25 percent of their income, it follows that the maximum that these 4,800,000 could pay would be $375 a year, or $31 per month. Of course, housing means more than mere shelter. It must include heat, light, refrigeration, cooking fuel, and water. Can you rent in the private market a one-bedroom efficiency suite, that is, living room, bedroom, kitchen, individual bathroom, with all utilities furnished, on the ground floor or in an elevator apartment, because many of the aged cannot climb stairs, for $31 per month in any city you know about?

Let us now turn to the aged single person. The 1952 median annual income in urban communities for all single persons was $1,407, among the aged it was $857. Three-fourths of the whole group, that is, those individuals living alone, had less than $1,500 per year in cash income.

I commend to you the study in New York set forth in my prepared statement filed with the committee, which shows what these figures verify.

The city of Cleveland was faced with this problem and believed that public housing was the place that we could undertake the housing of these families. I have brought with me some pictures that the committee can look at. I will introduce them if you desire with the report. They show how we, 2 years before the 1956 act, did use the vehicle of public housing to provide housing for the aged.

Of course, we could not build housing for the single persons, because the law did not make that possible. However, we so designed some units that the normal one bedroom unit designed for a family could be converted into a dwelling where two single men or two single women could live.

Now a few words to indicate this great interest that the Congress has. You of course know, Senator, that the current bill pending before you, the Housing Act of 1959, provides more liberal FHA terms in the Senate version to encourage the construction of housing for the aged as well as for nursing homes through the vehicle of the FHA. Of course, the House version goes even further than that and provides for direct Government loans. I shall not comment on the present law, but will wait until the law is finally enacted.

PRIVATE HOUSING

I would like to make just a few suggestions, not to develop a program for you, but just a few suggestions that you might consider during the deliberations of the committee as a basis for possible legislation for the next Congress.

I believe that a separate division for the elderly within the Federal Housing Administration should be set up. At the present time the program is administered, under the administration of section 207; that is the section which provides insurance for multiple housing. Very often recommendations for this type of reorganization are made because of dissatisfaction with the present administration of the law. This is not the case here. When one considers the newness of the program, which has been only since 1956, I believe the FHA has been doing a creditable job despite administrative difficulties, because it is not a separate agency.

43350-59-pt. 1-18

This division could undertake a vast program of education among financial agencies and builders, so as to induce a greater participation in the program.

I think that a new division would give stature to the program which it needs.

The law should make it definite that the administrative determination of FHA that it coluld insure recreational and other leisure time facilities as well as the dwellings themselves was a correct one. One of the principal differences between normal rental housing and that designed for the aged is the absolute necessity of providing for such facilities.

NURSING HOMES

Little money can be made in operating good private or proprietary nursing homes except where the clientele is composed of people who have substantial savings or who have children with enough assets to pay the necessary high charges. For this reason, the operator of a proprietary nursing home of high standards must have some financial asistance if he is to provide for those who cannot pay their way. If he can produce evidence of competence and has a good record of being able to finance a decent operation, he should have the benefits of the maximum FHA insurance of the full replacement cost of the home he wants to build. This is a matter on which there is not unanimity among the people working in the field.

PUBLIC HOUSING

The present formula as enacted in the 1937 act was reaffirmed in the 1949 act. Its continuation was recommended by the President's Advisory Committee on Housing Policies and Programs and was generally accepted by Congress and became the basis of the 1956 law. The annual contribution formula is still the best and only realistic one proposed. The President's Committee as well as congressional committees tried to find a better formula but failed every time. Until a better one is found, let us not stop low-income public housing because we may not like the formula now involved.

I do not think that there is a question about the fact that the law is broad enough to permit the Public Housing Administration to assist in financing not only nursery schools for children of residents, but also community facilities for the aged residents. We have always installed recreational facilities for the young-we can certainly have recreational facilities for the aged. PHA can assist in financing the construction of bathrooms-we can therefore finance construction of other sanitary and health facilities for the aged resident. Perhaps some sort of a resolution by this committee would be helpful in buoying up the courage of the Public Housing Administration against critics who question the propriety of doing some of the things necessary if indeed we are serious about building and operating housing for the low-income aged.

If we undertake a broad national program for housing of the elderly-be it either private or public, we are faced with the problem of what happens to residents over 75 years of age who show signs of senility and the body starts to wear out. Many of these are single persons living alone. When the crisis comes there should be a place

where their condition can be diagnosed and a solution arrived at in a calm, professional and rational manner. At present, management in panic gets rid of the person by delivering him to an outpatient department of a nearby hospital where in turn-unwanted-he finds himself in one of the often disgraceful State mental institutions. Therefore, all housing for the aged, private or public, should be not only located near a health facility where treatment can be obtained, but a small diagnostic unit should be installed so as to provide for this temporary study period.

One of the pictures on the wall there shows the location of a public housing development which is on the drawing boards in Cleveland. You will notice that it is located right near a hospital. The hospital will operate this diagnostic unit that we intend to include.

RESEARCH

And finally, I would like to recommend very strongly that a research program be started in this field.

