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ties and services for older people. These programs have not only used up every available professionally trained person but the demand for these personnel have far exceeded the supply. In consequence, many positions are going unfilled which means that many services needed by older persons are not being provided.

Counseling centers and health and mental hygiene clinics for older persons, State commissions on aging, local committees on aging, universities trying to institute courses in gerontology, old-age homes and senior citizens housing developments, State and Federal agencies, all represent groups that are seeking trained personnel.

The bills now before Congress, among them those we are discussing today, will, if enacted, make this situation even more critical since they propose to increase the moneys available to States, local communities, and to voluntary and public agencies for the further expansion of services to senior citizens. Obviously the demand for personnel will increase in equal proportion.

This shortage of trained personnel is a deep concern throughout the Nation. The reports compiled in 1960 by the States in preparation for the White House Conference on Aging contained 402 recommendations for the training of more and better qualified teachers in the field of aging and of professional personnel to give direct services to older persons. A year later, when the Conference convened, almost all its 20 sections called for the immediate training of a large number of professional workers to serve in a wide variety of programs designed to benefit the older age group.

The section which was devoted especially to the role and training of professional personnel determined that the basic requirement for increasing the supply of trained persons is for a rapid and thorough expansion to take place in the number of college and university faculties equipped to teach about aging within the biological and social sciences, and within the professional curriculums.

Yet, although it is considerably more than a year since the Conference, a year during which the need for trained personnel has become even more critical, there are still only three universities which have a training program with specialization in aging at the doctoral level, and only two which provide an undergraduate major in gerontology. And while there are 28 universities with gerontology institutes, research centers, or councils and committees, only one of these is a teaching unit. Rather, their functions are those of research, coordination, or informal education. During the academic year 1960-61 there were offered 71 courses in aging distributed among 56 institutions while for the 3-year period from 1958 to 1961, there were a total of 105 different courses offered at 77 different institutions. Only a small number of these were offered regularly each academic year.

This is a pitifully small number when measured against the total of 1,500 colleges and universities in the country. As has been cogently pointed out, there is no university in the United States which can now offer a well-rounded, interdisciplinary, advanced training program in gerontology taught by an instructional staff which has made its primary commitment to the field of aging, and this is not likely to change rapidly because the teacher supply is still very limited.

Social scientists, professional groups, government agencies, and universities are likewise keenly aware of this problem. In 1956, a

subcommittee of the Gerontological Society, Inc., developed a plan to remedy the situation. Believing that social gerontology and the training of persons to teach, do research, and serve in professional capacities could be promoted best through interuniversity and interdisciplinary cooperation, the committee sponsored the formation of Inter-University Council on Training in Social Gerontology.

The proposed purpose of the Inter-University Council was to systematize and publish the available knowledge about the social and psychological aspects of aging as a preliminary to the holding of intensive summer training institutes for already established faculty members. These institutes would provide the participants an orientation to the field of aging, stimulate their interest in gerontology, and prepare them to offer instruction in aging within their disciplines or professional fields.

If successful, the summer institutes could bring about an almost immediate increase in the amount of instruction offered in our universities and a consequent increase in the number of persons trained to work in aging in place of having to wait for the gradual preparation of a new generation of teachers and of their students; a process, which under present circumstances, would yield annually only a handful of new candidates for many years to come.

The Inter-University Council on Training in Social Gerontology was formed in 1957. It had representatives from 16 of the Nation's top-ranking universities. With the financial assistance of the National Institute of Mental Health and the National Heart Institute, it carried out the proposed plans described above. Three research works were published, and a total of 75 college and university faculty members were trained in two 4-week summer institutes held in 1958 and 1959.

That the summer training institutes were successful as a means of increasing the commitment of faculty to offering instruction and carrying out research on aging is attested by the results of a survey of the institute participants carried out in 1961.

Among the participants at the institutes, by the end of the 1961 academic year, a total of 28 had initiated and taught 31 credit courses entirely devoted to aging at 28 different institutions. Furthermore, three others had programs which were commencing in the 1961-62 academic year at an additional three institutions.

