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Programs of industry designed to extend the working life of older employees.

Development of objective tests for estimating the physical and psychomotor abilities of older people.

Housing and living arrangements:

More imaginative planning which will result in better housing and a wider choice of living arrangements-individual houses or apartments, institutions, foster homes, boarding care, hotels.

Services which will allow older people to remain in their own homeshomemaker service, home medical and nursing care, food services, friendly visiting.

Services needed in housing situations where older people constitute the major portion of the residents.

Recreation:

Programs of clubs and multiservice centers offering recreation and leisuretime interests.

Development of standards of such programs.

Education:

Programs of adult education and retraining through public school systems, universities, religious groups, social centers, and libraries. Counseling and casework services:

Strengthening counseling and casework services to assist individuals and families handle problems of adjustment, and economic, legal, housing, health, and other matters.

Community organization:

Organization of central planning bodies at National, State, and local levels to study and define areas of need, to provide for coordination of services, and to offer information and referral help.

YOU AND THE COMMITTEE

If you or your organization want help with any of the matters mentioned in this folder, the National Committee on the Aging will try to assist you or will refer you to other resources in position to help. The committee invites your assistance in the collection of useful material. Please send reports of pertinent programs, services, and research. You are invited also to send the names of good speakers and other possible resource personnel in the field of the aging.

NATIONAL SOCIAL WELFARE ASSEMBLY

The National Social Welfare Assembly is the central, national planning, and coordinating body for social welfare, created to study and define social welfare problems and to plan methods for meeting them. The program moves forward through a threefold partnership of government and voluntary, national and local, lay and professional interests. It is a nonprofit organization, supported by contributions from affiliate national organizations, some 250 community chests, united funds or councils, individuals, corporations, and foundations. The National Committee on the Aging, a standing committee of the National Social Welfare Assembly, receives a portion of its basic support from the assembly. Mrs. MATHIASEN. First of all, I think I might say just very briefly that the National Committee on the Aging is a voluntary group which is made up of about 250 people widely representative of the various interests in aging. About a fourth of our membership is made up of representatives of business and industry because it is our feeling that a good deal of what happens to older people in the country, particularly older workers in quest of employment and retirement, will depend upon a clear understanding of leaders in industry and organized labor about what these programs mean.

Basically, I think our service is divided into two areas. One is the national consultation service, which has as its backbone a library of some 4,000 collected items, most of which are valuable, I think, because they are unprinted, unpublished material not available elsewhere. They are pamphlets reporting a wide variety of experimentation and programs across the country.

We make these available, on request, as people from communities across the country present their problems. Whether it is a problem of preparation for retirement or building a home for the aged or trying to get a program going, we try to analyze these requests on the basis of the local situation and then answer them in whatever way seems best, very often by a loan folder of material which seems pertinent, based on the experience of other communities.

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We have about, I guess, 3,000 requests a year of this kind from all 50 States and from 23 foreign countries.

The other part of our work which we think is particularly important is that of picking up and doing some intensive work in areas for which nobody else seems to be either responsible or interested in. I will give a couple of quick examples of that. One is a consistent job we have done on standards of care for older people in institutions which began at the time when States were going to have to do something about setting standards but only about half of the States had any standards at all for institutional care for older people. So we got together with the people who were actively concerned in the field to help establish what might be not only desirable but also reasonable standards. And we have followed that through consistently going into an architectural competition because a lot of the standards are based on adequate architecture. We are having a new book out this fall published by the Dodge Publishing Co. on building and planning homes for the aged, the first material that architects and planners have done together.

Having done that, we are now working on standards for club programs. Again this is a very active program throughout the country, but has been developed for the most part without much thought of standards.

The other area of specialization has been employment and retirement. It has been the feeling of our committee that it does not do much good for anybody else to do a lot of talking about employment and retirement except those people who are in position to do something about it, namely, industry and organized labor. Therefore, we have been in one way or another working for about 7 years in involving some of the leadership in the country in these fields in employment and particularly in extending retirement of older people, beginning with an Arden House conference, with about 70 people representing wide interests in industry, meeting regularly over a period of 2 years informally, discussing the practical problem. And there were representatives of organized labor who could sit around informally and discuss what labor's position would be and so on.

