All parts of the institution were found in good order, well ventilated, suitably heated (now that the new system is installed), and the patients It can truly have an abundant supply of literature and amusements. be said that the interests of the patients are the first consideration of the management, which continues to be most efficient in every direction. Ayr District Asylum. Inspected 17th June and 11th November, 1926. (Average number of patients resident during year, 580-0.) This institution was found in good order in all its departments. Several of the corridors, day-rooms and dormitories have been painted and others are in process of being painted and repapered. One of the villas has just been redecorated and the result is most satisfactory. The Recreation Hall has also been recently decorated and painted in a tasteful manner. The patients were well clothed and, generally, in good health, and the food given to them is substantial, well cooked, good in quality, and served in an expeditious and orderly manner. They also have ample time for their meals. The occupation of the patients who were physically fitted was carefully attended to. It would be of great benefit to introduce Occupational Therapy in the care and treatment of patients who cannot on account of their mental conditions be employed at the ordinary avocations associated It has been found in those institutions with a large institution. which have adopted Occupational Therapy that manifest advantage to the physical and mental wellbeing of the patients taking part in this form of work has followed. The number of patients attending Divine Service on the Sunday previous to the first visit was 378 and 400 had been attending the associated amusements. It is observed that more patients attend the amusements than Divine Service. This is probably accounted for by the fact that a number of patients object to participate in Divine Service in a place where In such a large institution as amusements have recently been held. this it is a matter worthy of the consideration of the District Board whether or not a Church should be provided where patients will be able to worship in an atmosphere congenial to them. In several of the larger institutions in Scotland, and in the majority of English institutions. there is a Church attached to each institution. It is observed with approbation that the high percentage of postmortem examinations is still maintained. These reached almost 80 per cent. in relation to the number of deaths. The condition in which the hospitals were found was all that could be desired, both as regards nursing and medical care of the patients. The management of the institution continues to be active, capable and most conscientious. Banff District Asylum. Inspected 8th April and 16th September, 1926. (Average number of patients resident during year, 204·5.) There has been a good deal of repainting in this institution, and this is still in progress. The work has been done in a tasteful and artistic manner. The condition of the institution throughout was found to be very satisfactory. The villa at Woodpark has recently had a system of heating by hot water installed, the results being most satisfactory. The conditions in this villa were ideal. The laundry is being extended and new machinery is to be fitted. In providing temporary accommodation for the laundry a most thoughtful and economical plan has been adopted. A large enclosed verandah has been built at the end of the female hospital and is now used as a laundry. When the new permanent laundry is completed this verandah will become a very serviceable adjunct to the Female Hospital. It is observed with satisfaction that the dairy has been brought more into accordance with modern requirements, and the milk supplied to the patients is as clean as it possibly can be. This is of great advantage in an institution such as this as, in general, Asylums reveal four times the proportion of tuberculosis present in ordinary hospitals. By attention to the milk supply such as is given in this institution the death rate from tubercular affections has fallen below the average of the General Hospital. The medical work is carried on with conspicuous interest and energy. The training of nurses and attendants for their special work is favourably mentioned, and the position they take in the examinations of the Royal Medico-Psychological Association is a tribute to the energy and instruction of the Medical Officer. The patients presented every appearance of good care, both as regards food, clothing and accommodation in the sitting-rooms and dormitories. The management is characterised by progressive thought and much energy. Dundee District Asylum. Inspected 1st June and 27th October, 1926. (Average number of patients resident during year, 530-0.) A Committee of the District Board is at present considering plans for altering part of the institution so as to relieve the congestion that exists in the ordinary dormitory accommodation. The work of the nursing staff throughout the Asylum is most commendable, and it is decidedly without any idea of reflecting on the kindly and careful work of the present staff in the male hospitals that attention is again drawn to the possibility of introducing female nursing in these wards. Apart from the question as to the extent to which male nursing should be replaced by female nursing there is little diversity of opinion regarding its application to the sick and infirm. Its very general adoption and success in other Asylums are well known. It is understood that there is a difficulty in providing accommodation for any increase in the female nursing staff. The object in view is, however, so desirable that the District Board might, it is recommended, consider whether some accommodation for the few nurses required could not be satisfactorily and economically provided in part of the existing building. The general health of the patients was found to be satisfactory and their material comforts are adequately secured. Careful attention is paid to recreation, open-air exercise and congenial employment. The claims of Occupational Therapy are again brought to the notice of the District Board. It has a wider scope as a means of treatment than the ordinary domestic and other occupations which are in full use in this Asylum, and it lays no stress upon productiveness or utility per se. In those Asylums where it has been instituted, its contribution to the recovery of patients is marked, but its greatest success has been shown in the increased contentment of delusional patients and in a transformation in the habits and conduct of many patients who have not been so favourably affected by any other method of treatment. The medical care is assiduous and efficient. A good deal of painting is required in the main building, and when this is undertaken it is suggested that light and bright colours be used to remedy the present somewhat dingy appearance of several of the day-rooms, dormitories, and dining-hall in particular. Everywhere throughout the institution there was marked cleanliness and attention to the comfort and health of the