no overlapping of pedestrian and automobile traffic; no delivery areas in center of project. Facilities and services: A minimum of one attending physician. He should be in regular attendance and his duties should include examination of all applicants for a discussion, general physical care of residents, and periodic examination of residents at least annually. Full staff of consultants: These should include an eye, ear, nose, and throat specialist, dentist, orthopedic surgeon, internist, neuropsychiatrist, podiatrist, and various other specialties. Nurses: At least one supervising registered nurse per shift. On call, or on regular weekly schedule an X-ray technician, physiotherapist, chiropodist, laboratory technician. Volunteers from residents for part-time work: Able-bodied residents should be encouraged to take part-time employment (to assist as housekeepers, practical nurses, receptionists, maintenance men, buildings and grounds men, gardening, clerical assistants, waitresses, laundry, librarians, and as salespersons for flower, knitting, gift, bookshops, and assistant for recreation, therapists, laboratory technicians, motion picture operators, teachers, etc.). This system has a possible two-prong benefit (1) keeps people occupied and (2) better to have people employed in community-might save money even. Conclusion All of these suggestions, recommendations, check-list items (and many more items I haven't mentioned) are important factors to be considered in programing any housing for the elderly project under FHA auspices. This is not to say, however, that there is a pat formula for setting up requirements, design criteria, and methods of financing and operation, or that a set of factors and figures used on one project can be used as a pattern on any other. It just can't be done. Every job, every project is diffierent: Different because every sponsor is different, every sponsor's requirements are different, his budget is different and each different sponsor represents a different type of group. Groups have a different makeup, different incomes and desires. Certainly also, every site is different, and every code and program is different. Regardless of the variables, however, certain developed relationship may be stated as being more desirable than others. As architects on several such projects now underway, and having done considerable research, we can say that we have gained a certain facility in handling data in this specialized field. This housing for the elderly on a community scale is a relatively new and untried program on which very little in the way of prototype design has been attempted. We have learned the only way-the hard way-by hit and miss mostly just how to balance out these variables so as to arrive at a proper interrelationship of facilities on a specific site for a specific sponsor. We have thus been able to evolve a design for a project which serves its purpose most ideally and which at once is economically feasible from an investment and operating standpoint, and finally, one which also meets FHA approval. We are constantly reviving our design concepts. We have found it a challenging and stimulating field, and a very specialized and rewarding one in many ways. We believe you as builders and developers will find housing for the elderly equally challenging and rewarding, and perhaps even profitable. Mr. Berenson thought the Mariana-White project had too much of an institutional character. Mrs. Donohue said that there should be a distinction made between building housing for older people and institutionalization for older people, and that builders should give their attention to housing rather than institutions. Mr. Mariani responded that his firms project provided only 20 units of nursing care in a project of 500, that all of the other units would be for normal active living When Mrs. Cleverly stated that the FHA has had requests from organizations in the nursing home field, for inclusion in the FHA program for housing for older persons, Dr. Donohue repeated that a line should be drawn between nursing homes and housing for able-bodied persons. Mr. White made the point that in the community he described, the institutional care would be only incidental, and that the development would really be a rental housing project. Everyone would be 60 or over, but many of these people will, in time, need some kind of institutional care. In this project they could stay on, rather than being sent off to a hospital in another community. NORTH CAPE MAY Mr. Mitnick described his development at North Cape May, N.J. Of the 1,100 homes there, more than 600 are owned and occupied by retired families. The builder did not originally design the development for retired people, but soon discovered that they were buying better than half of the homes he was building. Most older people do not want to tear up roots and leave their home communities. They want to say near their sons and daughters; be within commuting distance for family get-togethers. Many of them have paid cash for their homes. They don't want ramps in their homes, nor do they want to be constantly reminded that they are aging They have their own civic associations, and some have picked up jobs here and there. SUMMARY This conference is a landmark in meeting the housing needs of the elderly, said Mr. Mitnick, in summary. It marks the end of a period in which a small group of pioneers struggled to direct national attention to a very serious social problem and a good business opportunity, he said. We have now entered a period in which the organized homebuilding industry and related groups are acutely aware of both the challenge and the opportunity in housing retired persons and the elderly. In this meeting we have learned a great many facts about the economic and social aspects of this market, and the various financial aids available to private builders. The consensus of the participants in the meeting was that there are four great needs in the field of private housing for the elderly: 1. A greater interchange of ideas and working informations between builders, community officials, government representatives, and welfare people. 