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materials covering the various sessions, and reading and bibliographical materials as well.

In the week following the workshop the participants received a postworkshop evaluation sheet. Returns have already been received. We have valuable suggestions for further redesigning of the future workshops which should enhance the learnings of participants. Two things especially were noted, we shall have to add a day to any future workshop, and there is an almost unanimous desire to have further training opportunities, especially seminars, such as were offered this past spring.

An innovation at the Amherst workshop was having the members of the instructional staff join the group for dinner the evening before their appearance and sit in on the evening small group sessions. There was mutual benefit through this procedure; the staff persons were able to know the group better; the participants found they could relate better to these leaders. We shall continue this practice in future workshops. Also, we were the beneficiaries of the presence of the health education consultant, nursing home services section, Division of Chronic Diseases, Public Health Service, Department of Health, Education, and Welfare, who came on from Washington to observe the workshop.

In the evaluation of both the seminars and the workshops, there was unanimous agreement that further training opportunities were needed. Advanced seminars will be offered to those who have completed the basic seminars. Four areas were selected including mental health of the aged, rehabilitation in a nursing home setting, financial operations, and social gerontology. It is interesting to note in regards to the first two areas that the Chief, Division of Chronic Diseases, Public Health Service, Department of Health, Education, and Welfare, in his address at the Massachusetts federation's 12th annual convention, urged his audience to be concerned with mental health and rehabilitation as they are extremely important to the welfare of their patients. In regards to the offering in social gerontology we envisage an interdisciplinary staff to possibly include a psychiatrist, a physician, a social worker, a nurse, a psychologist, a sociologist, and an anthropologist.

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We thus find definite expressions of interest by nursing home administrators for their continuing education. We contemplate undertaking during the coming academic year, in the fall, the two basic seminars in organization and administration and in interpersonal relations; and two advanced seminars in finance and mental health plus a third workshop. In the spring of 1962 we would again conduct the basic seminars. The advanced seminars would be in rehabilitation and social gerontology.

During these months of program development, the education committee of the federation also explored with us the possibility of developing a professional certification program for nursing home administrators. We see this as reflecting a commendable desire to upgrade the professional status as well as the training background and qualifications of administrators. This is no longer the dream of a few visionaries. It is a reflection of a constantly growing number of owners and administrators who have taken considerable time out to participate in the training offerings at Northeastern, some 100 since the program started less than 7 months ago. More than half of this number have attended both a workshop and the seminars.

As to our goals for the future we see our operation on three levels. (1) Further development of our current training program, through residential workshops and weekly seminars. (2) A special gerontology program involving an interdisciplinary staff of 5 or 6, working with a small number of nursing home administrators, preferably no more than 20, who may have to be specially chosen, at least for the initial undertaking. Our explorations in social gerontology we consider as vitally gnificant because it will provide us, we hope, with the theoretical underpinning necessary to the practitioner's operations. (3) Investigation of a professional certification program. In order to develop a meaningful certification program, we intend to invite outstanding leaders from the fields of medicine, geriatrics, nursing homes, human relations, executive development, and rehabilitation to sit down and explore with us the basic essentials necessary for a nursing home administrator to be considered properly trained and qualified.

6 Miss Alice Frazer. 7 Dr. Leslie W. Knott

EXPERIMENTATION NEEDED

To realize our goals means breaking into new frontiers of training, considerable experimentation will be involved; responsible evaluation will be required. Nevertheless we are challenged by the nursing home administrator's desire to become efficient and professional in his role, mindful of his responsibility of effective leadership both within his instituton and in the community. Such training, we believe, will have direct effect on the welfare of the patient in the nursing home. We already have evidence of this from the administrators who have participated in our training programs.

We feel constrained to add that for the fullest development of our program considerable funds will be necessary. We trust that we shall be able to obtain funds from the Department of Health, Education, and Welfare; from the American Nursing Home Association; and from foundations interested in the welfare of our senior citizens, in order to validate and enhance Northeastern's continuing education program for nursing home administrators.

