funds spent or administered annually by the Federal Government in connection with programs for older persons. 2. The Department of Health, Education, and Welfare, through its research arms, should continue its program of large-scale block grants to universities to support interdisciplinary research centers in the field of aging. In doing so, it should give increased attention to centers in which the primary focus is on the economic and social aspects of aging. 3. An effective research program in the field of aging requires support for long-range studies and thus for research grants with committed support for 10 years or more. Provision should also be made to support career investigators in the field of aging. 4. Grants should be made for teaching positions in gerontology in various universities for interuniversity training projects for faculty members, scientists, and other professional personnel, and for scholarships and fellowships to attract and train good research persons in the field. 5. The Federal Government should not only finance multidisciplinary research to be carried on by universities and other nonprofit organizations, but should itself, carry on basic and applied research, with particular emphasis in the area of social sciences. 6. Direction of the research program should be the responsibility of a National Institute of Gerontology staffed by competent scientists qualified to lead in both the physical and social sciences. * SENATE SUBCOMMITTEE ON PROBLEMS OF THE AGED AND AGING Seminar Medico-Biological-Chemical Researchers, Tuesday, October 4, 1960 PARTICIPANTS Dr. Albert I. Lansing, University of Pittsburgh, School of Medicine, department of anatomy, Pittsburgh, Pa. Dr. Nathan Shock, chief, gerontology branch, Baltimore City Hospitals, Baltimore, Md. Dr. Joseph H. Gerber, director, Center for Aging Research, Public Health Service, Department of Health, Education, and Welfare, Bethesda, Md. Dr. Ewald W. Busse, chairman, department of psychiatry, School of Medicine, Duke University, Durham, N.C. Dr. Geoffrey H. Bourne, professor and chairman, anatomy department, Emory University, Atlanta, Ga. Dr. John E. Kirk, Washington University, St. Louis, Mo. Seminar-Social Science Researchers, Wednesday, October 5, 1960 PARTICIPANTS Prof. John E. Anderson, Institute of Child Development and Welfare, University of Michigan, Minneapolis, Minn. Dr. Wilma Donahue, chairman, Institute for Human Adjustment, Division of Gerontology, University of Michigan, Ann Arbor, Mich. Dr. Edward A. Jerome, Acting Chief, Section on Aging, National Institute of Mental Health, Bethesda, Md. Dr. Leo W. Simmons, Teachers College, Columbia University, New York, N.Y. Dr. Gordon F. Streib, director, study of occupational retirement, Department of Sociology and Anthropology, Cornell University, Ithaca, N.Y. Dr. Marian Radke Yarrow, Chief, Section on Social, Developmental and Family Studies, National Institute of Mental Health, Bethesda, Md. Dr. Fred Slavick, Cornell University, Ithaca, N.Y. Dr. Clark Tibbitts, Chief, Program Planning, Special Staff on Aging, Department of Health, Education, and Welfare, Washington, D.Č. Subcommittee staff: Sidney Spector, Harold L. Sheppard, and Alice E. Robinson. CHAPTER V USEFUL ACTIVITY IN RETIREMENT TREND TOWARD RETIREMENT AND LONELINESS Few images are more clearly implanted in the minds of this subcommittee than that of lonely old people with little or nothing to do, waiting out their last years. This is a terrifying picture, especially when it is multiplied literally by millions. Today, there are more than 12 million people over 65 who are fully retired. Within 40 years, this may swell to beyond 30 million. Today, the average person at age 65 can expect to live 13.7 more years. Medical science and practice within a decade or so may double the length of time the average person can expect to live. 2 Some have found retirement enjoyable and have used this leisure time to create a satisfying way of life. Some manage to "get along.' But large numbers of senior citizens are most unhappy in retirement, isolated, and a burden to society in every way. In the future many millions of older people could spend their time wandering around our cities and our parks or sitting at home with nothing to do and contributing little. THE EFFECTS OF INACTIVITY UPON THE OLDER PERSON The retired person usually has about 80 hours a week of free time or double the normal workweek. Many retired persons find this time hanging heavy on their hands. As part of the White House Conference on Aging, four States made surveys of attitudes and activities of older people. These were Minnesota, Iowa, Missouri, and North Dakota.3 The studies revealed that problems relating to the use of their free time and the lack of social contacts were high in importance. For example, in Iowa, the major problems listed in order of their importance were 1. Health difficulties and physical discomforts; 2. Problems of finances; 3. Loneliness; and 4. A lack of satisfying activities. The survey in Missouri indicated that, in general, "boredom" was the most difficult thing about retirement for those interviewed. These studies emphasized the same points that experts in the field of aging and leaders of senior citizen groups have been saying for some time. Today, one out of every three mental patients is over age 65. Since 1939, the ratio of persons hospitalized for mental illness to the total 1 The 1960 report "The Aged and the Aging in the United States: A National Problem." The tables from the U.S. Census Bureau indicate that in 1959, there were about 24.7 percent of those over 65 who were fully retired and about 6.7 percent who were still employed full time. 2The 1957 Actuarial Study, No. 49," Social Security Administration, U.S. Department of Health, Education, and Welfare. It is projected that there will be somewhere between 29 and 35 million over age 65 by the year 2000. These reports are being prepared for publication by the Governor's Committees on Aging in each of the States early in 1961. population in each age group has decreased progressively. However, among persons 65 and older, the ratio has increased over the 20-year period by almost 40 percent. At the present rate of increase, there will be a 34-percent increase in the number of aged persons in public mental hospitals by 1970.