serves a largely native American population in a 15-county area in the central part of the State. Several of these programs are in cities of substantial sizeDes Moines and Omaha-Council Bluffs, for example and serve a predominantly urban client population. Others serve a mix of rural and small city clients. Only two programs could be described as principally serving rural populations-Panhandle Legal Services in Scottsbluff, Nebr., and South Dakota Legal Services in Mission, S. Dak. There is attached to this letter a list of the programs in the three states, the addresses of their main offices, the counties they serve, and their current level of funding from the corporation. Number of elderly served. The corporation does not have data on the number of rural poor over age 55 in the three States. According to 1970 census figures available to us, the number of rural poor over age 65 in Iowa is 43,321; in Nebraska, 24,743; and in South Dakota, 14,946. Obviously, we reach only a small fraction of that population. None of our programs in the three States serve the elderly exclusively. The percentage of clients over age 65 varies from program to program, from as low as 5 percent to as much as 15 to 20 percent. The programs do not keep separate records on the number of clients over age 55, but if the group aged 45 to 64 is included, then the percentage of older clients increases significantly. In most programs, the percentage of clients who are over age 55 is less than the percentage of the eligible population that is elderly. This is due largely to the transportation difficulties poor elderly people have, especially in rural areas. In addition, the elderly tend to be less aware of the fact that legal services are available and do not understand how the programs could be helpful to them. Those programs serving a relatively high proportion of elderly clients are the ones that have engaged in aggressive outreach efforts. For example: The director of the Legal Aid Society of Polk County (Iowa) regularly visits senior citizens centers and speaks during their meal programs. In addition, he lectures to the State welfare agency's adult protective workers around the State on the problems of the elderly. Black Hills Legal Services, Inc. (South Dakota) has a wide-ranging program for senior citizens, including presentations in senior citizens centers and monthly newsletters published especially for senior citizens. South Dakota Legal Services uses paralegals as well as attorneys to visit nursing homes and the elderly in their own homes to advise and assist them with their legal problems. For example, the program recently canvassed the elderly, to inform them of a South Dakota law providing special tax rebates and to help them fill out the forms needed to obtain the rebate. Unfortunately, few of our programs have the additional resources required for adequate outreach and community education activities. Title III of the Older Americans Act is being utilized effectively by some local programs to supplement Corporation funds in order to reach the elderly in need of legal assistance. Those efforts through the Older Americans Act must be continued and expanded. Nature of the legal problems of the elderly. Accordingly to program directors in the three States, most of the legal problems of their elderly clients are routine and not all that different from those of other clients. However, these problems are particularly serious for older persons and often affect their very livelihood. This most common set of problems relate to their ability to obtain government benefits and services to which they are entitled-social security, SSI, medicare and medicaid, and food stamps. A second set of problems are health-related, including insurance, medical bills, and nursing home problems. The elderly also come with property and personal tax problems, and for help with wills, conservatorships, and problems associated with the death of a spouse. To a lesser degree than younger clients, they need assistance with housing and consumer problems. The majority of these problems are resolved without litigation. In many cases. the client simply needs information on benefits available to him or her, and assistance in filling out forms. Many matters can be resolved through negotiation. The following are examples of how legal services programs represent elderly clients: When property taxes rose as much as 45 percent in Polk County last year, the Legal Aid Society representing 2,300 elderly persons in individual protest hearings. The vast majority of those cases, 1,500 in all, were won and another 300 are on appeal. In South Dakota, a legal services attorney represented a poor elderly client who needed life-sustaining drugs costing $80 a month. Since the State medicare plan did not include payment for drugs, the elderly had to rely on county relief. The county had set an arbitrary limit of $50 a month on payment for drugs. Negotiations failed, a successful suit was filed, and that limit was removed, providing relief not only for the particular client but for all of the elderly in similar situations. In Iowa, a legal services attorney represented a 91-year-old woman in an eviction proceeding. Friends agreed that the loss of her home would destroy all that bound her to life. The court delayed the eviction and the attorney was able to persuade the landlord to let the woman remain. The need for legal services for the elderly. Evidence of the need for legal services among the elderly poor is overwhelming. In Iowa, when the State's commission on aging set up a WATS line for the elderly, the bulk of the calls were about legal matters. As a result, the commission has awarded a small grant to the Polk County Legal Aid Society and refers calls there. Often, the program can take care of the problems simply by giving the callers information, and sometimes by writing a letter for them. In other situations, they refer them to a local attorney who can help. In Nebraska, the most recent needs assessment conducted by the State's commission on aging identified legal services as a priority among the rural elderly in three out of the four areas reporting. The Panhandle Community Action Agency in Gering, Nebr., conducted a separate five-county survey of needs of the elderly, which showed that home health services were the greatest need and legal services the second. In each of the counties, more than 70 percent of those responding to the question, “Is there a need for legal services?" said yes. In some counties, the response was as high as 89 percent. We understand that you will be holding hearings in all three of