Moreover, 22 of the fellows had directed a total of 48 student research theses and dissertations in the field of aging, while 38 had initiated 66 research studies of their own, 37 reported a total of 89 publications in aging, and 40 listed a total of 123 special training activities such as guest lectures, noncredit courses, and short training institutes devoted to problems of aging.

Only 1 of 71 fellows responding to this survey was opposed to further institutes. The great majority of them characterized their interest and involvement in the field of aging as greater than prior to their participation in the institutes, credited the institutes for a good measure of this, and reported that gerontological activities would be among their major professional career interests in the future.

The almost universally held opinion among these established faculty members was that a greater variety of programs for scientific and professional personnel is urgently needed for the stimulation of teaching and research activity.

Yet in spite of this proven success of the summer training institutes; in spite of the fact that no university has acquired enough trained personnel to staff an interdisciplinary curriculum of the type needed to offer a comprehensive training program; in spite of the growing concern about instructional needs and professional training on the part of such groups as the Southern Regional Educational Conference, the Mid-West Inter-University Research Committee, the Special Staff on Aging, and other agencies of the U.S. Department of Health, Education, and Welfare, and of the several departments concerned with senior citizen housing of the Housing and Home Finance Agency, and of such professional groups as the Council of Social Work Education, the American Psychological Association and the Gerontological Society, Inc., and in spite of the pending legislation, which will make many millions of dollars available for new staff positions, and, further, in spite of the considered judgment of the leading educators in aging from the universities represented on the Inter-University Council in Social Gerontology, the National Institutes of Health has, within the month, failed to approve the InterUniversity Council's application for funds to extend and expand its summer training institutes so as to prepare, within the next 4 years, approximately 280 more university faculty to offer instruction in aging in both the professional fields and scientific disciplines.

The opinion of the Advisory Council, supported by the opinion of the National Institutes of Health, is that there is no need now for such a crash program for training university instructors. Rather what is needed is long-term comprehensive graduate training for doctoral and post-doctoral candidates. Certainly no one can quarrel with the urgency of this need, but one may raise, and many do, the very legitimate and pressing questions of who will offer these long-term programs when the supply of teachers is still so wholly inadequate, and how the present generation of older persons can receive needed services while we are waiting out the years required for young people to complete their college and professional school training, and I might add that in the current year the National Institutes of Health did not have a single request for support of such intensive long-term training programs.

Since the support of the intensive training of established faculty to offer instruction in gerontology appears not to be within the area of interest of the National Institutes of Health, I recommend, Mr. Chairman, that immediate action be taken to place training grants for this purpose in some department of the Government, such as the Special Staff on Aging, which is deeply concerned and acutely aware that a crisis exists, and recognizes that the total effort in the field of aging may fail if we cannot fulfill personnel needs with adequately trained workers.

This recommendation leads me naturally to my second top which is a consideration of H.R. 10014 and its twin bill in the Senate, the McNamara bill, to provide for the creation of a U.S. Commission on Aging, and for grants to States for establishing or improving existing State agencies for aging, and for support of community planning, coordination, and development of programs. It also makes provision for research, training and demonstration grants.

When I spoke about my first point, the critical shortage of trained professional personnel and of instructional staff, I was expressing

my views as a member of the faculty of one of the Nation's top State universities, and as the director of the Inter-University Council on Training in Social Gerontology. But I wish to speak about my second point as one who has been a member continuously since 1949 of every Michigan committee, council, or commission for aging appointed by the Governor or established by the legislature, and as one who is currently a member of the Statutory Michigan Commission on Aging. And further, I wish to reflect experience gained as a consultant on aging to a number of Federal agencies, and as a user of governmental

services.

First I want to assure you that the goals outlined in the bill are those which deserve the wholehearted support of every person and agency, public and private, concerned about the welfare of the olderaged population in the United States. Michigan, as I am sure would be true for every other State, would welcome and profit immensely from their immediate accomplishment.

