United States in serving the aging and presume to add some recommendations for the consideration of this subcommittee. A. CATHOLIC SERVICE TO THE AGING 1. Institutional care of the aging: For well over a hundred years the Little Sisters of the Poor have been operating homes for elderly citizens. For many years they were the only Catholic representatives in this field. The interest has spread so that now there are 314 homes for the aging under Catholic charities auspices caring for about 28,000 guests. 2. Religious ministry to the aging: Many older members of the Catholic. Church remain in their own homes or the homes of their children. Religious services by the parish priest is provided for these senior citizens through— (a) Regular personal visits by parish priests. (b) Administration of the sacraments on a monthly basis. (c) Friendly visiting of older parishioners by parish volunteers. B. ANALYSIS OF PRESENT SERVICE 1. Obligation to develop proper attitude toward the aging: The church has a primary responsibility for correcting an attitude that has developed in relation to the aging. The "problem" aspect of older citizens has been featured in the literature and the commentary of the welfare field so that the financial problems and the relief service has been emphasized. Because of a current trend in our social philosophy, this has inclined us as a Nation to throw the aging into the pathological welfare group. This is contrary to the pattern of all cultured and mature nations of the world. The manner in which the citizenry of a nation showed their respect for the aged group was a sign of the high civilization of that nation. The opinion and the experience of the elders was sought before major decisions were made. There was no substitute for the sage advice and counsel thus brought to bear upon current community problems. At the present time we have been led to believe that our senior citizens are to be relegated to the category of "excess baggage." We give them the lesser end of any bargain we make. We depreciate the value of the contribution they might still make to our society. It is the obligation of the church to bring back to its former glory the place of the elderly citizen in the church, family, and the community. 2. Expanding of institutional programs for the dependent aging. 3. Develop institutional care for specific groups among the aging: (a) Nursing care for the bedridden. (b) Special programs for the care of seniles. (c) Special programs for the care of the poor aging with chronic and/or terminal illnesses. 4. Personal service to aging couples and individuals by neighborhood and parish groups: This must necessarily be the largest area of development. It does not seem possible that the erection of institutions and the recruiting of service staffs could ever be achieved in such volume as to meet the total needs of the growing aging population. It is not only impractical and unattainable, it is un-American. From the earliest days, Americans banded themselves together to meet a common need. In this instance service given by one neighbor to another might well enable an aging couple to maintain their own home in peaceful and quiet dignity, not beholden to anyone. Essential services performed by several neighbors might provide for the cleaning of their house, the providing of warm meals, doing the shopping, and visiting them in their own home regularly. Several neighbors banded together could keep the elderly couple, or individual, pleasantly involved in neighborhood activities, such as, attendance at church, participation in family birthdays and holidays, and other meaningful associations. 5. Church welfare groups should continue constant study and research as to what the older generation needs and wants: Research thus far has not been as scientific as it should be to give us a proper view. In many instances the schedules have been oversimplified or poorly interpreted to the group or individual being interviewed. Visits to the old folks have not been handled diplomatically, ofttimes being too brief and too curt. Scientific preparation of schedules and procedures which utilize the services of parish organization members to do the actual gathering of information has already been tried successfully by the National Conference of Catholic Charities in its study of the aging in Milwaukee, Wis. Similar types of research under church auspices should be fostered. C. SPECIFIC PROBLEMS OF THE AGING 1. Indiscriminate retirement: Under the present economic system people are being retired at a fixed age without regard to their ability to continue as productive workers in the same capacity or possibly on a shortened work schedule. 2. Insufficient development of programs through which the skills and talents of retired people could be used for a few hours each week to perform essential services. 3. Minimum preparation for retirement: As of now, individuals looking for retirement consider financial stability their main concern. Many other aspects of their lives in retirement should be considered. Through expert counseling workers should be shown that interests, avocations, hobbies, related work projects might be fitted into their preretirement age thus making a smooth transition into the days of actual retirement. 4. The problem of fixed incomes in the face of fluctuating prices is also a matter of great concern to a large part of our aging population. 5. Medical and hospital care are not readily available at prices which the aging can bear. It is recommended that some plan be developed whereby this group can purchase these professional services and not receive them solely through welfare programs or through extreme cost to themselves. 6. Housing for the aging is scarce: That which is available is often inappropriate or low grade because of their income limitations. 7. The major problem of aging is the popular attitude toward them: They are considered by many of our unthinking population to be "banished." They are thought to have no further usefulness or potential. A clear outlining of our cultural patterns must rectify this attitude which has developed only because thinking people have not been expressive in their attitude of our aging population. The popular attitude toward the aging has developed by default and it is our obligation to promulgate the concept that the later years of life can be vital, interesting, and productive and that the aging individual is an asset to the whole community. 8. The hesitancy of the rank-and-file member of our voluntary organizations to become active in the field of the aging has been a problem. Because of the age and maturity of the beneficiary, the potential benefactor has been hesitant to offer their much needed service. A program to overcome this hesitancy should be fostered among churches, fraternal and patriotic groups. 