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Mrs. ATWOOD. Those we have heard of with a need. We are only taking those who have the problems that come to our attention. Mr. BRADEMAS. That comes to your attention?

Mrs. ATWOOD. Yes.

Mr. BRADEMAS. If they don't come to your attention?

Mrs. ATWOOD. We try to reach out as far as we can.

Miss SHOWALTER. We have pursued all the possibilities because the meals are prepared at the hospital. We have limited space.

As someone has suggested almost all churches have adequate kitchen facilities which a program such as Meals on Wheels could be utilized. Mr. BRADEMAS. How many meals do you serve in a day in the Elkhart Meals on Wheels program?

Mrs. ATWOOD. We have 28 and 34 has been our highest we have had. Mr. BRADEMAS. Up to 34?

Mrs. ATWOOD. Yes.

Mr. BRADEMAS. So that you would judge that that would pretty well exhaust the number of clients in the Elkhart community?

Mrs. ATWOOD. No.

Mr. BRADEMAS. I am not sure that I am clear.

Miss SHOWALTER. We have not done much publicity because of the limited space we have to prepare them, rather than exhausting the amount of people.

We have not set any limit. We would be able to handle more.

Mr. BRADEMAS. The lack of space has just been suggested or the shortage or relatively low number of persons who might need service. That is the reason you have so low a number of persons that you serve? Mrs. ATWOOD. We have a great number of people and this matter of pride is very important.

Mr. BRADEMAS. I am delighted in a county of 110,000 people there are less than 30 people who are in need of this kind of service.

I think Elkhart can take great pride in that kind of a record. That is not what we have found in other communities in the country.

It would be very helpful, certainly to me and I am sure to the subcommittee, if we could perhaps, at your convenience, receive from you some description of how you carry on the mechanics of your program because other communities might well learn from what you are doing here in Elkhart.

There seems to be an extraordinarily successful program here.

You also make the point of special diets and surplus commodities. As I understand Mr. Pepper's proposal, it would not be essential to provide these nutritionally balanced meals that he has contemplated solely from surplus commodities, but I appreciate the point that you have made.

Thank you.

Mr. Hansen.

Mr. HANSEN. Thank you, Mr. Chairman.

As I listened to your statement, Mrs. Atwood, it seemed to me your comments were right on the point as to these needs.

You stated the welfare recipients are offered the program at a reduced cost and many are unwilling to take them because they are unwilling to adjust the food pattern intake.

Would you amplify on that, please?

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Mrs. ATWOOD. I could give you an example. We found we have some people who have been on the program for a week or two discontinue because, well, for instance, they like to eat bologna and a little beer. They have eaten them all these years.

Some of the older gentlemen do not like the spinach and such. The people who do call in quite a lot have definite food preferences. We try to make as many adjustments as we can.

Mr. HANSEN. What you are saying is they do not want to spend money for something they don't like as well as what they can get eating hand-to-mouth as they have been?

Mrs. ATWOOD. We have gone back two and three times with volunteers, people who have done social work. We have gone back to see if they couldn't make some arrangements so the people could have the meals. They have said, "Thank you, but no, thank you."

Mr. HANSEN. I understand these are people who in your judgment have food patterns who do not provide them nutritionally balanced meals and are then willing to change those patterns?

Mrs. ATWOOD. Yes.

Mr. HANSEN. So that they do have a meal that is nutritionally balanced?

Mrs. ATWOOD. Correct.

Mr. HANSEN. It is true then there is a need?

Mrs. ATWOOD. Yes.

Mr. HANSEN. There is a need?

Mrs. ATWOOD. Yes.

How to get people to accept these meals is the problem.

Mr. HANSEN. It is an interesting point. Several others have made the same point in these hearings that there is a need for an educational effort in connection with this program to make people aware of what is a nutritional meal and aware of the importance of it and they get at least one every day.