the States during August. Representatives of legal services programs, including paralegals and the elderly clients themselves, as well as staff attorneys, program directors and board members, could provide useful testimony about the need for legal assistance and the benefits when it is available. Perhaps even more important, since those attorneys and paralegals work directly with elderly persons who find it difficult to obtain services and benefits available under Federal programs, they can offer useful insights into the way those programs are serving senior citizens. I am enclosing letters1 some of our programs sent in response to our request for information. If you need any further information, or if we can be helpful in identifying potential witnesses for your hearings, please let us know. Sincerely, [Enclosure] JUDITH ASSMUS RIGGS. Legal Services Corporation funded programs in Iowa, Nebraska and Iowa: Annual funding level Legal Aid Society of Polk County, 102 East Grand Ave., Des Moines, Dubuque Area Legal Services Agency, 630 Fischer Bldg., Dubuque, $308, 000 75, 900 Hawkeye Legal Aid Society, 114 East Prentiss, Iowa City, Iowa (319) 351-6570; Johnson, Jones, and Washington Counties (on referral from county bar association) _-. 77, 880 Black Hawk County Legal Aid Society, 708 First National Bldg., 99, 000 Total Iowa funding---- 560, 780 1 Retained in committee files. 80-319-1977-7 Nebraska : Legal Aid Society of Lincoln, Inc., 800 Anderson Bldg., 12th and O Total Nebraska funding-- South Dakota : 90, 400 277, 700 66,000 434, 100 South Dakota Legal Services, P.O. 727, Mission, S. Dak., (605) 290, 758 74, 800 Total South Dakota funding Total funding in 3 States 365, 558 1, 360, 438 ITEM 3. LETTER FROM HARVEY C. DAVIS, ACTING DIRECTOR, MATURA ACTION CORP.; TO SENATOR DICK CLARK, DATED AUGUST 12, 1976 DEAR SENATOR CLARK: Matura Action Corp. has been working with and is an advocate for the low-income elderly since 1966. In the last 10 years changes have been made in public attitude toward the elderly. More affirmative thought is going into the well-being of the elderly. Even with this progressive change in the attitude toward the elderly, some more assertive changes need to be incorporated into the programs. For instance, in housing, HUD's low-income housing has been eliminated or cut back so drastically that many of our towns and cities that had hopes of a program have been dropped and the elderly are then forced to find other means of housing. Also in the housing that has been established, the housing authorities are encouraged to keep running in the black so HUD will not have to subsidize the program. When this happens, the really low income elderly are sometimes passed over as residents because their 25 percent payment would make their contribution for the rent a little over $25 per month for the rent-and with very many of these in a housing complex, it runs in the red. HUD encourages them to eliminate running in the deficit. Transportation for the elderly is another area that has made some progress the past 10 years, especially in Madison County. In the other counties that Matura Action Corp. is funded, the area agency on aging has used title III of the Older Americans Act to furnish transportation. This has been a help. Matura Action Corp. has submitted a proposal to the State department of transportation for the coordination of transportation systems. This would be a boon to the area, but some of the boards of supervisors are reluctant to enter into the agreement, although they know there is a need, because it might become so popular they might be forced to contribute to the program. It is my belief that rural public transportation is going to have to be subsidized by the State, Federal, and the agencies purchasing services for the program. The elderly would benefit from this coordination of transportation systems. Matura's network of neighborhood centers have been a home-away-from-home for the elderly. In most of the counties in our area, these need to be kept in existence by Matura and supplemented by moneys made available by the Older Americans Act. Matura was helping the elderly long before the Older Americans Act designated regional AAA. Out of our centers we also sponsor 16 other projects for the elderly in other smaller towns in the areas. The title VII nutrition program of the Older Americans Act has been a valuable asset to our area. I have some constructive criticism: In some instances, the wealthy tend to monopolize some nutrition sites and the low-income will not attend because of this; and in other instances, the low-income elderly are patronizing the nutrition program in large percentages and now the middle-income and above have some hesitancy to take advantage of the program. I do not have a solution for this problem, although I think it was created in the recruiting phase of the program. I am concerned about the low-income elderly participating in the program and will use Matura's outreach and encouragement for the elderly poor to participate. Thank you. HARVEY C. DAVIS. ITEM 4. LETTER AND ENCLOSURES FROM DAVID L. ADAMS, HUMAN AGING COORDINATOR, DRAKE UNIVERSITY, DES MOINES, IOWA; TO SENATOR DICK CLARK, DATED AUGUST 30, 1976 DEAR SENATOR: I was pleased to receive your request of August 11, 1976 for copies of my research on the rural elderly. I regret that I missed the hearings you held in Iowa, but am very pleased that you got to talk with Woody Morris and with Governor Blue. I am enclosing copies of those articles which seem most directly relevant to your inquiry. Three of these apply specifically to the small town rural elderly of Missouri and have been done in conjunction with Dr. C. T. Pihlblad of Columbia, Mo.' We will soon issue another series based on a restudy of his sample done in 1973-74. The fourth was done for the Gerontology Society and applies to the general concept of rural elderly in America. It may be of particular use to you, If I can be of further assistance to you, please feel free to contact me. Sincerely, [Enclosure] WHO ARE THE RURAL AGED?? DAVID L. ADAMS. By David L. Adams, Ph. D., Drake University In accepting the offer to write this paper, the task of defining the rural aged and of setting the pace for contributions which follow seemed fairly easy and straightforward. After all, there have been several studies of rural and small town elderly done in the past 15 years and while publications in this area are not as voluminous as those in urban aging, they at least offer a high degree of consistency in defining the study sample. Basically, the rural elderly are those persons aged 65 and older who