9. Insufficient trained personnel: Professional attention to this field has not kept pace with the numerical growth of the aging group. America has been a youth-centered nation. Its concern and its programs have been geared to develop, exploit, and promote the assets and accomplishments of youth. As of now, we are a mature nation with the numbers of our population more evenly distributed over youth, middle age, and the golden years. Specialists in meeting the particular challenge of service to the aging are now required in quantity. D. RESPONSIBILITIES OF VOLUNTARY GROUPS, STATES AND FEDERAL GOVERNMENT In meeting the wide area of service to the aging group, it does not seem practical to conceive of it as the responsibility of any single group. Because of the breadth and width of the problem, it seems that only the widest base of citizen activity is capable of meeting the whole area of need. 1. Church, fraternal and citizen groups must be alerted (a) to their opportunity to be of service to the aging and the ease with which this performance can be given; (b) to their responsibility and duty to be active in this field of service; (c) to the fact that no arm of government alone is equal to the task. (1) This is a task that can be done on a voluntary level with moderate expenditure of funds and maximum expenditure of individual citizen effort. (2) The alternate is to ignore the problem and through default let it grow until it becomes a major national crisis. Then we would have to turn to that level of government which could be capable of doing the service. This level of government could only turn back to the citizen for the money and personnel to do the job. It is better, then, that the citizens accept initially the individual responsibility that is pointed out to them. Congress is to be commended for authorizing the 1961 White House Conference on Aging to alert the citizens of the United States to the problem while there is still time for the citizen, individually and through groups, to encompass the problem. 2. States should be helped to improve their services and their grants to the 4 percent of the aging population in the pathological group who are in need of this kind of service. 3. Federal Government should be encouraged to promote(a) Research; (b) Training of personnel; (c) Future White House Conferences on Aging on a regular basis to keep the citizen attention focused upon the need and the role of the citizen in meeting the need. STATEMENT OF RUSSELL M. TOLLEY, NATIONAL CONFERENCE OF HEALTH AND Re Subcomittee on Problems of the Aged and Aging. U.S. Senate, Washington, D.C. AUGUST 18, 1959. DEAR SENATOR MCNAMARA: In response to your letter of July 20, 1959, with reference to your committee's interest in the thoughts and suggestions of organizations confronted with the problem of providing benefits for the aged and aging, we are very pleased to submit herewith the general thinking of the conference in connection with this subject. The National Conference of Health and Welfare Plans, Trustees and Administrators consists of trustees and administrators from management and labor who are responsible for the administration of health and welfare programs created by collective bargaining agreements and are responsible for the health and welfare programs of some eight to ten million employees and naturally, inasmuch as these programs cover all eligible members regardless of age, the progressive problem of providing benefits for the aged and aging is one that is of primary concern to the trustees responsible for these programs. Most health and welfare funds of the nature above described have made at least a cursory study of the needs and desires of the aged and aging and the costs involved in providing adequate benefits and in many instances some provision has been made in the eligibility rules of these funds to provide some form of coverage, usually on a limited basis as compared to the coverage provided for the regularly employed. However, there have been no standard eligibility rules or benefits established by the health and welfare industry and there are also no overall acturial statistics from which the health and welfare trustees may draw in order to establish benefits for this category of the American citizenship. It is the feeling of the national conference that a very large percentage of the health and welfare programs now in existence are financially in position to provide adequate, if limited, health and welfare benefits for the aged and aging if these programs are provided with the proper guidance and sufficient statistical information on which to base actual studies and projections of cost. Therefore, if a subcommittee such as yours were to gather together experience and statistical information, as well as a composite picture of benefits being provided by various types of organizations and private benefit programs, this information would be of considerable value to health and welfare programs interested in providing such benefits for their aged and aging member employees. In the course of your hearings and investigations of this serious problem you will undoubtedly develop much statistical information as to claim incidence and claim costs with reference to benefits provided for the aged and aging. In many instances any information that this conference has in this connection would perhaps be redundant, however, should you wish to draw on the experience of our conference members, we will be most happy to assist you in any way through this office. The national conference is holding its annual workshop in Los Angeles on October 5 through 8 and while we are in session it is my intention to appoint a committee to discuss your correspondence and the subject matter under investigation by your committee and this committee will be in touch with your staff director to assist in any way possible. Very truly yours, RUSSELL M. TOLLEY. UNITED COMMUNITY FUNDS AND COUNCILS OF AMERICA, INC., Senator PAT MCNAMARA, DEAR SENATOR MCNAMARA: This letter is in response to your invitation to our organization to appear at a hearing held by the Senate Subcommittee on Problems of the Aged and Aging. While we appreciate this opportunity and the method the subcommittee is using to gather information on the conditions and needs of the aging in the country in preparation for their report to the Senate, we regret our inability at this time to be represented on the date these hearings are scheduled. We have interest in the subject of your hearings, however, and have taken this opportunity to prepare the enclosed statement, according to the outline you suggested, for use of the subcommittee. Should you have occasion to consult local community planning groups, we would gladly suggest the names of local community welfare councils which are actively engaged in working for better services for older people. Sincerely yours, HOLLIS VICK, Consultant on Planning for the Aging. STATEMENT OF HOLLIS VICK, CONSULTANT ON PLANNING FOR THE AGING, UNITED COMMUNITY FUNDS AND COUNCILS OF AMERICA, INC., New York, N.Y., JULY 30, 1959 Community welfare councils in some 500 American