The CHAIRMAN. Thank you, Ms. Glasse. The Older Women's League is a fairly new organization, is it not? Ms. GLASSE. We are 8 years old, sir. We have 20,000 members nationwide and we are growing very rapidly. The CHAIRMAN. Then, you are in most States now? Ms. GLASSE. We are in 37 States across the country. We have about 115 chapters. We are a grass roots organization of women who come together as a result of their concerns about the problems they are facing such as inadequate income and care giving. The CHAIRMAN. Well, the book by Tish Summers and Laurie Shields, "Women Take Care," has provided us here on this committee with a beginning of understanding how much of a drag this is on women. Laurie, in your documentation for this book—I think Ms. Glasse said that 75 percent of the care givers, that is, someone helping somebody at home, are women. Is that borne out by your Ms. SHIELDS. It certainly is, Senator, which does not say that we found men are not care givers. Men are caregivers, but they do it in a different way. They are able to pay for services that the dependent spouse cannot. In addition, from a demographics point of view, women outlive men by 8 years now, and the gap is growing. As in the case of the Glakas', men are very often married to younger women who outlive them and will wind up becoming care givers. I have been a care giver twice in my life, once for my husbandand I was younger than he was, and for Tish Sommers, my colleague and co-founder of the League. However, the differences are more than just gender. What it is is an acceptance of a societal kind of dictum that says women are scheduled to do this because theirs is the nurturing role in the family. As a wrinkled radical, let me be the first to tell you that I would like to have women have the same option men have, and that is to be able to say it is not my cup of tea; I can't do it—and not feel guilty about it. In Senator Bradley's State of New Jersey, we have some wonderful programs going, and some of the most exciting ones coming out in other States-I just came from Georgia-—are going for State respite care bills. Adult day care centers are another badly needed form of help. Compassion is in very short supply in this country today, and we shouldn't load it all on the backs of unpaid women care givers. We need a new partnership. We need private sector, we need government, we need care givers, we need the whole works, even though we aren't going to get the whole enchilada. However, with the help of people like yourself and the members of this committee who have long had a reputation that we are aware of of bringing to the fore problems of older people that nobody else wants to touch, believe me, this is a hot issue. The CHAIRMAN. Thank you. Senator Bradley. STATEMENT BY SENATOR BILL BRADLEY Senator BRADLEY. Mr. Chairman, I would only thank the witnesses for their testimony. I think they have been very helpful. Ms. GLASSE. Thank you. The CHAIRMAN. Thank you both very much. Next, we are going to hear from Don Peterson who comes from my State. He is the Executive Vice President of St. John's Lutheran Home in Billings, Montana, a home that I have had the privilege of visiting several times. Also, at the same time, we will call Ms. Kay Larmer, Chairperson of the National Institute on Adult Daycare, a membership unit of the National Council on Aging. Please proceed, Don. STATEMENT OF DON PETERSON, EXECUTIVE VICE PRESIDENT, ST. JOHN'S LUTHERAN HOME, BILLINGS, MT Mr. PETERSON. Thank you, Senator. I am Don Peterson, Executive Vice President of St. John's Lutheran Home in Billings, Montana. You have copies of my written testimony, and I will only excerpt some of that to emphasize certain points. St. John's is a multi-service provider which includes an adult day care center. I want to emphasize I am here today representing the American Association of Homes for the Aging, a national non-profit association which represents more than 3,200 non-profit providers of longterm care, health services, housing, and community services for the elderly. On behalf of AAHA, I would like to thank the committee for providing this opportunity to testify about this country's need for adult day care. I would also like to thank you, Senator, for the support you have given to the adult day care issue in the United States Senate. The introduction of S. 1839 is an important step in making this health care option available to additional numbers of older Ameri cans. The National Institute on Adult Daycare has noted that adult day care programs have risen from 12 in the early 1970's to nearly 1,400 today. This is certainly progress, but you and I know that we have barely scratched the surface. There is such a great need for this kind of program. I think our program at Billings is an example of the kinds of individuals who need this service. We have a total of 16 participants who spend from 1 to 5 days per week at our center. They range in age from 65 to 92. Some are there because of dementia. Some have chronic health problems. Some are lonely and just come for the company and socialization. Adult day care programs are designed to provide socialization for the participants and, at the same time, address their health needs. In addition to medical monitoring and medication assistance, we provide psychosocial, recreational, and other programs for participants who have degenerative or chronic conditions. We also ad 34 AMAN Thank you, Ms. Glasse. der Women's League is a fairly new organization, is it M GLASSE We are years old, sir. We have 20,000 members na- CHAIMAN Then, you are in most States now? GLASE. We are in 37 States across the country. We have - our documentation for this book-I think Ms. Glasse from a demographics point of view, women outlive Gacas, men are very often married to younger women who outyears now, and the gap is growing. As in the case of the live them and will wind up becoming care givers. I have been a care giver twice in my life, once for my husband— and I was younger than he was, and for Tish Sommers, my colleague and co-founder of the League. However, the differences are more than just gender. What it is is an acceptance of a societal kind of dictum that says women are scheduled to do this because