Few of us know exactly what living arrangements for the elderly are best. There are many who are holding up doing anything until the answer is available. I happen to be an impatient man, therefore I grope and often blunder toward arriving at a solution. In absence of research, this is the only thing I can do. Perhaps this is not logical, but it does produce housing and experience which is of value on the next development.

A legislative program should therefore be sponsored by this committee to undertake an intelligent, down-to-earth research program. I am not suggesting boondoggling or providing additional material for our Archives Building, but a program which will help decide these things.

U.S. PUBLIC HEALTH SERVICE

I think that the Hill-Burton law should be examined to see whether or not more assistance could be given to public housing and to good nursing homes. The U.S. Public Health Service should be looked into for possible assistance.

Mr. Chairman, finally, I want to recommend for your reading a publication of the National Association of Housing and Redevelopment Officials, being the October 1958, issue. I have taken the liberty of asking its secretary to send a copy to everyone on the committee. There are some good things coming off the press, but this is a general description of what the situation was and what is being done in the various private and public agencies in the field.

Let me state, which I know you will agree with, that there is no royal road to meet the housing needs of the aging and the aged. This is a job that has to be done by private investors, realtors, and builders, by fraternal, church, and labor organizations, by the public acting through housing authorities, by Congress, by State legislatures, city councils, and most importantly by men of good will in all walks of life.

Thank you very much, Mr. Chairman.

Senator MCNAMARA. Thank you, Mr. Bohn.

Senator Clark sent a message saying that he was tied up in another meeting this afternoon, and he wanted especialy to express his regret

to you, Mr. Bohn, because he wanted to be here to hear your testimony. And he points out that you and he serve together on the American Council to Improve Our Neighborhoods.

Mr. BоHN. As a Republican I am always pleased when a Democrat says he is sorry he is not here to hear me.

Senator MCNAMARA. Thank you again.

Are there any questions?

Is there any comment on Mr. Bohn's statement from the other panel members?

If not, we will hear from Dr. Wilma Donahue at this time.

STATEMENT OF DR. WILMA DONAHUE, CHAIRMAN, DIVISION OF GERONTOLOGY, INSTITUTE OF HUMAN ADJUSTMENT, UNIVERSITY OF MICHIGAN, CHAIRMAN OF THE COMMITTEE ON AGING, ADULT EDUCATION ASSOCIATION

Dr. DONAHUE. Mr. Chairman and members of the committee, thequestion of housing older people is an especially pertinent one for your committee because Government programs for financing special housing for the elderly are stimulating considerable activity directed toward providing accommodations for this age group. Unfortunately, interest and action are outstripping the establishment of a clear-cut set of policies with reference to housing the aged. Opinions are strong, research is at a minimum, and not all the knowledge now at hand is being applied. No one seems to be concerned with evaluating what type of society will be created if we follow one philosophy or one line of development as opposed to another. I would, therefore, urge that this committee give consideration to a study of the underlying social implications of various solutions to the problem of housing the elderly as a basis for sound legislation in the resolution of difficult issues not yet met.

SOME FACTORS UNDERLYING THE HOUSING PROBLEMS OF OLDER PEOPLE

1. Changing family structure and responsibility: The importance and urgency of the problem of housing older people can scarcely be overstated. Industrialization, urbanization, and increased mobility of the population have brought about profound changes in family structure which are generally unfavorable to the security of the older generation. When the family members no longer needed one another to preserve their economic life, the cohesiveness of the family group and the interdependence of generations lessened markedly. The nuclear family made up of parents and their immature children began to replace the extended kinship group. Practically all the resources of the nuclear family-money, time, energy-must of necessity be directed to the rearing of children if they are to be able when grown to compete successfully for their share of the goods and services produced by the industrial economy. Thus the older generation has come to have no definite claim or expectation that their adult children will provide them with shelter, economic support, or companionship. This trend is not likely to reverse itself in the foreseeable future.

The present living arrangements of older people reflect the separation of the generations (see following table). At ages 65 years and

over, approximately 46 percent are living as married couples in their own households; another 24 percent are not married but are serving as heads of households. The other 30 percent are living in some other type of arrangement including institutions, homes of relatives, or of adult children. Of those living in three-generational families, and there are some 1.2 million of couples who are doing so, most report that they regard the arrangement as undesirable. Middle-aged and older people usually capitulate to living with their children only when forced to do so because of long-term disabling illness, absence of income, or devastating loneliness brought on by the loss of spouses or other social contacts. A larger supply of good housing and wellplanned developments to serve older people would help resolve many difficult problems of younger families who cannot offer the space or support of their parents without depriving their children or disrupting their households.

TABLE 6.-Present living arrangements of the middle-aged and older

population

TABLE 7.-Old-age beneficiaries, national survey, 1958

2. Increased length of family life and postparental period: Another important consideration related to the housing needs of middle-aged and older people is the fact that families endure for a greater number of years than at the turn of the century, and that the average couple can expect more than a decade of life together after its last child leaves home. Some of the increase in the length of married life is the result of earlier marriage, but most of it is the product of a striking decline in the mortality rate. Persons starting their first marriages in 1900 could expect, on an average, 30 years of married life; the average couple marrying today can look forward to 43 years (or 13 years more) together before death intervenes for one of them. At the turn of the century there was a 50-50 chance that one spouse would have