2. Federal legislation of administrative regulations that spell out more completely the role of the builder in this area of homebuilding. 3. An adequate explanation to and participation by local FHA offices in this program. 4. More education of people everywhere in the requirements and possibilities in housing for older persons. INTERNATIONAL UNION, UNITED AUTOMOBILE, AIRCRAFT & AGRICULTURAL IMPLEMENT WORKERS OF AMERICA-UAW, Senator PAT MCNAMARA, Chairman, U.S. Senate Committee on Labor and Public Welfare, Subcommittee on Problems of the Aged and Aging, Washington, D.C. DEAR SENATOR MCNAMARA: Due to other commitments I regret that I personally will be unable to participate in the hearings you plan with Federal agencies and national organizations for the last week in July and the first week in August. My earlier letter describing my general areas of concern in response to your general questions, plus my testimony on June 17, in part at least answers the questions outlined in your letter of July 17. However, I am enclosing some other materials developed by the UAW which may be helpful to the committee. You may feel free to use part or all of these materials in any way that seems appropriate. Please be assured of my continuing interest and support of the fine work you are doing in the field of aging. Sincerely yours, CHARLES E. ODELL, Director, Older and Retired Workers Department. STATEMENT OF C. E. ODELL, DIRECTOR, OLDER AND RETIRED WORKERS DEPARTMENT. UAW Any discussion of the program goals for retired workers must face up to the fact that our tremendous progress in the creation and prolongation of human life has far outrun our capacity to provide meaningful and productive roles for an expanding population. As long as we continue to regard retired workers as "problems" rather than as human beings with the same needs and desires as other human beings, it is doubtful that we will accomplish very much in their behalf. We need to conduct a widespread and penetrating program of public education which emphasizes that retired workers can be assets and not liabilities when they are afforded an opportunity to develop and maintain active and productive roles in our society. This does not mean, of course, that they must all be compelled to work until they drop, but it does mean that they should be afforded opportunity and freedom to choose and plan for a constructive and personally satisfying role in the later years of life. This role may involve full-time employment if they are able and willing to work, or it may involve part-time employment, a productive and remunerative hobby, a small business, or a wide variety of leisure-time pursuits which afford enjoyment and activity which is satisfying to the older person. There are thousands of opportunities for retired workers to serve in the community and in the union. One very good example is the job they can do in citizenship, political action, and community services. The primary goal of the UAW retirement program was to provide adequate income for retired members. This has been accomplished to a great extent through collectively bargained private pension plans and through extension and improvement of benefits under the Social Security Act. We shall continue to work toward more adequate income maintenance programs and particularly to see to it that these benefits keep pace with rising prices and rising costs. Health security is another basic objective of the union's program which has been achieved in part through the extension into retirement of Blue Cross, Blue Shield, and other types of protection. However, a great portion of the costs of this type of protection must be borne by the retired worker out of his retirement income, and therefore we believe that something must be done to provide prepaid hospitalization and medical insurance to retired workers and their dependents either under collectively bargained plans or though some form of national health insurance. More adequate housing for older persons is another UAW goal, and we expect that this can be best achieved, not through segregated skyscrapers for oldsters but through the allocation of suitably designed apartments and homes within existing public and private housing projects and through the liberalization of FHA and other type of loans that would permit older people to repair and even build homes. The 1956 amendments to the Nation's housing laws make these things possible, but there is still much to be done to see to it that older people really get the benefits of these amendments. Now, if older persons have resonably adequate incomes, health protection, and decent housing, it seems to me we can begin to talk intelligently about encouraging them to lead happy, active, and useful lives. This is difficult to do on an empty