Purposeful activity of some sort and the necessity for contributing to the welfare of others are essential parts of a wholesome life. If these essentials are entirely eliminated from the life of an invalid, the patient's greatest needs are probably left unsatisfied, even though the physical care he receives may be perfect in every detail. All that was said in regard to occupations for invalids applies with particular force to occupations for chronic patients, since however valuable manual occupations may be as a means to bring about recovery, they are still more valuable in furnishing interest and purpose in a life whose only prospect is a succession of weary, useless years. Handicapped patients sometimes learn
occupations that yield a financial return, and ability to earn even a little stimulates self respect and mental health, whether the money is needed or not. The important point, however, is that the finished product should have a recognized use.
In addition to enabling the patient to make things with his hands, a way should be found if possible by which he may contribute to the group of people with whom he lives. If a way can be discovered for him to do so, the opportunity should not be denied him nor should his service fail to be noted and appreciated, even if it is nothing more than telling a story to a restless child.
CARE OF THE AGED
At the end of life, as at its beginning, every individual especially needs the interest and protection of his own family. In ordinary circumstances neither a baby nor an aged person can be cared for so fittingly or so successfully in any other place as he can be in his own home.
With advancing years is to be expected a general slowing down of all the powers. In old age both body and mind show characteristic changes, and particularly changes causing lowered resistance and diminished vigor. If the manner of living is adapted to these changes, both happiness
and usefulness may be prolonged. But so gradually do the changes often come that they may escape notice for a long time, and the younger generation in looking back sometimes realizes with regret how much earlier measures might have been taken to prolong the usefulness and to mitigate the discomforts of aged parents and friends.
Old people are keenly sensitive to cold, since the circulation gradually becomes less vigorous and they take little exercise. Keeping them warm both in bed and out adds more perhaps to their comfort than any other one measure. They should have warm underclothing and soft shawls and other extra wraps. A real service will be rendered by the person who invents a suitable and dignified wrap for old or feeble men, who dislike the informality of sweaters and feel disgraced by shawls. Old persons should and can be kept warm in bed, by providing them with hot water bags, with warm night clothes including stockings, by using woollen or outing flannel sheets if necessary, and by providing a sufficient number of light but warm bed covers. It is not always understood that many covers do not remedy the deficiencies of a thin mattress. If a thick mattress or two thin mattresses cannot be provided, a thick comforter or even many layers of
newspaper should be placed between the mattress and the springs, and another thick comforter should be placed between the mattress and the lower sheet. Rubbing the body with warm olive oil often affords great comfort, by improving the circulation and thus increasing the sensation of warmth, and also by relieving the tendency of the skin to become dry and cracked. Poor circulation at night may cause cramps in the muscles of the legs; the cramps can usually be relieved by warmth and gentle rubbing.
Old people frequently wish their rooms to be very hot, both by day and by night, even as hot as 80° or 85°, but if it is possible to keep them warm in any other way the temperature of the room should be kept at 70°. Well ventilated rooms are highly important for old people as for all others of low resistance, and it is entirely possible for their rooms to be warm and yet well ventilated. Aged persons should be carefully guarded from chill, exposure, crowds, and infected persons. Like little children they are peculiarly susceptible to the respiratory diseases, which cause many of the deaths commonly attributed to old age.