cities-organizations of governmental and voluntary agencies, civic and professional groups and representative citizens, are devoting an increasing amount of effort in planning services to meet the needs and interests of the aging. We are pleased to present this statement, based on our work with local community welfare councils, for use of the subcommittee. (a) Summary of interests and work in the field of the aging and aged In line with their purpose of developing adequate, balanced, and efficient programs of health, welfare, and recreation services to help all people and bring about a richer community life, community welfare councils undertake the following: Factfinding about needs and services. Developing new services, realining programs, eliminating outmoded services, in line with changing needs and conditions. Developing high standards of service, efficiency, and effectiveness. Building public understanding of problems, services, unmet needs. Consultation and assistance to agencies and civic organizations in the organization and operation of service programs. There are united funds or community chests in over 2,000 local communities for the financing of voluntary services including programs for the aged and aging. In the smaller communities where there is no community welfare council, the united fund or community chest assumes some responsibility for coordination and upgrading of service programs, especially in the voluntary agencies. The Community Planning Division of United Community Funds and Councils of America, Inc., provides consultative services in connection with the organization and operation of community welfare councils, and to councils, chests, and united funds on matters of community planning and program development. Activities related to services for the aging include the following: Information is disseminated on national developments and trends in the field. Loan folders are prepared which reflect experience of local communities in dealing with problems and developments such as community surveys, improvement of health resources, housing, home and institutional care, income maintenance and employment, group work, informal education and recreation services, counseling services, and friendly visitors' programs. Workshops are held dealing with recent developments in the field, particularly in relation to local organization of health and welfare resources in order to meet the needs of the aging. Field visits are made to local communities for consultation on programs and community organization in this field and occasionally to survey needs and resources in a local community. (b) Evaluation of activities and indication of future emphases · Welfare councils provide a channel for planning of programs and services for the aging as an integral part of community planning of health, welfare, and recreation services for all people. This we feel is invaluable, since availability of effective services of good quality needed by people of all ages is basic to any effort to meet the special needs of older people. The welfare council brings governmental and voluntary agencies together to help them to coordinate their efforts, work together on common problems and determine the best way to meet new needs. Whether programs are made possible through tax funds from Federal, State, or local sources, by voluntary funds contributed by citizens through their united fund, grants from foundations or fees paid for services, all must be geared to the needs and resources of a specific community. The council serves as a vital force for coordinating efforts of agencies, management, organized labor, the churches, the schools, public and private housing interests, and physical planning groups. In this way the many agencies and organizations concerned with services to older people can keep in close touch with one another and with the total community. While meeting human needs has always been charged with emotional sentiment and personal satisfaction, there are indications today that communities are becoming both more discerning and mature in their approach to community services. Community leaders are concerned about the future pattern of all welfare services, their administration and financing. They seek the unbiased, community focused examination of problems and services which will give sound guidance for future programs. Each community is unique and any national approaches must recognize community differences. Programs can be flexibly adapted to local conditions through a community planning instrument such as the community welfare council. For the future local communities will need more research about the conditions and problems of older people and the effectiveness of various programs in meeting them. They will be aided by public information programs which will develop perspective in the citizenry and avoidance of emotion or fragmentary promotions. Now and in the future there will no doubt continue to be a shortage of personnel and all efforts to recruit and train competent people for this field should be encouraged. The United Community Funds and Councils of America, Inc., will continue to advise and consult with local communities in the development of sound programs in this field. We shall be interested in flexibility and the adapting of services to local conditions and the avoidance of pat answers or panaceas. Both national and local groups need to be on guard against the possibility of an imbalance caused by an overdevelopment of structures and services for special groups. (c) Needs of the aging as seen by community welfare councils While there has been increase in services for the substantially increased population group over 65, certain community efforts seem somewhat futile unless the basic needs of income maintenance, housing, and health care are met. Some services for the aging are of good quality; many need to be improved. Some represent an orderly development of basic programs, others a response to public demand, while still others have developed through the interest of particular sponsoring groups which sometimes fail to clear their plans with broad community groups to achieve balanced services related to needs. Early detection of problems is needed, particularly in the health field, with emphasis on prevention as far as possible. There is need for further research and experimentation in rehabilitation and differentiation in health care of the physically and mentally ill. Programs of rehabilitation should be expanded. It is neither humane nor good economy to limit rehabilitation to those who can enter the labor market. Rehabilitation is important also to promote capacity for self care. There should be further development and coordination of programs of home medical care, homemaker services, "meals on wheels," and other community services which have been found effective in meeting the needs of older people, helping them to remain in their own homes and to retain the highest possible measure of self reliance. |