The future looks optimistic. A trained nursing home administrator with the ability to initiate programs soundly based in human relations and good patient care will be performing a valuable community service; and incidentally help to dispel the current negative community image. He can join with dignity and on an equal status level the ever widening circle of acceptable administrators in the medical profession.

WORKSHOP IN NURSING HOME ADMINISTRATION

Conducted by Northeastern University in cooperation with Region I, American

Nursing Home Association, Henderson House, Weston, Mass., November 27–30, 1961

PURPOSE

The nursing home is occupying a position of increasing importance in our medical and social communities. Its rapid growth demands of the administrator knowledge and understanding of its current status and comprehension of sound and effective management methods. The workshop is designed to serve the needs of top-level administrative personnel responsible for policy and operation, with two basic objectives:

(1) The development of sound management policies and practices for profitable operation;

(2) an analytical discussion of the community image of the nursing home with recommended procedures for future actions.

FACULTY

An outstanding faculty, each a specialist in his respective area: Dean Albert E. Everett, Center for Continuing Education, Northeastern Uni

versity Prof. Francis L. Hurwitz, director of special programs, Northeastern University Mr. William D. Brohn, Department of Drama, Speech, and Music, Northeastern

University Prof. Stephen G. Burke, Bureau of Business and Industrial Training, North

eastern University Prof. Herman V. LaMark, director, Bureau of Business and Industrial Training,

Northeastern University Dr. Reuben J. Margolin, associate professor of social science, Department of Spe

cial Programs, Northeastern University Mr. Theodore H. Needle, instructor in accounting, Northeastern University ;

partner, Penn and Needle, CPA's Boston Dr. A. Daniel Rubenstein, M.D., director, Division of Hospital Facilities, Massa

chusetts Department of Public Health Mr. Jerry Solon, director, Medical Care Studies Unit, Beth Israel Hospital,

Boston
Prof. Robert L. Wells, Fine Arts Department, Northeastern University

PROGRAM

Monday, November 27, 1961 :

4 p.m.: Registration
6–7:30 p.m.: Dinner
7:30–8 p.m.: Greetings and overview. Dean Albert E. Everett, Northeastern

University ; Mr. Theodore E. Hawkins, vice president, region I, American
Nursing Home Association; Prof. Francis L. Hurwitz, Northeastern

University.

8 p.m.: Problem census. Tuesday, November 28, 1961:

7:30 a.m.: Breakfast. 9 a.m. : “Managing a Nursing Home.” Organization for Effective Opera

tion-Planning as a Basis for Action-How To Manage Your Organization-Elements of Control-Job Analysis and Evaluation. Reaction panel

and audience participation. 12–1 p.m.: Lunch. 1:30 p.m.: "Getting Things Done Through People.” Recruitment and Selection-Indoctrination for Orientation-Induction for Job Knowledge Training for_Improved Skills-Supervision for Effective Performance Climate To Develop Morale-Nurture for Continued Growth. Reaction

panel and audience participation. 6–7:30 p.m.: Dinner. 7:45 p.m.: Small group session. An opportunity to explore in the small

group setting through discussion pertinent problems revealed in the day's

presentations. Wednesday, November 29, 1961 :

7:30 a.m.: Breakfast. 9 a.m.: “Financial Control and Budgeting.” Profitable Nursing Home Man

agement and Operation—Cost Control–Record Keeping—Tax Planning.

Reaction panel and audience participation. 12–1 p.m. : Lunch. 1:30 p.m.: "Social and Psychological Forces Confronting Nursing Home Administrators." Significance of various interpersonal patterns among staff and between staff and visitors-Leadership role of Administrator in these

relationships. Reaction panel and audience participation. 6–7:30 p.m.: Dinner.

7:45 p.m.: An evening of entertainment. Thursday, November 30, 1961:

7:30 a.m.: Breakfast.
9 a.m.: "Improving the Image of the Nursing Home in the Community.”