So, it would be correct to state there is an obstacle especially when you are dealing with elderly people who are not willing to change. Mrs. ATWOOD. Yes.

Mr. HANSEN. The point was made this morning to many young people on a diet of Coke and potato chips.

Mrs. ATWOOD. Yes.

Mr. HANSEN. Another of the obstacles you made reference to I am very much aware of coming from a more sparsely populated part of the country is there are many who are in remote places where a meal program provided at a center for which there is no answer at all. They may be 50 or 20 miles from the center and the need is still there.

Do you have any suggestions for a program such as this or any other means that you might devise to meet most of the critical needs of the nutritional needs of the elderly people who live in the sparsely populated areas?

Mrs. ATWOOD. I did have a question.

I noticed the proposed funding was 90 percent. I wondered if it needed to be that much. We are overlooking one of our greatest resources in America and that is our volunteers.

I think if things are fully funded people hold back and from the volunteer standpoint, why should I go out and help. But if you say, look, we need you; there are more of them who are willing.

I do not think any of our clients could come out. We have had a few, one or two who could pick up the meals, go somewhere to get them. But for the most part they cannot get out at all unless someone went and got them.

But even if someone went and got them, they would be in a wheel chair. It is physically impossible to take them to the places.

Utilizing volunteers is an extension and I think there could be great possibilities. In this county the churches I mentioned are a great possibility if they have funds for the purchase of food and so forth.

Mr. HANSEN. My observation on the Meals on Wheels program it seems to me one of its great strengths is it does have this reservoir of volunteers who help and they are available and utilizes this very effectively to keep the cost down.

It strikes me out of all of this, is this, is what we would have to try to devise in the final legislation that you do have volunteer help that is available and can be organized.

There is surplus food which can go along with it. There are a great number of kitchens that are idle and can be utilized with some input of money and with the construction of administrative machinery we can mobilize these resources to meet the needs.

Mrs. ATWOOD. I think you would have to involve the volunteer transportation of some sort because there is not any transportation. Mr. HANSEN. To what extent can you utilize the older people themselves on a partially paid basis?

Mrs. ATWOOD. Most of our drivers are older people.
Mr. HANSEN. Are they paid something?

Mrs. ATWOOD. No. They even donate their gasoline. It is surprising how many of our volunteers who are office workers-we don't have any paid personnel except the hospital and as the program we have no paid personnel. It comes out of what we pay the hospital for the meals.

The office workers for the large part are people who are retired. A large number of the drivers are retired.

Mr. HANSEN. Thank you, Mr. Chairman.

Mr. BRADEMAS. I have just two more questions.

Do you receive any funds at all from the United Fund here?
Mrs. ATWOOD. No.

Mr. BRADEMAS. Are you completely self-sustaining?

Mrs. ATWOOD. Yes.

Mr. BRADEMAS. Mr. Hansen and I were here last night urging people to contribute to the United Fund to help meet your $840,000 goal. You may also be interested to know that Congressman Reid, my other minority colleague, from New York who was with us this morning, and I were cosponsors to the amendment last year to the Older Americans Act establishing a program initiated by Mr. Reid known as RSVP, retired senior volunteer program which we put together really in response to President Nixon's 1968 call for more attention to volunteerism in American life.

The program is now law but we do not have any funds for it; but at least we are moving in that direction on our subcommittee.

I know that both Mr. Hansen and I are grateful to you for giving this additional evidence and the constructive role the volunteers are playing in Elkhart in the Meals on Wheels program.

Mrs. ATWOOD. It was one of the greatest surprises of our lives that we did not have to seek additional funds. We were originally funded by several organizations in small amounts in order to buy the equipment to carry the meals.

We wanted to subsidize some people but we have not had very many at all on that basis. Our program has been self-sustaining. We have been able to do it this way.

Mr. BRADEMAS. Thank you.

Mrs. Showalter, I appreciate your taking the time to be with us today.

Our next witness is Mrs. Florentine Warskow.

