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I have had a number of individuals, case instances, where individuals have been brought to the hospital and the family has been rather indifferent. They have left it up to the hospital authorities to find ways and means to take care of them. However, that is just a minor group. By and large, in my experience, the majority of instances, the family is looking for alternatives, since they have no space for mother or daddy, they want to arrange for a satisfactory place.

I do not think that the majority of older people as has been quoted here, go to the hospital and stay 6 months. This has not been the experience of American medicine. We may have some such statistics on it. But the older people are susceptible to the same diseases as the younger people; incidentally in the Lankenau Hospital, the average age of the patients coming in, we have some 400 or 500 beds there, is 6112 years.

Now, the average stay is from about 11 to 15 days and the majority of cases that come into the Lankenau Hospital are cases of deterioration of the blood vessels, cancer, arthritis, rheumatism or mental disorders.

Senator McNAMARA. Thank you, Doctor. I am sure that Senator Clark has some questions. In the meantime I see Senator Yarborough, of Texas, in the audi

I would like to have him come up here and join the subcommittee so he can introduce his guests next.

Senator Clark, have you any questions or comments!

Senator CLARK. I would like to congratulate Dr. Bortz on his very helpful testimony. We are quite proud of our medical history and our medical profession in Philadelphia.

Dr. Bortz for years has been one of the brightest jewels in our crown. I had occasion to know him and the splendid work he was doing when I was mayor of Philadelphia.

The Lankenau Hospital, one of the services he heads, is one of the most modern new hospitals in the world, a real tribute to the Lutherans who are responsible for its start.

Doctor, I am awfully glad you are here and I listened to you with great interest. I would like to ask you just a couple of questions.

In the field of senility are you making real progress, first, in detecting it, and secondly, in treating it?

Dr. Bortz. Of course that is one of the basic questions, and I think that I could say, sir, that we are making definite progress in evaluating before clinical breakdown of an individual in these four basic tissues, the bones, the muscles, the blood vessels, and the nerve cells. We are now studying methods of detecting deviations from the normal earlier in patients as they come into the hospital. Now, we know we can increase the health span, the life span of experimental animals. I do not believe there is any doubt that we can also add considerable to the life span of human beings today if we were to take advantage of the known facts that would delay the deterioration of the blood vessels that takes blood to the brain; after all, the mind is the measure of the individual, and it does not matter how strong the back muscles are, if an individual's mind is gone he is a lost citizen.

Senator CLARK. This is what concerned me.
Dr. BORTZ. Yes.

Senator CLARK. Is it true that the major cause of mental deterioration as distinguished from mental disease is the failure of the circulatory system to carry enough blood to the brain?

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Dr. BFRTZ. That is our impression, Senator Clark, there are researches being carried on at NIH, for example, and also in Philadelphia, to study the vascular flow, the blood supply to the brain. The better the blood supply to the brain in individuals who are integrated, the better the mentality of the individual, we think.

Senator CLARK. Now, are there pretty well established tests for determining mental alertness as age progresses?

Dr. BORTZ. Yes. This again is a relative matter. However, in a scientific query pro and con there are always areas that are unknown.

Senator CLARK. I say this in somewhat the lighter vein. The median age of members of the U.S. Senate is 57 years of age. .

I am 57. Therefore, I speak with an impartial point of view. It would be

very interesting to take some mental alertness tests to see if those over 57 measured up better, worse or about the same as those under 57. I expect, of course, I would not take the test because I am just 57.

In this connection you spoke of the nursing home, and I think it is a necessary tool in connection with our treatment of the aged. The nursing home, as you know, has been a matter of some controversy. My own view has been that a proprietary nursing home can be an enormously useful institution in the community. While there occasionally have been some scandals, efforts to impose on people, not giving adequate care and making a lot of money out of patients, by and large they have done a good job and with reasonable Štate standards of inspection, the proprietary nursing home can be an effective social institution. I wonder if you agree.

Dr. BORTZ. Senator Clark, I think this is one of the most important developments in the last couple of years, but you have a brilliant and attractive young woman to testify, Mrs. Baltz, who is president of the Nursing Homes Association.

Senator CLARK. She has already been in testifying before the Banking and Currency Committee asking for money to build more nursing homes.

Dr. Bortz. I suggest you give it to her.
Senator CLARK. We will have this transferred to the other record.