stomach or in the face of anxieties concerning health, housing, and the wherewithal to keep food on the table. Admittedly, people with no such problems fail to achieve the goal of a satisfactory retirement, and that is why we can well afford to discuss the problem as a general one which goes beyond economic considerations. To hel our retired workers along these lines, the UAW plans to strengthen its existing programs for them by extending the concept of activities or drop-in centers such as those operative in Detroit and 30 other communities. These are organized programs of education and recreation, and systematic attempts to acquaint them with the facilities and resources of the community which are available to them when they have individual and family problems. However, this program is now meeting only the surface needs of our retired workers, and much more needs to be done to reach more of them and to serve them better. To achieve a broadening of community services for retired workers through activities centers and through information, counseling, and referral services, all our local unions have been asked to organize standing committees on retired workers. These committees should be composed of representatives of such other standing committees in the local union as education, recreation, community services, citizenship, the pension board, and including representation from retired workers themselves. In those communities where there are several local unions, a communitywide committee on retired workers should be organized and we also recommend that there be a steering committee composed of retired workers themselves to advise and assist the communitywide committee on policy matters. In those areas where other unions have an interest or a problem in serving retired workers, it will certainly be desirable to combine forces with them in areawide committees representative of the entire labor movement. And in most communities it will be desirable to seek support from the community chests and welfare councils which finance and coordinate services to senior citizens. While the UAW is willing to initiate programs for its own retired members, the union recognizes the need for communitywide action to meet communitywide needs. In an effort to demonstrate what can and should be done to provide retired workers with the services they need, we plan to build and operate a model retired workers' activities center in Detroit. We are now working with the architects on this project, which will ultimately seek the cooperation of the mayor and the city council, local colleges and universities, and the community welfare council in financing and staffing the model center. The center will also be used to train UAW personnel and other community leaders so that similar programs can be set up in other parts of Detroit and in other cities throughout the Nation. This is the main outline of our program in behalf of those who have already retired. In addition, we feel that something positive needs to be done to help our older members prepare for retirement. We therefore plan to seek, through collective bargaining, the development of joint-and by "joint," I mean management-labor-community-sponsored retirement preparation programs which will start well in advance of retirement and which will afford the worker an opportunity to explore the full range of his retirement needs and problems and develop an effective plan or program to meet his individual interests and needs. This is not intended to be a compulsory "blitz type" program which tells the worker what to do and how to do it, but rather it will be a phasedout informative type of program which encourages the worker to think through his own problem and to work out his own plans with whatever expert assistance he thinks he needs. The UAW is also opposed in principle to compulsory retirement at a fixed age. It is our belief that the worker should be permitted a choice based on his ability and willingness to work, and we intend to work to create a situation in which the worker will be free to make this choice. This does not mean that everyone will go on working until they drop, nor does it mean that retirement will be indefinitely delayed for the majority of workers. Our feeling is that if workers have adequate income expectancy in retirement and proper retirement-preparation education and some option in the direction of early, as well as phased, retirement, the chances are that the great majority will choose to retire on an orderly and planned basis. This is as it should be. However, we are opposed in principle to the arbitrary scrapping of individual talents and abilities when these abilities are needed and when the individual prefers to go on using them. Finally, the UAW program recognizes that retirement problems are nothing more than a cumulative reflection of problems that have developed much earlier in the working lives of our people. We are therefore concerned that middleaged and older workers be hired and utilized in accordance with their abilities without regard to their age, and that they be afforded those personnel training and medical services which will help them to develop and maintain their skills and abilities as workers. There are far too many Americans who are being told, when they lose their jobs and have to seek new ones, that they are "too old to work, but too young to retire." This then is the UAW older and retired workers' program. It represents a sort of bill