I find myself in entire agreement with the grant provisions of the Fogarty-McNamara bill. The small grants made to each State for use in preparing for the White House Conference on Aging have already demonstrated the effectiveness of the proposed State planning grants. Although the White House Conference State grants were by regulation, somewhat restricted in their use, they, nevertheless, stimulated far greater activity and achieved far more than the survey of State activities for which they were intended.

In Michigan, as in other States, the grant made it possible to solicit the active interest and participation of hundreds of citizens of all ages who never before were aware of the growing needs in the field of aging. The Michigan commission was able to expand its program greatly and to help many counties and communities to initiate senior citizen programs and services for the first time. Additional funds are, however, now urgently needed to help the Michigan commission develop a truly comprehensive program of services and to determine the patterns and extent of facilities required by the older population. Other States, I am sure, must have similar needs.

The authorization provided in the Fogarty-McNamara bill for grants-in-aid to enable States to support projects proposed by local communities for demonstration and development of methods by which services for older persons can be provided and staffed, may be an even more compelling need than are the planning grants to States. It is only at the grassroots where the solutions to individual problems can take place.

In connection with this point, I would, Mr. Chairman, urge that the bill be amended to provide additional funds for building multipurpose activity centers for older persons. The few existing multipurpose centers amply demonstrate the value of such facilities to older persons whose energies, health, and transportation problems make difficult their seeking out from a multiplicity of community services those which meet their special needs.

Mr. BAILEY. Might the Chair inquire, Have you experimented in this field in the State of Michigan?

Dr. DONAHUE. Yes, sir.

Mr. BAILEY. Could we have just a little more detail on that?

Dr. DONAHUE. Yes. In the multipurpose center we have a number of communities in Michigan which have been able, largely through

voluntary effort, to establish a multipurpose activity center where older people may come to spend the day together, to combat loneliness, on the one hand, and to find meaningful kinds of activities, on the other. These activities range from participation in workshop activities for which they may earn a small amount of money, through service activities given to the community, and to the social, recreational types of things which are frequently done.

Mr. BAILEY. Would you suggest that they be built in close proximity to your rest homes?

Dr. DONAHUE. I would suggest that they be built in central locations that are easily accessible by transportation. These usually mean somewhere near the central parts of cities. However, if there are collections of homes and nursing homes in some specific parts of cities, which is true for a few, then I think at least one or more of these multipurpose centers could be well located in that vicinity also. I would like to add that in these multipurpose centers, not only are these activities available, but most of them also include counseling services, some diagnostic health services, and out of them frequently are operated services which may be taken to the homes of older people themselves, such as meals on wheels, and other kinds of home

services.

If these can be concentrated, and where they have been they have been exceedingly useful, in some of these multipurpose centers, representatives of the regular agencies, such as the employment commissions, veterans' organizations, will provide a counselor in the center so that the older person need not go to any other point except on specific referral.

In other words, he gets his service here and goes only to another point if it has been determined that this is a desirable thing for him to do. It brings the specialists together at a single point where the older person can be fully served, and it is for this reason that I would recommend strongly that this bill be amended to include these kinds of centers. I think the funds should be of such magnitude that they would not only help the large communities, but would also provide similar centers in rural areas and small communities too.

Although I wish to be on record as supporting the bill's provision for research, training, and demonstration grants, I would like to qualify this support. I do not believe that ample consideration has been given to the fact that the largest number of workers needed in aging are those professionally trained to serve older people directly or to plan and develop programs and facilities to serve them.

The emphasis in the several grant programs of the National Institutes of Health is upon research and upon the training of research investigators. There are practically no grant programs which will support the development of curriculums and training of persons who will serve in such practical jobs as those of managers of old age and nursing homes or of senior citizen housing projects; as directors or staff members of State commissions and community committees on aging; as specialists on aging in voluntary and governmental agencies, and in business and industry, and in unions; and as executives of senior citizen counseling centers or multipurpose centers that I have just mentioned.

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