THE RECOMMENDATIONS

In every regional meeting the role of religion was stressed as a major force in helping people of all ages to face the exigencies of life.

In several sessions it was indicated that the church can do much "to influence the way young people view aging persons and the way the individual views his own later years," and religious leaders were urged to give attention to these teaching objectives.

It was emphasized that not only could the church serve the aging more effectively, but that the aging could make a better contribution to the church if they were given opportunities to devote more of their time and skills to the church and church-sponsored organizations. This would make "the retiree an available resource of the church, while at the same time making it possible for the individual to remain useful in retirement living."

To encourage a greater role for religion in the life of the aging, the Committee adopted the following recommendations:

General

94. We advocate the full use of the facilities of the church in providing an outlet for the older citizen in an atmosphere which is close and familiar to him.

95. Visits from lay volunteers to aged persons separated from their parishes or congregations should be encouraged.

96. We recommend that in group-living facilities for the aged the spiritual needs of each individual be recognized and preserved. To implement this, local clergy should be actively encouraged to participate in visiting and ministering to the spiritual needs of these residents.

97. Religious leaders should seek to improve chaplaincy services in institutions which care for aging where such services are inadequate. 98. Religious leaders should be aware of their moral responsibility to speak out against inadequacies of service and care in nursing homes and psychiatric and other related institutions.

99. With the increasing number of aged shut-ins, it becomes a special responsibility of the church and society to seek out and to minister to the home-bound, according to their individual needs.

100. Integration of aging members in the congregation should continue to be our goal.

"Surely it is one of the strange paradoxes of our times that man's most magnificent achievement over the past half century should constitute the basis for one of the most serious problems of the century....I recently read a report on interviews with a number of men and women ranging from 60 to 90 years of age. These people listed their wants in the following order: bodily health, health of spirit, a cheerful state of mind, money, friends, work to do, pleasant family relationships, a chance to watch people develop, doing things for others, and just plain kindness and consideration."

Daniel Bergsma, M.D.

"Already we have enough information at our command that, if we could utilize it, we could control about 50 percent of the sickness being caused by four diseases that are now the major causes of death in old age."

Edward Bortz, M.D.

chapter 8

Inadequate nutrition is a problem with the great majority of aging. It need not be, for present knowledge is sufficient to correct many of the nutritional problems of the aging. However, the shortage of nutritionists is hampering the flow of this knowledge to physicians, institutional staffs caring for the aged, and the aged themselves.

Similar shortages of professional personnel are retarding correction of many health conditions that are widespread among the aged.

THE PROBLEM

There are aged individuals and couples suffering from diseases, disabled by illness, dependent upon others, living in mere custodial care in institutions, or otherwise subjected to conditions that could be corrected or alleviated if there were available a sufficient number of trained personnel to apply the knowledge and know-how at hand.

Philosophy and practice in some institutions for the aging are as old or obsolete as the buildings themselves. Shortage of professional rehabilitation specialists and absence of modern rehabilitation philosophy mean that a number of residents in such facilities will get custodial care only and will not be returned to independent living.

Social workers, nutritionists, vocational counselors, and other specialists are not available in sufficient number to provide the opportunities the aging must have to live healthier, happier, more productive, and more normal lives. One fundamental reason for this situation is lack of interest in the field of aging, since many of these professional workers prefer to work with children instead.

A U. S. Senate subcommittee reports: "A major problem of America's senior citizens is how to benefit now from the considerable body of knowledge already accumulated for sustaining their health and independence.

"... the subcommitee was greatly impressed with the knowledge gained through a number of forward-looking experiments in screening for early detection of disease, in organized home-care programs, in centralized referral and counseling services, and in programs of multipurpose activity and social centers.

"These research and experimental efforts have provided convincing evidence that coordinated community services led by trained personnel can improve and sustain physical and mental health. They enable older persons to continue as self-sufficient, integrated members of their families and communities. For those affected by long-term chronic illness they help restore physical, emotional, social, and economic resources."

THE RECOMMENDATIONS

Recommendations were made on professional personnel in all fields concerned with the aging. In the field of medical care alone, 19 proposals were made in the regional meetings, including one to make positions in that specialty more attractive through higher standards, better working conditions, and better salaries. Increased emphasis on geriatrics in nursing schools and medical schools was also suggested, as was staff education relating to institutional facilities. Financial support of educational institutions for professional training was also recommended.

Shortage of professional personnel was noted among medical personnel trained in gerontology as well as geriatrics. Attention was also called to the lack of trained workers in social work, recreation, nutrition, rehabilitation, nursing, counseling, homemaking, and other specialties.

Education and training have failed to keep pace with the growing body of knowledge, as well as the increasing need for services to an expanding aging population, the workshop discussants observed.

Communities need to know about the needs of the aging so that they will provide the opportunities for adequate professional training that are not now available. Colleges and universities must encourage students to enter careers in the fields of service to the aging.

In-service training is needed to broaden the knowledge and skills of personnel now engaged in working with the aged, and unorganized communities should be assisted by a trained person to assist in community programming and in training agency staff and volunteers.

In response to these problems, the Committee adopted the following recommendations:

General

101. In regard to shortage of all types of professionally trained personnel, it is recommended that schools and colleges direct students towards health careers, and that financial aid programs be continued and/or expanded.

102. It is recommended that education in medical

and allied fields should include in their respective curriculums training in the problems of the old-age group.

103. Educational institutions should become more familiar with the need for nursing. medical, and other staff in the nursing care and institutional field and should be encouraged to train professional staff specifically for this field.