of rights for older workers, for persons looking forward to retirement and for those already retired. UAW CHARTER FOR RETIRED WORKERS We, the retired members of UAW International Union, believe that all retired workers should have the opportunity to enjoy their earned leisure and to continue to be respected and useful members of the community. In part, this is a responsibility of each retired person, but many senior citizens need help from both public and private sources in order to live out their lives with dignity and self-respect. Our union is doing all it can to help us, but the job is too big for any single organization. We therefore urge public officials at all levels of government-local, State, and National-as well as those responsible for private voluntary programs, to lend their wholehearted support to the enactment of the following specific points in the UAW Charter for Retired Workers: (1) Automatic, cost-of-living adjustments in social-security benefits; (2) More liberal disability retirement policies under the Social Security Act: (3) Prepaid hospital, medical, and nursing home benefits, as provided in the Forand bill, H.R. 4700; (4) More adequate public housing programs providing a minimum number of specially designed low-income units for senior citizens; (5) Special staff and programs, such as retired workers' centers, in public and private education, recreation, health, and welfare agencies to meet the special interests and needs of senior citizens in their own neighborhoods; (6) Revised surplus food eligibility requirements, making it possible for the majority, rather than a small minority, of deserving retired persons to qualify; (7) Positive organization and leadership in the community and at all levels of government to develop sound social policy and to direct and operate a comprehensive program for senior citizens. STATEMENT Presented bY ROBERT L. RICHARDS, EXECUTIVE DIRECTOR, Gentlemen, I am representing the views of the American Society of Internal Medicine, an organization of over 6,000 specialists in the field of internal medicine, with offices located in San Francisco, Calif. My remarks are necessarily limited to the broad scope of the problems of the aged and the aging because I am speaking for a national organization which is a federation of 45 component societies throughout the United States and its territories. However, our society does wish to present certain fundamental needs of these persons, both as patients and as citizens, as we see them each day in our offices. The doctor-patient relationship is of necessity so intimate we feel that we have a particular insight into not only the medical but the family economic and, indeed, the whole sociological aspect of this growing problem, which we believe to be the greatest medical and socioeconomic challenge before the Nation. We, therefore, feel well qualified to present our opinion as to the needs of these persons and certain basic concepts and requirements for any enduring and successful program. We fully concur with previous statements presented by the American Medical Association on this problem, but we feel that we are in a unique position to observe and make recommendations because the nature of the practice of the medical specialist, or internist, encompasses the great majority of the diseases affecting the aged and the aging. Indeed, the greatest portion of the internists' professional services is and will increasingly be devoted to the diagnosis and treatment of this group. The problems of the aged must be viewed as one total sociological problem, with areas of medical care, hospital, nursing home, and other institutional services included in that consideration. But even before these can be solved we must provide useful activity for these persons, such as continued employment on a part-time or full-time basis. The present laws and regulations for retirement are neither medically nor economically sound. Long medical experience, rapid scientific discoveries have greatly extended the years of productivity beyond present-day arbitrary laws and rules. This conclusion is abundantly confirmed by many recent sociological experiments. We deem it important, above all, that the older individual be allowed to retain his identity as a useful, productive member within his community for as long as it is medically possible and he so desires, thus retaining his personal dignity and economic status. We consider arbitrary retirement a great loss to the Nation, but to many individuals the consequences of economic insecurity, loss of status in the community, idleness, and loss of purposeful living are altogether catastrophic. It follows that any program prepared for these citizens must avoid any impression that they have lost their usefulness to the Nation and to their families. Both as physicians and as citizens, we see in the future of our population growth the proportion of persons over age 65 increasing at such a rapid pace that the medical consequences are but dimly realized. We know that persons in this age group require 21⁄2 times as much medical care as those in lower age brackets. Thus, within two or three decades, in at least some of our States, 50 percent of all medical care will be rendered to this group. Further, if a major breakthrough should occur in arteriosclerotic or hypertensive vascular disease or cancer, the resultant sociological and medical problems will be overwhelming and are presently incalculable. 47461-59--21 |