WHERE THE OLDER PERSONS LIVE People 65 and Over as a Percentage of the Total Population, by State, 1953 Source: Appendix Table 1 4 A BILL OF OBJECTIVES FOR OLDER PEOPLE AND A PROGRAM FOR ACTION IN THE FIELD OF AGING A BILL OF OBJECTIVES FOR OLDER PEOPLE Officials, legislators, agencies, and committees dealing with the problems of aging can work most effectively, and with the largest degree of cooperation, if they are agreed upon certain common objectives. The objectives, surely, should accord with the rights and privileges to which older people are entitled as human beings and American citizens. These are not, in fact, essentially different in many respects from the rights and privileges of the people generally. But it is evident that the majority of older persons are deprived of them to a greater extent than most people. A bill of objectives for older people might consist of 10 points: 1. Equal opportunity to work. Our society recognizes the value of work to the person and to the community. The older person should have equal opportunity, if physically and mentally able, to be gainfully employed. 2. Adequate minimum income.-Older persons should have a retirement income sufficient for health and for participation in community life as self-respecting citizens. 3. Home living.-Older persons are entitled to the satisfactions of living in their own homes and, when this is not feasible, in suitable substitute private homes. 4. Homelike institutional care. For older persons who need care that cannot be given them in their own or other private homes, they have a right to expect the institutions that serve them to be as homelike as possible and have high standards of care. 5. Physical and mental health.-Older adults should have adequate nutrition, preventive medicine and medical care adapted to the conditions of their years. 6. Physical and mental rehabilitation. Older persons who are chronically ill, physically disabled, mentally disturbed, or unemployable for other reasons, have a right, to the fullest extent possible, to be restored to independent, useful lives in their homes and communities. 7. Participation in community activities. Older citizens can expect encouragement and assistance to form social groups and to participate with those of other ages in recreational, educational, religious, and civic activities in their communities. 8. Social services.-In planning for retirement and in meeting the crises of their later years, older persons should have the benefits of such social services as counseling, information, vocational retraining, and social casework. 9. Research, professional training.-Older citizens should be able to expect an increase of research on the human aspects of aging and development of special courses in schools and departments of medicine, nursing, clinical psychology, and social work to train professional workers in the field of aging. 10. Freedom, independence, initiative. In securing the foregoing objectives there should be increased emphasis on the right and obligation of older citizens to free choice, self-help, and planning of their own futures. A PROGRAM FOR ACTION IN THE FIELD OF AGING EMPLOYMENT Older persons who wish to continue working encounter almost insuperable obstacles. After 40 years of age workers have increasing difficulties in getting new jobs. At 65, or another fixed age, many are arbitrarily retired. They receive little or no assistance, such as vocational retraining and counseling, in meeting special problems of reemployment. Relatively few part-time of full-time jobs are reserved for older workers. This failure to utilize the productive capacity of older persons constitutes a waste of manpower and a loss to the national economy. 1. Governments, employers, and unions should join in abolishing compulsory and automatic retirement at a fixed age and substitute a flexible and selective policy of retirement. 2. State governments need to take the lead in eliminating employment policies which discriminate on the basis of age. It is recommended that they urge employers and unions to abandon the age criterion in hiring or laying off employees. 3. Appropriate levels of government, as well as private organizations, should organize and finance special services for the rehabilitation of the handicapped aging and the vocational training and retraining of otherwise unemployable older persons. INCOME At 65 almost all persons, unless they have full-time work, experience a sharp drop in income. Many with little or no resources apply for old-age assistance. An increasing number are eligible for and receive benefits from old-age and survivors insurance. Others with insufficient funds are supported by relatives. Of those on OAA more than one-third of the couples and one-fourth of single and widowed individuals have total incomes insufficient to provide for their basic needs. Particularly critical is the situation of those who require medical care. 4. Payments under old-age assistance need to be made adequate to meet the basic individual requirements of older persons. Special provision should be made for medical care beyond their financial resources. HOUSING Older persons, in general, reside in dwellings not adapted to their needs. Only in 2 or 3 States does legislation provide public housing for the aged or facilitate private construction specifically for them. Urban redevelopment