104. There is a great need for appropriately trained professional personnel in the field of social services for the aged. This implies the maintenance of sound standards and the recruitment of the kind of people who have an understanding and empathy for older people.

105. Medical students should be trained in gerontology- the study of older people - as well as in geriatrics and in the study of patients with chronic diseases.

106. Educational programs by qualified groups should be set up in order to bring before the professional people and the community at large the needs of the aging. Medical societies should be encouraged to establish programs which will make physicians more aware of the need for, and the availability of, rehabilitation services for people, including the aging.

107. Since there is an ever-increasing number of persons who need nursing and bedside care there is a greater need to prepare families to undertake the home care of the aging. An educational program designed to train persons in this area should include not only methods of nursing care, but also factors such as recreation and the like.

108. A comprehensive medical approach to the problems of the aging is required, including the approach of the general medical practitioner, psychiatrist, social worker, nutritionist, religious leader - the team approach to the physical and emotional needs.

State Level

109. Appropriate State education, welfare, and public health agencies should be encouraged to explore ways to train personnel for homemaking and other services to enable better and sustained care of the aging patient within the home so that the trend toward institutional care may be reduced.

Local Level

110. It is recommended that communities at the grass roots level provide financial support for educational facilities to enable the latter to train specialized personnel that may be required in the care of the aged. 111. There should be coordination of both professional and volunteer services directed by qualified personnel. These services may be provided by a referral center or a worker in an existing agency who is available for this purpose.

"For humanistically inclined researchers, the biological objective of gerontology is to make old age attainable; the sociological objective is to make it satisfying. Medical progress has increased the proportion of the aged, technological progress has reduced the proportion of meaningful roles available to them, while the cultural lag in the social sciences leaves us as yet inadequately equipped to deal with resultant problems of personal and social adjustment."

Howard E. Jensen

chapter 9

"What our old age will be tomorrow depends upon how well we do our research homework today."

Individuals, professions, agencies, institutions, and communities can do little about problems of the aging without facts.

The aging in a community must be known collectively and individually; their needs identified; the means of meeting those needs determined and established; the lack of necessary knowledge and know-how corrected; and the problems of the future anticipated. None of this is possible without research. What our old age will be tomorrow depends upon how well we do our research homework today.

THE PROBLEM

Insufficient research in preventive health care and in some chronic illnesses associated with aging is responsible for large numbers of aged individuals suffering from sickness that might otherwise be prevented or alleviated. Research in rehabilitation has now made it possible to return many dependent aging to a status of self-care. Studies in new approaches in modern institutional care would also improve the services to many aged men and women in those facilities. Basic inquiries into the housing needs of the aging would help many aged individuals and couples to obtain the kind of housing they require but are now denied.

In the field of mental health, Dr. Paul H. Hoch, New York State Commissioner of Mental Hygiene, describes this basic problem:

"Civilization has created more problems for the aged than it has solved. Now we insure more and more life with less and less in it. The challenge is to find new ways to put interest and zest in aging the aged."

Leo W. Simmons, Ph.D.

"Dealing with the mental health of the aged represents a vast problem, the answers to which are not now in our hands. Extensive research in various aspects of the problem is needed to form a basis for constructive planning. The psychiatric needs of the aged fall into two broad areas and much confusion exists today because of a failure to differentiate between them. On one hand, it will be necessary to provide mental health services for the aged in general; on the other, psychiatric care of the mentally sick aged will continue to be necessary along traditional lines. While both types of care have community aspects, psychiatric facilities organized to serve the aged who are not mentally ill will be far more community based. No program for the aged will be complete and effectual without carefully planned provision for meeting these important mental health needs."

In every major aspect of aging there is need for inquiry, research, and development of facts that will identify, analyze, interpret, and resolve the problems to be dealt with.

THE RECOMMENDATIONS

In every workshop where research was discussed the participants reflected the optimistic view of most students of the aging: basic research holds the key to a happy and healthy old age.

In general, basic research was advocated in the biological, economic, psychological, and social aspects of aging, and further research in geriatrics to control, and hopefully eliminate, diseases that now cripple and kill the aged.

Other recommendations included social research to identify the kinds of retired people in the community and individual differences of aging persons; further study of the principles and operation of the old-age and survivors insurance program and of old-age assistance.

In the housing area, it was recommended that studies be made to develop criteria and set standards for health and supportive services in housing developments. Also suggested were continual studies of the economic and social aspects of housing for the aged; determination of the needs of individuals and couples in various stages of health and capabilty; and studies of new approaches in the field of institutional care.

In the economic area, it was recommended that studies be made of the costs of private pension plans for small employers; the portability of pension funds; the part-time or fulltime employment of the aging; the number of retired aged who desire to continue work; the economic aspects of retirement; the loss of purchasing power to the economy through retirement; and the economic status of the aging, community by community.

Recommendations in the health and medical care field included suggestions for basic research, inquiry into better diagnostic services, study of improved rehabilitation techniques, development of increased knowledge of disabling factors in the aging process, study of better nutrition, and surveys of ways and means of financing adequate medical care.

In considering these proposals, the Committee adopted the following recommendations:

General

112. Before establishing new agencies, every community-state, city, county or otherwise should undertake an objective evaluation of all of its existing resources, both public and private, to determine how effectively existing resources, if effectively and fully utilized, could meet the medical problems of the aging.

113. Social research should be undertaken to determine the kinds of retired people there are in a community; and programs for the aging should be based on the self-determined needs of the aging.

114. The results of the social research recommended to be undertaken, and that which has already been done, should be made generally available to increase our knowledge and to facilitate coordination in this field.