The CHAIRMAN. Our first witnesses this morning will be Jean and George Glaskas of Falls Church, Virginia.

Please proceed.

STATEMENTS OF JEAN AND GEORGE GLAKAS, FALLS CHURCH,

VA

Mr. GLAKAS. Gentlemen, I am a little nervous, so you will have to bear along with me.

My name is George Glakas. I used to be a very active man with two jobs. When I was 63, I had a stroke that left me paralyzed on my left side.

I was in the hospital for three and a half months. From there, I I went to the Woodrow Wilson Rehabilitation Center in Fisherville, Virginia for three months of therapy.

I got to the point where I could take a few steps, but I needed a lot of help and spent most of my time in a wheelchair. I was glad to go home, but my bed had to be in the kitchen, and there was no bathroom on that floor.

I was in bed most of the time, because I needed so much help to get up and out of bed. It was too much for my wife. I needed to have someone with me, dress me, feed me, do everything. I was a burden.

I was miserable and depressed. I couldn't go up and down the steps in the house, so we sold the house and bought a condo where everything is on one floor. We hired people to take care of me, but it was very hard to get somebody good, and it was expensive.

Money was really getting to be a problem with my wife and I. I still was in bed most of the time, feeling unhappy and guilty. I had to depend on my wife for so much.

Luckily, I had a young wife. [Laughter.]

That wasn't planned.

Senator CHAFEE. Young and attractive wife.

Mrs. GLAKAS. Thank you.

Mr. GLAKAS. I had a good family that helped me. My sister in Maryland located the day care center here in Virginia.

My first reaction was it is not my bag sitting around with old people, but when I went in 1985, I liked it and still do. I like the staff. They care about me and help keep my spirits up. I have made a lot of friends there. It has been really important to me to have friends to sit around with and talk to about current events and lie about our women. [More laughter.]

The center bus picks me up at my door and brings me home. At the center, we do many different things. We have competitive sports we can play like bowling, golf, volley ball, football, and baseball. That doesn't mean we go out on a football field and play. This is my football. We have box hockey. We even play against the other centers.

This year, we took first place in the volley ball tournament and second place in the box hockey.

We go to a movie occasionally and then out to lunch. We have trivia games to wrack what is left of our brains. We have singalongs and dances. Those dances are something; you should see

them. I do the wheelchair shuffle. When we have parties, I tell jokes.

We have lunch there, and I get only the foods on my special diet. There is a nurse to check my pressure and heart and to walk me, and there are other people to help me in whatever way I need.

Being at the center is much better than sitting at home. I can talk and enjoy myself. I can still lead a half-way decent life, a normal life.

I have one of two choices, the center or the nursing home, and I prefer the center 50 to 1. I only wish there were centers for people like myself in all 50 of the States.

Thank you, and please support us.

The CHAIRMAN. Thank you.

Mrs. Glakas.

Mrs. GLAKAS. I feel like most of my little speech has already been said. I have a lot of things that I have prepared here, but it is repeating, so bear with me.

I know you will be presented with numerous facts and figures today concerning Medicare and financing which we have already heard, but I would like to present the human or personal side of having these centers available from the care giver's point of view which is mine.

Some people might think of the center as a social club or a recreation club for the elderly. It is much more than that. It is exactly what the name implies, with the emphasis on care.

Before my husband started attending the day health care centers, we had tried all sorts of alternatives. Of course, we had family to help us, but since my husband needs assistance with all of his activities and his personal hygiene, any outside help that we had had to be considered "skilled.

Since he was declared totally disabled, it was necessary for me to work. Even then, we could not afford more than a few hours for someone to care for him and bathe him.

When I was at work, my husband spent most of his time in the bed. His condition deteriorated, and he was either watching TV or staring into space. He was hospitalized several times after falls and also for hip rotation from lack of exercise from staying in the bed too much.

He required much physical therapy. It became more difficult for me to assist him and transfer him from the wheelchair to his bed. He finally fell on me and crushed my hip.

