Pioneering treatment of older people
Retired geriatrician shares how the speciality has come a long way
Walking sticks up if you have heard of Dr Marjory Warren. No? She was the mother of geriatric medicine and Dr Fred Hirst’s hero.
Hirst, a retired Palmerston North geriatrician, spoke about the English doctor who pioneered the study and treatment of diseases in older people as part of Heritage Month.
His talk on March 13 at Boho Cafe was titled A History of Awapuni Hospital, with Hirst putting the care of older people at the Maxwells Line hospital into context by talking about Warren and the development of specialist hospital services for older people.
He said Warren had tremendous vision, writing what became the bible of how to look after older people in a respectful way and to maximise their potential. She was a real pioneer, bringing in suitable armchairs so people could stand up, walking aids and rehabilitation equipment “for neglected, forgotten patients no one wanted to see again”.
She advocated for geriatric medicine to be a recognised speciality and included in medical and nursing training, Hirst said.
Warren also advocated for geriatric inpatient services to be at general hospitals. Patients were to receive comprehensive, multidisciplinary assessment, diagnosis, treatment and rehabilitation with an attitude of optimism and hope, not one of them never getting out of hospital again.
Mobility and independence were encouraged as was them wearing their own clothes.
Warren practised at a time when geriatricians were not held always held in high esteem. Writing in the Journal of the Royal College of Physicians in April 1982, Dr Michael Lye said geriatric medicine suffered from a poor image.
He said the situation could be summed by the belief that geriatric medicine was “a second-rate speciality, looking after third-rate patients in fourth-rate facilities”.
Hirst was born in Blackpool and studied at the Royal Free Hospital Medical School in London.
He moved to New Zealand in 1974 to work as a medical registrar at Wellington Hospital and later returned to England to undertake specialist training in Bristol.
In 1982, Palmerston North Hospital Board appointed Hirst its first specialist physician in geriatric medicine. He retired in 2016.
Awapuni Old People’s Home was opened in 1915 with additions in 1936 and 1944. It opened with 55 beds and nine “inmates” and the following year had 21 men and seven women. The land was to be cultivated by the “so-called inmates”.
The intention was for the hospital to be selfsufficient but Hirst hasn’t found any evidence of that.
It was renamed Awapuni Home in 1936 and Awapuni Hospital in 1945.
It closed in 1989.