* This is a serious enough problem to warrant national attention and action. In 1953, the World Health Organization estimated that between 10 and 20 percent of all older people are isolated, and estimated that in the United States this percentage was approximately 20 percent.5 The studies by the Governor's Committees on Aging in the four States mentioned earlier tend to bear out these estimates. WHO also indicated that there appeared to be a close relationship between social isolation and mental health. Recent, and as yet, unpublished reports of NIMH studies indicate that there is a direct relationship between isolation and mental illness. Similarly, research in Great Britain indicates a high correlation between isolation and hospitalization in a general hospital. The Mayor's Advisory Committee on the Aged of New York City reported a high correlation between membership in senior citizen activity programs and physical and mental health. In a study of 300 members of the Sirovich and Hodson Centers made by the Welfare Department of New York City, it indicated that after 6 months' membership in the center there was an 87.9 percent decline in clinic (medical) attendance. There were also proportionately fewer hospital and nursing home admissions. In the first 7 years of operation of the Hodson Center, Dr. Howard Rusk estimated that there should have been between 40 and 60 admissions to mental hospitals. There was only one. Ben Grossman, executive director of Drexel Home of the Aged in Chicago found a substantial reduction in sick call reports when activity programs were started in the home. 6 In retirement and particularly after age 70, many people begin to lessen their social contacts with others and to lose motivation and drive. Gerontologists have begun to call this the "disengagement process" and have observed its close relationship to mental and physical deterioration. While not a necessary process in old age, it is all too common today. INDIVIDUAL AND SOCIAL RESPONSIBILITY TO BE ACTIVE IN RETIREMENT The subcommittee believes the time has come to change our fundamental concept of retirement. There should be no longer a feeling that retirement is only a long-desired rest, a time when responsibilities end and contributions to society are unexpected. Retirement should only be from regular employment, not from the activity of life. While increased productivity may require fewer workers in our economy, our Nation cannot afford to waste what the older person can contribute in other ways. An increasing proportion of older per "The Aged in Mental Hospitals," a report by the Senate Subcommittee on Problems of the Aged and Aging, 1960, pp. 1-3. "The Aged and Mental Illness," World Health Technical Report No. 110, Geneva, 1953. "Mental Health and Aging," Harry Levine, a paper presented at the 1955 annual meeting of the Health and Welfare Council of New York City, mimeographed, 1955. 7 Elain Cummings, Lois Dean, and David Newell, “A Disengagement Theory of Aging," a paper presented to the 1958 Gerontological Society in Philadelphia. sons now look forward to retirement and to a change in their productive activity. In the decades ahead, with adequate social legislation, this proportion will increase. The subcommittee is convinced that retirement should be a time when older persons can, on a voluntary basis, both enjoy life and, at their own pace and in their own way, contribute to the society. But our ideas of what a contribution is must change. For many who are able, it may mean volunteer work in community services, their churches, or organizations. It may mean being an enlightened and well-informed citizen through continuing education. For the less fortunate, it could mean being just a little less of a burden to others, and helping make the lives of those around them more enjoyable. For most older people, however, the potential contribution they can make is limited only by their means and their imagination. In the testimony given to the subcommittee, we learned what some retired persons are doing to contribute to their communities while still enjoying their retirement. In the next decade, we must develop more ways through which older people can both enjoy life and make a contribution to the Nation. Dr. Halbert Dunn, Chief of the Office of Vital Statistics, has written: A In general, the older person is still respected for what he was but not for what he is today. Yet respect for what one is, is the foundation upon which personal dignity rests. person must feel that he is useful to those about him. Personal dignity requires one to live in the present and for the future and not in the past. Dignity departs when one is tucked into a niche of inactivity until he dies.3 THE GROWTH OF SENIOR CITIZEN PROGRAMS One of the fastest growing indigenous movements in America today is the senior citizen program. In every section and type of community, the subcommittee found that older people have banded together to gain fellowship and to participate in the variety of activities which such programs provided. The number of clubs established during the last 2 years has increased considerably, partly because of the activity at the State level in connection with the White House Conference on Aging. This activity was stimulated by Federal grants. Because of the rapid growth of senior citizen programs and the lack of assistance or organization at the National or State level, except in a few States, only an estimate can be made of the total number of such programs. A rapid, informal survey by the subcommittee indicates that there are more than 2,000 individual senior citizen clubs. But it is likely that this represents less than half of the total number. In a survey of over 1,000 senior citizen type programs, it was found that 218 were centers and 803 were clubs.9 A center was defined to include social, education, recreational, and/or counseling services for older people available 2 or more days per week, with paid leadership. 8" High Level of Wellness for the Older Person and Its Relation to Community Health," Dr. Halbert Dunn, Public Health Service, mimeographed 18 pages. • National Committee on Aging, Survey of Senior Citizens Clubs and Centers, 1959. 67714-61-8 |