At this point, our daughter came home from college to help us. During my recuperation, my sister-in-law was investigating possibilities for care of my husband. I would no longer be able to lower him down to a bathtub bench or to exercise him. She was referred to the Annandale Day Health Care Center.

He was accepted, and our routine changed drastically. My husband began to feel better and was much more alert. He looked forward to his days at the center which were filled with activities.

I was more relaxed about going back to work knowing that he was being well taken care of all day and that a nurse was on duty to check his health. A therapist was also made available through their efforts and also a podiatrist to cut his toenails which I couldn't do myself.

At first, I had to drop my husband off on my way to work, but, eventually, transportation was made available to us.

The financial burden was eased also, because the charge was based on a sliding scale.

The staff was also helpful to me in many other ways. When I developed carpal tunnel syndrome and was again faced with surgery and not being able to take care of my husband, they furnished me with a list of companions and other help which was available to

me.

Middle income people of our generation have contributed to local, State, and Federal governments through our taxes all of our working lives. Saving for the future is almost impossible when you are trying to buy a car and a home and help children though college. All of a sudden, we are in our fifties, and we start to think of saving for 10 or 15 years for retirement.

Not many of us expect or plan for a major disabling illness when we are enjoying good health.

I realize it is a traumatic experience for my husband and for any person who has to spend the rest of his life in a wheelchair. But it is also a major upheaval in the life of the care giver.

The day health care center helps preserve the sanity of both parties. I think it has also prevented further hospitalization of my husband by keeping him active. It has also enabled me to continue working.

Even if we could afford a nursing home, neither of us would prefer that choice. The center is a much more agreeable arrangement for both of us. There is nothing else comparable or similar to a day health care center.

Had we not been able to avail ourselves of this opportunity, I don't know how we would have managed the past few years, financially or otherwise.

I am happy and honored to have met all of you today, and I hope you will consider making day health care centers available to anyone who is in need.

Thank you.

The CHAIRMAN. Thank you.

Mr. Glakas, you said at the outset that you were a little nervous, but that obviously hasn't taken away from your sense of humor. Do

I detect that you spend just certain days in the day care center?
Mr. GLAKAS. Three days a week.

The CHAIRMAN. Like Mondays, Wednesdays, and Fridays?
Mr. GLAKAS. Monday, Tuesdays, and Fridays.

The CHAIRMAN. And then, on Wednesdays and Thursdays, what happens then?

Mr. GLAKAS. I mean Mondays and Thursdays.

Mrs. GLAKAS. Someone comes in.

Mr. GLAKAS. Someone comes in to take care of the house and she takes care of me. She bathes me and takes care of the house, does my wife's ironing. She has worked on occasion for us for 17 years, and she stays with me until my wife comes home.

The CHAIRMAN. On those two days a week?

Mr. GLAKAS. That is right, Mondays and Thursdays.

The CHAIRMAN. You said you pay for this on a sliding scale, Mrs. Glakas. How much is that?

Mrs. GLAKAS. The day care center?

The CHAIRMAN. Yes.

Mrs. GLAKAS. It is $8 a day for us. We were paying $9 an hour for help from other sources. When we had to get help from nurses aides who were considered skilled, we were paying $9 an hour for them to come in to take care of my husband.

The CHAIRMAN. Does the $8 include the meal?

Mrs. GLAKAS. At the day health care center, yes, it does include the meal. He has coffee in the morning, and he has lunch there. Mr. GLAKAS. Yes, the Monocle caters the place. [Laughter.]

The CHAIRMAN. Thank you both very much.

Senator Shelby.

Senator SHELBY. Thank you, Mr. Chairman.

I just want to commend both of you for the courage to come here before this committee. I believe what you are doing is you are demonstrating here the need by testifying here for adult care centers, and you are showing as an example of what it can do for you. Mr. GLAKAS. There is a need.

Senator SHELBY. I have long advocated that. I know myself of hundreds of people in my home State of Alabama that don't want to be in a nursing home, would like to stay at home as long as they could, but they have to have some type of support such as a day care center for adults and others.