These two things have resulted in a couple of books which have had a good deal of circulation and I think some influence, "Flexible Retirement" and "Criteria for Retirement."

Right now we are engaged on a rather interesting new field of this kind which I believe is going to have increasing attention of the country but which so far nobody has taken any very serious thought about and that is the problems of guardianship and protective services. This is what the American Bar Association calls a concern with the not quite incompetent incompetent, that vast group of people that are not quite competent to handle their own affairs but should not be handled in what is very often taken as the easiest way out and that is commitment to mental institutions. We have just begun work on

this with a lawyer as the person directing the project and we believe that this is going to result in some interesting new proposals for a kind of an imaginative breakthrough in the way of handling this particular situation.

Now, I would like to state briefly what I think our Mr. Hobbs would like to say. It is not that we are not concerned with the humanitarian aspect of aging because we very obviously are. But Mr. Hobbs is a banker, and he often likes to describe himself as a Wall Street banker concerned with the problems of aging, he is concerned not only from the humanitarian aspect but from the economic aspect, and he believes that it is the work of our committee, and I believe I could say your committee and the White House Conference on Aging and whatever groups are at work, to help make the business community understand that it is important to the business life, the economic life of the country and community to maintain a higher level of buying power in the population over 65. I was just reading a report from the community in which they are trying to find out how the older people reduce their spending and it begins first of all in food and then goes into clothing; and, when it gets down to durable steel goods, it drops practically to nothing, and so on.

The other thing related to this, I think, is that we feel from where we sit in the committee that we see a lot of activity going on around the country in very many fields. There are experiments in housing, experiments in social services, like friendly visiting and meals on wheels, and a number of all kinds of visiting services, and so on. We see experiments in employment, some experimentation with trying to provide community programs to provide employment, and so on. But we see this as having been very spotty and experimental, out of which we have learned a good deal about what older people need if they are going to remain independent and active. But so far nobody has taken very seriously the need to consider that the total range of programs for older people nor what it would mean in terms of providing these services to all the people who need them.

Mr. Hobbs, I know, believes as your committee proceeds and as the White House Conference makes its recommendations that unless there is some concept of the price tag on these things, what housing for instance, adequate housing, would really cost, and what some of the other of the social services would cost, what good standards of institutional care would cost, that a lot of the talk will end in frustration rather than in real progress.

He likes to point out that old age is big business, whether it is in the field of potential productivity of older workers, of which we think there is a good deal, old-age and survivors benefits and private pension plans, health programs, and care of the chronically ill, housing or social services. And therefore for this, as well as for humanitarian reasons, the National Committee on the Aging is grateful to know of this study which is being undertaken by your committee and its staff. Senator MCNAMARA. Thanks very much.

Do your studies indicate that people are retiring earlier or are they staying in the labor force to an older age? Testimony earlier revealed that some industries were encouraging people, in some cases compelling them, to retire at 60. Have you had any experience on that? Mrs. MATHIASEN. We have had some experience with this. This is true in some cases. Again this is a very spotty thing. I believe the

best thing we can say about this is that a number of companies are now reconsidering their policies in this direction. Some of them are actually lowering the age. This is particularly true in the oil industry. But there is also some evidence, on the other hand, that there is a good deal of experimentation also in extending the retirement age, particularly either in a completely flexible way or at least experimenting with extending it by 3 years, for example, or maybe 5 years. Senator MCNAMARA. Thanks very much.

Your testimony is very helpful and your statement will be published, including the notes at the end, if you have a copy for the reporter.

STATEMENT OF DR. FREDERICK C. SWARTZ, CHAIRMAN; ACCOMPANIED BY JOHN GUY MILLER, STAFF ASSOCIATE, COMMITTEE ON AGING, AMERICAN MEDICAL ASSOCIATION

Senator MCNAMARA. Next is Dr. Swartz, the chairman of the Committee on Aging of the American Medical Association. Glad to see you again.

I see you have one of your associates.

