Opportunities for anticipatory care with the elderly.

Contacts made by the elderly in a group general practice were monitored over seven months to describe how the elderly use services and to consider how a program of anticipatory care might be instituted. Eighty-four percent (1,562) of the patients aged over 65 years were seen during this period, and there were 4,315 contacts logged. Contact rates and the proportion of home visits were higher for patients aged over 75 years. More than three quarters of contacts were with a physician, one fifth with a nurse, and only 11 (0.3 percent) were with a health visitor. Referral and investigation rates were very low. Almost three quarters of elderly patients contacted were functionally independent. The most common diagnoses were osteoarthritis, hypertension, heart failure, and depression. Prescribing levels were relatively high, but people aged over 75 years were given fewer medicines than those aged 65 to 74 years. There is great scope for case finding by general practitioners provided good use is made of each contact. Health visitor case finding or screening would require either a major change in existing work patterns or recruitment of extra staff.