patients. The institution continues to be well managed and the kindly relationship existing between the patients and the nursing staff is specially commended. There were many other evidences of the kindly spirit that animates the medical and administrative direction. East Lothian District Asylum. Inspected 27th April and 8th October, 1926. (Average number of patients resident during year, 249-5.) All parts of this institution were found in good order, and it was obvious from a thorough inspection that the interests of the patients are the primary consideration of the management. . The hospital wards were found in good condition, and the nursing. and medical care continues to be of an excellent description. The Medical Officer is ably assisted by a competent staff of male and female nurses, including the Superintendent and four general hospital trained nurses. The general health of the inmates is good and the dietary is satisfactory. A large amount of painting has been going on inside the buildings. This has been done by the staff in a tasteful manner and the effect is cheerful. On the Sunday previous to the first visit 189 patients attended. Divine Service and an almost equal number attend the associated amusements. Among these amusements is a very good installation of wireless which is much appreciated by the patients and staff. The management is described as being earnest and efficient. Edinburgh District Asylum. Inspected 22nd June and 6th and 7th December, 1926. The special arrangements made for hydro-therapy, massage, physical exercise, and treatment by light, especially by ultra-violet rays, are most complete and under the care of competent and qualified persons directed by the medical staff. The new pavilion, which is to be devoted entirely to purposes of treatment of the nature outlined, has been designed in accordance with the most modern improvements, and the Consulting Radiologist of the institution has given his advice in the adaptation of its several parts towards the particular ends in view. The X-ray room, when completed, will be one of the most perfect of its kind. In addition to a Consulting Dentist, Consultants have been appointed for General Medicine, Surgery, Radiology, Ophthalmology, the Ear and Throat and Gynecology. The energy, skill, and interest of the nursing and medical staff not only in the hospitals but throughout the institution are commended. In the villas the special features which allow of much freedom to the patients and produce a homely atmosphere are fully developed and taken advantage of. The working patients are mostly employed in the open air. The workshops were visited where a number of patients give valuable assistance to the various artisan members of the staff. It was noted that in the joiner's department the organ case for the organ in the new Church is being built. For those patients who are not mentally fitted for work or who have not been considered so in the past, a beginning has been made with Occupational Therapy, and, as it was a military hospital during the war, there are ample means in this institution of carrying out Occupational Therapy to its fullest extent. The amusements provided for the patients are numerous and varied, and those who are of a literary turn of mind have their wants supplied by an excellent and well-equipped Library conducted on the lines of a Public Library. This Library is much used and is a source of great pleasure to many of the patients. The dietary of the patients was found to be satisfactory, and it is obvious that they are well fed and well cared for in all material respects. The conditions of the several sitting-rooms, day-rooms, and dormitories were such as to conduce to the physical and mental well-being of the patients. The large number of post-mortem examinations which it has been found possible to conduct is very commendable. The institution is represented as being managed with the highest efficiency, enthusiasm, and interest, and the staff is able and competent. Fife and Kinross District Asylum. Inspected 23rd March and 23rd November, 1926. (Average number of patients resident during year, 768-0.) It was observed at the first visit that the day-rooms throughout the Asylum were comfortably heated by open fires, but the dormitories appeared to be cold. Except in the observation dormitories, where there are fires at night, all the dormitories are unheated. The absence of A dental room has been equipped and is now in working order. The Dentist was seen at work, and it is obvious from the short time he has given attention to the teeth of the patients that his appointment will have beneficial results on their health. A second Assistant Medical Officer has been appointed, and the medical work of the institution can now be more fully dealt with. The medical staff have no special conveniences, such as are required in a large modern hospital, for making those extensive investigations which are required to complete the medical diagnosis, and until a clinical laboratory has been installed in connection with this institution it cannot be expected to produce the best results in the care and treatment of the patients, though it is only fair to state that the Medical Officers do all in their power and attain a high standard of efficiency. This was evident in the state of the hospitals and in the general good health enjoyed by the whole of the patients. By extension of the verandahs of the present hospital and at a relatively small cost the arrangements for the open-air treatment of tubercular and newly admitted patients could be made to meet the present requirements. If these alterations are undertaken it would be desirable to add to the benefits of open-air treatment those of light therapy. The nursing of the patients reaches a high standard. It is hoped that the consideration of a Nurses' Home will not be too long delayed as it is not in accordance with modern ideas to have nurses sleeping in the institution under circumstances where their much needed rest is likely to be disturbed. All patients who are physically and mentally fitted are employed at varied occupations with obvious benefit to their health. For a certain type of patient who cannot be employed in out-of-door occupation but whose energies can be directed into other channels with a view to lessening their noisy and destructible tendencies it has been found that Occupational Therapy is of very great value. This is a matter which There are several institutions throughout should be enquired into. Scotland where Occupational Therapy is extensively used, and there is no doubt that an investigation into the result of such treatment will result in the establishment of Occupational Classes with a special Instructor or Instructors in this institution. The provision for dealing with an outbreak of fire has, as was recommended, been the subject of a report by the Firemaster of Dundee, and it is satisfactory to know that his recommendations are being given effect to. The recommendations as to providing accommodation for relatives attending the funerals of patients are again brought to the notice of the District Board. |