Dr. SWARTZ. This is Mr. John Guy Miller, who is staff associate on the Committee on Aging of the American Medical Association. Senator MCNAMARA. Glad to have you here, sir.

I take it you want to have your prepared statement published in its entirety in the record at this point.

Dr. SWARTZ. If it would please the committee; yes, sir.

Senator MCNAMARA. You may proceed in your manner, Doctor. Dr. SWARTZ. I am Frederick C. Swartz, chairman of the Committee on Aging of the American Medical Association. Before I begin my remarks, I would like to pay very high tribute to the two speakers, and their associations, who preceded me. We have had a great deal of contact with Dr. Andrus and her group. We are studying the proposal that she has made on our committee on insurance, and we certainly commend them for the dramatic way that they have demonstrated to the Nation the people of the retired group are capable of taking care of themselves and planning their future.

This National Committee on Aging, too, has physicians represented and we participate in their ideas and ideals to the same extent. We would like to point out in the prepared material that has been submitted to the committee that there is an error on the division which has to do with the examples of individual and community initiative in the field of aging. On page 1 in the middle of the page it says "New York City Home for Aged and Informed Hebrews."

This should be "Infirm" but it should also be informed because we feel that the aged group are really more informed than given credit for.

Senator MCNAMARA. Thank you. We will see that that correction is made in the record.

Dr. SWARTZ. I would like to begin by saying that the medical profession applauds the Senate's concern with the aged and aging, and the way in which this subcommittee is going about its work. It is commendable that you have set out to gather all available facts before seeing any conclusions.

Moreover, your approach to this complex problem is similar to our own. For we, too, have been after the facts since the formation

of the committee in 1955. When the committee was first formed it was charged with the responsibility of studying the diseases of the aged, and we found very quickly that there were no diseases of the aged as such. The aged became sick, it is true, but there were no diseases that were particularly truly diseases of the aged. In the 1954 death statistics of the United States there were 98 children listed as having died with arterosclerotic heart disease including coronary disease below the age of 5. We feel conclusively there are no diseases of the aged. The geriatrics committee renamed itself the committee on aging. Since that time every aspect of living which bears directly or indirectly on health of our older people has been under our intensive study.

Good health is far more than the mere absence of disease or infirmity. This is only the negative side. Health also has a positive side, a physical, mental, and social well-being. There are certainly degrees of health. And any factor which detracts from that well-being detracts from the individual's total health.

Loneliness, rejection, lack of useful things to do, these emphatically affect the overall health of the aged. For hardening of the arteries is certainly no worse than softening of the will to live. This applies to every human being. It applies particularly to the aged.

The older person wants just about the same things out of life_the rest of us do, to be part and parcel of his environment, to be loved, to belong, to feel that his skills and talents have value and that they will be used and appreciated.

Let us talk about health in its broader sense for a moment. All of us, no matter who we are or what we do or where we live, have definite responsibilities in regard to our elder citizens. Let me cite a few examples.

We believe it is society's responsibility to stimulate in older people that intangible quality called the will to live. I have seen people with this quality survive illnesses against which they seemed to have little chance. I have seen people without this quality die long before they should.

The will to live is the difference between fighting on and giving up; the difference between staying in the mainstream of life, active and interested, or becoming segregated and remote from life, a passive spectator who no longer cares.

It is a plain fact that people who feel rejected, shunted to the sidelines by society, all too often lose the will to live. Medical and hospital care, important as they are, can never compensate for rejection.

To stay alive and make their later years full and rewarding, old people must care. But they will not care unless we make it plain that we want them to care because we care about them, that we value their wisdom and experience and are anxious to use it.

We believe it is society's responsibility to encourage our elders in their desire to be self-reliant, to maintain faith and pride in themselves. It has been my experience that the overwhelming majority of these people don't want to be the wards of anyone. They want a helping hand if needed, yes; but a handout, no. For anything that undermines the self-respect of a man or woman undermines health, and saps the will to live.

Let me give you an example, typical, I suspect, of situations in many homes. I know of an elderly woman, plagued with all sorts of physical

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