One final comment and question, then, Doctor. You and I come from Pennsylvania and our philosophy has always

been that it is up to the family to take care of the older people. But this is a real philosophical question in the United States today. There are wide areas in this country who do not believe in that philosophy. I happen to have some wide connections in the State of Louisiana, and I became involved in a friendly discussion with Senator Long of Louisiana on the subject the other day. They do not think the family should take care of the older people. They think this is the responsibility for the community, that you should not inhibit the growth and development of the younger generation by imposing on them this burden to take care of people who have made their contributions to the community and made their contribution to the State.

For example, in the State of Louisiana there is no means tests for public assistance. In our State there is. They think they are right. We think we are right.

Are you sure that we are right and that is a proper obligation of the children, to take care of their parents and grandparents?

Dr. BORTZ. Is the strength and vitality of the Nation ultimately resident in the strength and vitality of the citizen?

Senator CLARK. Surely.

Dr. BORTZ. OK. Then the stronger the vitality of the citizen and the family of the citizens and the more contributing they are to the social well-being and welfare

Senator CLARK. Correct.
Dr. BORTZ. The more they will take care of themselves.

In the last analysis what happens to an individual as he grows older does not depend on the Government, it depends on that individual. We can develop a philosophy that will encourage this individual to develop his own potentials as he grows older.

Senator CLARK. I could not agree with that more. What I am speaking of—and I do not want to detain the hearing any longer, because there are a number of other witnesses—but this question, I think we all agree it is up to the individual himself or herself, and there will come a time when they are unable to care for themselves, then there is this large school of thought to which I never belonged hitherto and I can tell from your testimony you do not, which says it is not up to the children and grandchildren to look out for them, it is up to the community resources.

Dr. BORTZ. But who is the community, Senator Clark, other than other families and other members? There is not such a visionary thing as a government as such. A government is people. And you get the strength from the people and if one family does not do it, another family must in the aggregate.

Senator CLARK. I would not be too sure. Do not forget social security and all of the proposed increases of social security to help meet this problem and take at least part of the burden off the children and grandchildren. The public school system, of course, is another in which everybody pays for school. AlI am pointing out to you is that there seems to be quite an argument going on on this question, and I want to be perfectly sure that you are what might be called an oldfashioned conservative in the feeling that it is up to the family, thu children and grandchildren to take care of the aging parent.

Dr. Bortz. I am a very liberal individual. I have been interested in welfare all my life. I have heard of certain groups that have taken to themselves the prerogative of being interested in welfare. I have been doing welfare work all my life, for over 30 years.

Senator CLARK. Doctor, I was not criticizing you. I was trying to get your point of view on the record.

Senator McNAMARA. I will put a tag on you again, Doctor. Thanks

very much.

Dr. BORTZ. Thank you.

STATEMENT OF MARIE C. McGUIRE, EXECUTIVE DIRECTOR, HOUS

ING AUTHORITY OF THE CITY OF SAN ANTONIO, TEX. Senator MCNAMARA. The next witness represents the National Association of Housing and Redevelopment Officials as well as the housing authority of the city of San Antonio, Tex.

We are very happy to have Senator Yarborough with us this morning, who has a great interest not only in the problems we are considering here today, but in all of the other problems that come before the Congress.

Senator Yarborough will introduce the witness.

Senator YARBOROUGH, Mr. Chairman, I am grateful for the generous remarks of the chairman.

I have been here and had the privilege of hearing Dr. Bortz's statement, and he almost persuaded me to quit my 16-hour workday and go back to fishing again.

I do not think the exigencies of Senate life will quite permit that until I reach that somewhat envious third cycle which he talked about.

Mr. Chairman, it is my sincere pleasure this morning to present to this subcommittee a lady who has unselfishly dedicated herself to making better homes for American senior citizens. She has been doing this for a number of years. In fact, Mrs. Marie C. McGuire and her sister are both working toward this goal. Her identical twin sister, Mrs. Margaret C. Schweinhaut, is now serving her second term as member of the Maryland General Assembly.

Senator McNAMARA. Glad to have both of the ladies here.

Senator YARBOROUGH. This lady I am presenting this morning, as you mention, is the executive director of the San Antonio Housing Authority and a director of the National Association of Housing and Redevelopment Officials. And I might mention, Mr. Chairman, that she started her work with the housing authority in the 1930's, in that decade of idealism in American Government. In these positions she has worked personally with many elderly persons and has helped to improve the living standards of those in need.