programs often entail special hardships for older people, who find moving much more difficult than younger people do. 5. It is recommended that State and local governments review their housing legislation in the light of the needs of the aging. Public housing projects should include units properly designed for older couples and individuals, and similar provisions are needed in private housing developments. Governments are urged to give special consideration to the problems encountered by those of the aged who are forced to move because of urban redevelopment programs. PREVENTION OF DETERIORATION Physical and mental diseases of old age generally have their origins in the younger and middle years. Prevention in the early stages is easier, more economical, and more effective than treatment after an ailment has become chronic and disabling. 6. The States should encourage and support localities and nonprofit groups in establishing all-purpose facilities for counseling, for early detection and followup of diseases and disability, and for promotion of public education in nutrition, health, and mental health. REHABILITATION The present goal in treatment of physical illnesses and disabilities is rehabilitation or restoration of the patient to his highest potential of physical self-care and employability. 7. It is suggested that grants be made to public bodies for development of rehabilitation services for th eaging in local hospitals and in public and nonproprietary nursing homes. MEDICAL HOME CARE Persons over 65, although only 1 in 12 of the total population, are one-fifth of the patients occupying hospital beds. Many of them require intensive hospital treatment for only a short time, or not at all. They would be happier in their own homes, and as well or better cared for, if such services as housekeeping, homemaking, and nursing were made available. 8. It is recommended that State governments encourage and support hospitals, social agencies, medical societies, and public health agencies to utilize the team approach-a typical team comprising physician, nurse, homemaker, housekeeper, and social worker for home visits to older persons who can be cared for in their own homes. SCREENING OF MENTAL PATIENTS The tremendous increase of older patients in mental hospitals (3) times as rapid as that of all patients in the past 50 years) confronts the public with a problem of tremendous magnitude. Some patients are now being admitted who do not require psychiatric treatment. Others, who have improved, are not discharged because they have no homes of their own or relatives to receive them. 9. Every State should see that diagnostic processes are set up for screening patients before admission to a mental institution. Pro cedures need to be established to place those who do not require hospital care, or who have recovered, in private homes, boarding homes, homes for the aged, or nursing homes. NURSING HOMES A considerable proportion of older persons need nursing care under medical supervision in an institution that is intermediate between a hospital and a private home. The majority of nursing homes which have developed to meet this need are functioning with low standards of service and relatively untrained personnel. 10. State grants to local governments for construction of medically supervised nursing homes, which will meet high standards of care for older persons, can help solve this problem. ACTIVITY CENTERS A high proportion of older persons are inactive, lonesome, and unidentified with social groups. They are left out of existing recreational programs. Some withdraw into themselves, develop imaginary illnesses and, in extreme instances, experience mental breakdown. 11. State governments can assist by encouraging communities to establish centers where their older residents may join in interesting and productive activities. TRAINING Specialized professional work with the aging is a relatively recent development. There is as yet no adequate training program for workers in this field. Persons interested in entering it can find few organized courses of training or stipends available while in training. 12. It is recommended that State governments encourage the development of courses in schools and departments of medicine, nursing, social work, psychology, education, law, and the ministry for the special training of persons to work with the aging. Leaves of absence with pay from public employment are one important means to enable individuals to take such training. EDUCATION Employees, in general, are not adequately prepared for the adjustments in modes of living required by retirement. Courses in planning for retirement have been tried out on an experimental basis. Evaluation of the results, as measured by changes in knowledge, attitudes, and behavior, indicates that those who take the courses gain in their capacity to adjust to retirement. 13. The State should stimulate action by public schools, colleges and universities, business concerns, labor unions, and farm organizations to develop and sponsor adult education courses on planning for retirement. RESEARCH The existing body of basic knowledge on the physical, mental, and social aspects of the aging process is fragmentary and unintegrated. Programs for the well-being of the aging are many, but few of them have been evaluated scientifically. No gerontological research center |