We are very pleased to have you with us.

STATEMENT OF MRS. FLORENTINE WARSKOW, PRESIDENT, SENIOR CITIZENS CLUB

Mrs. WARSKOw. Thank you, Mr. Brademas and Mr. Hansen. First I would like to say that this amendment to the Older Americans Act is very timely and very much needed.

You know I am primarily here because I am the president of the Senior Citizens, among other things.

Years ago, however, I worked for a doctor in South Bend and I lived in South Bend, too. I lived there many years and I worked for this doctor for over 25 years. He was a typical family doctor if you know what I mean. The kind of a doctor that once he had the patient in the family he took care of that family and after the children were married and had children he took care of their family and so on and so forth.

His very first patients became his friends. He was really a very good family doctor. That is where I learned what it takes to be a good senior citizen before and afterwards.

After that it seems I had an ambition or something and I came to Elkhart and operated a nursing home for 10 years and sold it.

I thought I was retired and one thing after another it seems I get busier every year, and glad to be.

A well-balanced diet containing adequate amounts of protein, calcium, iron, and vitamins, prepared in such a way that the whole meal is eaten is desirable.

Much research is needed concerning nutrition in the aged, such as their requirements for protein, calories, minerals, and vitamins. Commercial food supplements are necessary in many cases, and especially where disease is affecting the nutrition of the aged.

A balanced diet is most effective when combined with some degree of physical activity. The type of activity depends on daily activity throughout youth and middle age, and must not be injected suddenly into the life pattern of an aged person.

Some older persons who have been somewhat health minded in younger years would be able to ascertain and understand the need for energy foods, so on in later years.

But many older folks would not, so the logical place to receive such information would be through the yearly checkup and their family physician if they can afford it.

I believe it is one of the most important things for older Americans to have a health checkup each year if they can afford it. Medicine and physicians' fees are expensive and retired folks should have some kind of discount.

Since 1966 the cost of health care has been climbing at an average annual rate of 7 percent, well above the rates of increase in other consumer prices.

Since the beginning of 1966 doctors fees have jumped by 29 percent and hospital charges by 59 percent.

The amount of money to be spent on food affects the proportional expenditure for the different classes, of food.

Weight of food alone cannot be used, since a part of that weight may be water, which relatively increases the cost, but lessens the amount of nutrients.

Cost per 100 calories places the comparison on the common basis of energy yield, but again no fair conclusions can be drawn as to the economy of the foods because their content of protein, minerals, and vitamins is no more measured by the energy value of the food than by its total weight.

Probably the best plan that has been suggested is contained in the classification of foods into groups and the expenditure of a certain percentage of the food budget for each group.

Such a plan, was suggested and issued during the World War, advised the division of the money spent for food into fifths as follows: One fifth, more or less, for vegetables and fruits;

One fifth, or less, for meat, fish and eggs;

One fifth, or more, for bread and cereals;

One fifth, or less, for fats, sugar, and other groceries and food adjuncts.

Now, if we all hope hard enough maybe our medical scientists will come up with a nonsenility pill and then we will all be young and useful and happy forever.

Mr. BRADEMAS. Thank you, Mrs. Warskow.

That takes me back to the days of Ponce de Leon. We used to read about him searching for the Fountain of Youth.

I suppose what we are trying to do now is to find the good meal for the elderly, and indeed, for all of us.

We will begin the questioning with Mr. Hansen.

Mr. HANSEN. Thank you, Mr. Chairman.

Our thanks to you, Mrs. Warskow for a very fine and helpful statement.

I was particularly interested in the observation on the need for some kind of daily physical activity which comets from earlier life which leads to the question that has come up in the course of the hearings sort of bearing on the importance of providing the meals at some central location as contrasted with delivering them to the home.

If older people are able to come to a central location this would appear to fulfill the need for daily activities. I would like to hear your comment on the relative values of serving the meals at locations

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