Mr. Chairman, I have had the privilege of seeing her up here on forums in my home State for some 10 or 15 years.

Now, she has been a leader in this program for years and she has encouraged this type of study and fought to bring it about at a State level for a good many years. She has been working with the housing authority for 18 years, and particularly in the last few years has helped guide the pioneering work in her hometown of San Antonio, Tex., in the field of providing housing and recreation facilities for the aged. At this time San Antonio leads any city in the Southwest in service in this field. In Texas she is one of the leading citizens in the progress that has been made.

Because of her work elderly citizens have moved into thousands of San Antonio public housing units and in about 2 weeks from now they will move into 36 motel cottage units that will be open. As part of this study of the problem of the aged, it will be valuable to determine whether they would do better in the motel-type unit than in the conventional housing units of the past.

This lady is also the author of a book on this subject entitled "Housing for the Elderly.” She, I might say, and her sister think alike in this field; both believe that elderly persons should become more active in politics and lend their weight and experience to campaigns of candidates that they believe in best. They are quite active in that respect, also.

I hope they will continue, but, Mr. Chairman, I can say that I want to give my vote right now to Senator Clark's proposal to take a mental test of all of us in the Senate. (Laughter.]

. [ The exigencies of campaigning place a hard enough burden on a man's physical endurance, and I do not know if we had both mental and physical—we get a physical test every few years now.

Mrs. Schweinhaut recently introduced a bill which the Maryland Legislature speedily passed establishing a committee to consider prob

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lems of Maryland's aged. She has been appointed by the Governor

. of Maryland as chairman of the Government Commission on Problems of Aging in the State of Maryland. Mrs. Schweinhaut, would you stand up, please? She is an identical

, twin sister.

Mrs. SCHWEINHAUT. Don't confuse the committee too much. I will have to admit I am 5 minutes older. I want to say that before my sister says she is 5 minutes younger.

Thank you, Senator.
Senator MCNAMARA. Glad to hear from you.

Senator YARBOROUGH. Mr. Chairman, these two ladies have fine ideas of citizenship and also exhibit the mark of good citizens in their willingness and ability to translate their ideals and hopes and aims into definite, positive action that has actually done something for people.

It is with a great deal of pleasure that I present to this Special Committee of the Senate of the United States for Study of the Problems of the Aging Mrs. Marie C. McGuire, of San Antonio, Tex.

Senator MCNAMARA. Thank you, Senator.

I am certainly sure that the younger sister has been properly introduced. I see you have a prepared statement, and you may proceed in your own manner.

Mrs. McGUIRE. Thank you, Senator Yarborough. I appreciate those gracious words, and the committee should also know that those of us working in this field in Texas know we have a real champion in Senator Yarborough, who has been a great assist in many hard struggles in which we have reached our goal.

I will not read the prepared statement, Senator; the time is getting late. Rather, I will summarize the chief points that the National Association of Housing and Redevelopment Officials would like to place before the committee this morning.

Senator McNAMARA. Your statement will be printed in the record in full at this point.

Mrs. McGUIRE. Thank you.
(The prepared statement of Mrs. McGuire follows:)

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STATEMENT OF MRS. MARIE C. MCGUIRE Mr. Chairman and members of the committee, I am Marie C. McGuire, a member of the board of governors of the National Association of Housing and Redevelopment Officials. I am also the executive director of the San Antonio Housing Authority, operating a program of 5,154 apartments for low-income families, 15 percent of which are, or will shortly be, occupied by the elderly of low income.

The National Association of Housing and Redevelopment Officials is a private, nonprofit professional association founded in 1933. Its membership comprises civic leaders and public officials interested in the improvement of public administ cive practices in housing and urban renewal, and in the achievement of a healthful living environment for every American family. The members of our association are largely those who administer the low-rent public housing and urban renewal programs in communities throughout the United States. They are concerned with all the problems of planning, financing, building, and managing housing for low-income families and with slum clearance, redevelopment, housing rehabilitation, neighborhood conservation, and the enforcement of minimum housing standards.

Out of the work of our association in these fields we came to recognize some 15 years ago that the housing needs of the elderly were not being met and that their problems would be aggravated during the process of slum clearance and city rebuilding if they were not given special attention. Ten years before enact

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