reside in areas of less than 2,500 population density. The assumption which underlies this demographic definition of the rural aged is that the social persons so named rather suddenly came into existence at the age of 65 and in the locations where they are found. Perhaps this is a necessary assumption, for it does underlie most of the gerontological research of the past 30 years. The theories of aging—subculture (Rose, 1962), role (Phillips, 1957), and disengagement (Cummings and Henry, 1961)-all presume that the variables necessary to explain the elderly are to be found in their current environments and social persons. Even the lifestyle theory (Williams and Wirths, 1965) is limited to existing, rather than preexisting styles of life. There is one approach, however, which is concerned with both past and present environments-the lifecourse frame of reference (Youmans, 1969). This approach indicates that a full understanding of human aging requires that the cultural expectations and abilities associated with older age be compared with those of earlier stages of life. It also indicates that to function effectively, a given society must provide the means by which a person can move in an orderly fashion from one status position to another, and the society must provide the motivations for individuals to fulfill the roles of each position. Consider, for example, the individual who has lived a lifetime in a highly urbanized area, who has achieved considerable class, status, and power in a bureaucratic structure, who has maintained a lifestyle and a value system commensurate with this position, and who at the age of 65 leaves this lifestyle for the quiet countryside of the Ozark foothills of Missouri (Oliver, 1971). By the : Retained in committee files. * Published by the Gerontology Society, November 1975. demographic definition, he would be considered rural aged and there would be nothing to distinguish him from the successful store owner who has spent a lifetime in the region-but surely they cannot be considered "rural" aged in the same qualitative sense of the term. Without the earlier environmental history of the respective individuals, we would be lacking valuable information for explaining much of the variance in their current values and life styles. The "aged" portion of this definition is also subject to qualitative inconsistencies. For instance, the successful grocery store owner mentioned above might be 75 years old, but still puts in 10 hours a day, 6 days a week at the store. He is still treated and greeted by his customers and friends as he has always been. He has come to be defined in terms of functional age, as ageless. His urban counterpart, while 10 years younger, is structurally defined as a retired old man. Consequently, while the store owner is rural, he is not aged-and his younger counterpart while aged, is not rural. These examples illustrate the weakness of considering only the current characteristics and environments of the rural aged and emphasize the necessity of further inquiry into the past history of the rural aged and their social worlds. Central to this life-course approach are the dual concepts of social role and socialization. The roles provide for the orderly movement through the life cycle as mentioned by Youmans. Socialization provides the continuing motivations to assume these roles. As used here, socialization is considered a lifetime process of modifying adaptive mechanisms, but its foundation is in childhood socialization— the language, values, expectations, and other patterns of environmental adaptation acquired during the younger years. With respect to the current generation of rural aged, their basic socialization occurred in a period which preceeded the instantaneous communication and value exchanges made possible by automobiles, radios, telephones and television. Consequently, change in their social world was slower and social roles were less abstract or ambiguous than is the case today. In 1942, a role theory approach to understanding adjustment to present and future roles was proposed which included the following requirements for successful adjustment (Cottrell, 1942): (1) The clarity of such future roles. (2) Emotionally intimate contact with persons in such roles. (3) Practice of the role through play or other activity. (4) The completeness of the shift in responses and expectations of others to the individual in his new role. All of these factors were more evident in rural America of 1920 than they are today. Consequently, the rural aged were socialized not only to a different society, but also to a different pattern of socialization and speed of expected social change. They were raised to expect that future roles would remain relatively clear and unchanged during their lifetimes and that societal response to them would be towards the total individual (functional worth) rather than towards some social characteristic of the individual (structural definition). The difference in orientation to one's social world which such a role expectation affords is vividly described by Parsons: . . . the (urban) father does not work in the home and his son is not able to observe his work or to participate in it from an early age. Furthermore, many of the masculine functions are of a relatively abstract and intangible character such that their meaning must remain almost wholly inaccessible to a child. This leaves the boy without a tangible meaningful model to emulate and without the possibility of a gradual initiation into the activities of the adult male role. An important verification of this analysis could be provided through the study in our own society of the rural situation. It is my impression that farm boys tend to be "good" in a sense in which that is not typical of their urban brothers. (Parsons, 1942) If we substitute for the word "good" other descriptive adjectives-such as neighborly, family oriented, independent, etc., the relationship or comparison remains basically the same. The rural environment of the early 1900's produced a social animal well equipped for survival in a society which existed at that time, but less well prepared for a society which was to change quite drastically during the lifetime of that social animal. The remainder of this discussion represents an inquiry into the nature of this change-especially that directly related to "rural" and to "agedness." It is based on the assumption that the rural aged of contemporary America are not simply old people who happen to live in rural places they are rural people who have aged while their environments have become progressively less rural. |