a state facility, probably at greater cost and with lower-quality care. The success of such a program depends upon many factors, including finding the “right” people willing to work in the program, making its goals and principles clear, effective training in home care for both patient and family, and ongoing supervision.

Because home care is not a new concept, details of procedure need not be endlessly researched, though they might be continuously refined. The points to be emphasized for prospective home-care workers are: (1) that gentle attentiveness, above all, is the most important feature in such care; (2) that medication helps alleviate anxiety and agitation in the patient; (3) tha