I believe not only will it be cost effective-I mentioned this in my statement, because we have budgetary restraints-but it will be wholesome and be a lot better than warehousing people.

Mr. Chairman, I commend the people for coming here today.
Mrs. GLAKAS. Thank you.

The CHAIRMAN. Thank you, Senator.

Senator Chafee.

Senator CHAFEE. Thank you, Mr. Chairman.

We thank you for coming here today and giving us such a fine statement. It has helped us a great deal, and it gives us a perspective of how one family located a particular center.

Who operates this center? How does it finance itself?
Mrs. GLAKAS. The County of Fairfax, as far as I know.
Senator CHAFEE. It is a county operation?

Mrs. GLAKAS. I am sure that will be covered by testimony from other people. I don't know too much about the financial end of it, but we send our checks to the County of Fairfax.

Senator CHAFEE. Oh, I see. And how do they arrive at the sliding scale? They ask you what your income is and then determine-Mrs. GLAKAS. Yes. When we first started, my husband wasn't working at all, and he wasn't declared disabled for six months. So, he actually had no income and was not on Medicare until he was 65. That was three years ago.

So, we had no Medicare. We had a minor hospitalization comprehensive plan, and I was not even working at the time except helping him with one of his jobs. He was working two jobs.

After he had his stroke, he was unable to work. So, I had to work.

Senator CHAFEE. So, what they do is they ask your income and then arrive at some kind of a figure.

Mrs. GLAKAS. Yes, that is right.

Senator CHAFEE. Well, that is good. I suspect that, judging from you and your husband said that, absent this day care center, it would be necessary probably for Mr. Glakas to be in some kind of a nursing home, wouldn't it?

Mrs. GLAKAS. We were faced with that possibility before the day health care center. After I broke my hip, I wasn't able to work.

We had spent a lot of money when he first had his stroke. We had a savings account, but that was wiped out because we didn't have full coverage for hospitalization. I didn't really know what I was going to do with him. As I said in my speech, we didn't have any other alternatives. I suppose we would have had to apply for some sort of State institutionalization.

Senator CHAFEE. So, this is a clear cut case where the presence of the day care center has made it possible for Mr. Glakas to remain at home.

Mrs. GLAKAS. Definitely.

Senator CHAFEE. Well, thank you both so much for coming.
The CHAIRMAN. Thank you, Senator.

Senator Grassley.

Senator GRASSLEY. Mr. Chairman, the questions I have I wouldn't expect the family here to be able to answer, but maybe for the benefit of the discussion that you and Mr. Chafee had previous to their testimony, it might be beneficial if we could maybe take four or five families from this day care center and, in relationship to their paying $8, find out how much comes from the family and how much comes from other sources and then compare that to what it would be if these people were in a nursing home.

Then we would have at least some real live examples of the savings that come from day care centers as opposed to being in a nursing home. Obviously, we all know that it is going to be cheaper, but I think that the $8 obviously doesn't reflect the real cost of what it would be for Mr. Glakas or anybody else to be there.

Would it be possible maybe to get some information like that? Mrs. GLAKAS. Excuse me. How much would it cost for the government, if I had no income, to put my husband in a nursing home? Senator GRASSLEY. Well, it is my understanding that that is about $20,000 a year, isn't it, Mr. Chairman?

The CHAIRMAN. That is correct.

Mrs. GLAKAS. As compared to $30 a day, five days a week for a

year.

Senator GRASSLEY. Yes.

Mrs. GLAKAS. I don't know how to figure that out quickly, but it is still a lot less money.

Senator GRASSLEY. Yes, I think you are making my point for me. The only thing was if we could do something like that, Mr. Chairman, I would appreciate it very much.

The CHAIRMAN. Ms. Kay Larmer who is the director of this particular center will be a witness today, and she will be able to fill us in with those details.

Senator GRASSLEY. OK. I will read the record, Mr. Chairman.* The CHAIRMAN. Senator Burdick.

*See appendix, Item 4, p. 117.