theirs is the nurturing role in the family As a wrinkled radical, let me be the first to tell you that I would like to have women have the same option men have, and that is to be able to say it is not my cup of tea; I can't do it—and not feel guilty about it In Senator Bradley's State of New Jersey, we have some wonderful programs going, and some of the most exciting ones coming out in other States-I just came from Georgia—are going for State respite care bills. Adult day care centers are another badly needed form of help. Compassion is in very short supply in this country today, and we shouldn't load it all on the backs of unpaid women care givers. We need a new partnership. We need private sector, we need government, we need care givers, we need the whole works, even though we aren't going to get the whole enchilada. However, with the help of people like yourself and the members of this committee who have long had a reputation that we are aware of of bringing to the fore problems of older people that nobody else wants to touch, believe me, this is a hot issue. The CHAIRMAN. Thank you. Senator Bradley. STATEMENT BY SENATOR BILL BRADLEY Senator BRADLEY. Mr. Chairman, I would only thank the witnesses for their testimony. I think they have been very helpful. Ms. GLASSE. Thank you. The CHAIRMAN. Thank you both very much. Next, we are going to hear from Don Peterson who comes from my State. He is the Executive Vice President of St. John's Lutheran Home in Billings, Montana, a home that I have had the privilege of visiting several times. Also, at the same time, we will call Ms. Kay Larmer, Chairperson of the National Institute on Adult Daycare, a membership unit of the National Council on Aging. Please proceed, Don. STATEMENT OF DON PETERSON, EXECUTIVE VICE PRESIDENT, ST. JOHN'S LUTHERAN HOME, BILLINGS, MT Mr. PETERSON. Thank you, Senator. I am Don Peterson, Executive Vice President of St. John's Lutheran Home in Billings, Montana. You have copies of my written testimony, and I will only excerpt some of that to emphasize certain points. St. John's is a multi-service provider which includes an adult day care center. I want to emphasize I am here today representing the American Association of Homes for the Aging, a national non-profit associ6tion which represents more than 3,200 non-profit providers of longterm care, health services, housing, and community services for tat elderly. On behalf of AAHA, I would like to thank the committee for pr viding this opportunity to testify about the hunts neer adult day care. I would also like to than senator for the sur port you have given to the adult de 2* States Senate. The introduction of S. 1839 is a health care option available to as: cans. The National Institute on Ar I theme: day care programs have risen from 12 in the early 1970 s 1,400 today. This is certainly progres but you and I know have barely scratched the surface mer is such a great this kind of program. I think our program at Bills dividuals who need this service who spend from 1 to 5 days sample of the kind a total of 16 partic of our cente. They wil e have chronic The company to provide someone for address their medication ather progra Conditions dress their nutritional needs with a daily lunch and an optional breakfast service. In addition to meeting the specific needs of participants delineated above, I believe our program has made valuable contributions to three other social concerns which confront this country. The first is the need to maintain and enhance the ability of family care givers to continue their roles. Second, is the desire by all of us to promote the elderly person's independent living as long as possible. Third, is the ability to use limited fiscal resources to reach as many individuals as possible. Let me expand on these three just a bit. First is maintaining and expanding the role of the family care giver. Family members provide 80 to 85 percent of the care given to our elderly. These care givers, many times, are retired spouses of the individuals who need assistance. More and more frequently, however, care givers are middle-aged wage earners who struggle to balance the demands of their jobs with the responsibility of caring for aging persons. All these care givers need the kind of support which adult day care can provide. For those retired spouses, adult day care can relieve the isolation and other stresses that may eventually impair the ability of that care giver to live independently. For employed care givers, the respite provided by adult day care can help them to continue their own growth and establish a financial base for their own retirement years. It also permits many of these individuals to contribute economically to the welfare of their parents. My second point is promoting independent living. Behind the phrase "promoting independent living" is the implicit intention of avoiding nursing home placement. Although I feel very strongly that there is a place for the nursing home in the overall continuity of care, I do share the value that there is no substitute for independent living if that individual can remain healthy and safe. I believe adult day care centers can provide this environment for many, many individuals. Day care can also help some elderly persons over the rough spots which might otherwise result in nursing home placement. We had an example of that in our own center not long ago. An 86-year-old woman who lost her husband, became depressed, confused, over-medicated, and eventually ended up in the hospital. She entered our day care program after six months of treatment and therapy, both in the hospital and in the community. Within six weeks, she was able to move into our retirement home, where she continues to function well. This was a case in which the nursing home staff worked with the day care staff to successfully avoid nursing home placement. We believe that this teamwork has helped most of our participants avoid or at least delay placement in nursing homes. My third issue is the efficient use of limited resources. We are all concerned about health care costs, and nursing home costs have especially captured public attention. The program at St. John's not only reduces the State and national burden of nursing |