Misconceptions of Nursing Homes—Competitive Aspects of Nursing

Homes—Community Relations-Public Relations. 11:20 a.m.: Small group session. 12:30 p.m.: Lunch. Address : “The Relation of the Nursing Home to the

Medical Community.” Discussants, summary remarks, presentation of

certificates. Senator SMITH. This committee is extremely interested in hearing especially from the elderly people today at this afternoon forum, so we would be glad to hear from them. I think we covered pretty well the problems of the nursing home this morning and we would like to hear from you people this afternoon.

STATEMENT OF MARY KELLEY, BROOKLINE GOLDEN AGE CLUB,

BROOKLINE, MASS. Mrs. KELLEY. My name is Mary Kelley and I am from the Brookline Golden Age Club. Sometime ago about a hundred Golden Agers met at a meeting and formed six different study groups, and out of that came 25 important things that these Golden Age people would like.

First, more service needed to be taken to those older people who are not able to travel to existing facilities such as hospital out-patient departments. I know of a case where two people have to help one person to get down the stairs and over to the Peter Bent Brigham Hospital and has to go in a taxi each time. That person is on old age, too.

Then study should be made for the needs of homemaking service. Senior citizens who are able to perform homemaking services might supplement their income and be of service to others, senior citizens who are willing and anxious to perform volunteer service and community progress. However, material and transportation should be provided by the agencies involved. They need the transportation because old people like us, we cannot stand on the street and wait for buses to take us there. People have to change probably once or twice to get there. Transportation for elderly volunteers and of older people to and from the recreational, educational and health facilities is the problem that should be studied. Some suggested solutions include volunteer drivers or taxi pools.

Local nursing homes should receive more inspections and closer supervision from the State Department of Public Health. I know they probably claim they have taken care of us all right but what about the mental health there?

There should be greater flexibility in compulsory retirement ages with more individual evaluation after 60.

Social security payments should be more flexible and tied in with the cost of living.

I think that that is all I have to say. Thank you.

STATEMENT OF CHARLES J. FLYNN, BOSTON, MASS.

Mr. FLYNN. My name is Charles J. Flynn. I am a World War I veteran and also a member of the VFW. My remarks are concerning the disability provisions of the Social Security Act. I notice that the finding of disability introduced into the Congress by the administration was defeated. I also note that in the final vote of the Senate you abstained from voting. The provisions of the Social Security Act provide that disability must be of long standing or resulting death, also that a person must be so disabled as to prevent him from following a substantially gainful activity-they use the word activity.

The regulations are very drastic. I have legal opinion that they are not in accord with the provisions of the Social Security Act. The prior session of the Congress, subcommittee of the House Ways and Means Committee, studied the disability situation but failed to establish any criteria. The courts have been more liberal. I hope you will favor å legislation which will establish a criteria in accordance with the Social Security Act. Thank you.

Senator SMITH. Thank you very much. STATEMENT OF WILLIAM H. MCMASTERS, NATIONAL OLD AGE

PENSIONS, INC., CAMBRIDGE, MASS. Mr. McMASTERS. My name is William H. McMasters and I am the president of the National Old Age Pensions, Inc., and have been so for about 25 years.

78681–62—pt. 4.

7

Mr. Chairman and gentlemen of the committee, first I wish to thank the committee for allowing me a few minutes to speak in behalf of the aged of my State whose economic condition compels them to be confined in a nursing home at public expense. I am sure that the committee will agree with me that living in a nursing home at public expense, no matter how well the home is conducted, is not the best approach to the "life, liberty, and pursuit of happiness” that the founders of the Republic assured us are the God-given, unalienable rights of all men.

Practically every resident in these homes is in what we refer to as the middle or lower income bracket. Those living in the homes at public expense are in the lowest income group. In order, therefore, to find the right answer to the problem of nursing homes, that I understand to be the reason for this hearing, it should be the first objective of the committee to learn whether the amounts paid for public patients in the various homes engaged in this highly specialized activity, is sufficient to make things mentally and physically adequate for these special guests. I do not use the word “inmates” because it savors too much of penal or mental institutions.

In this very practical age, I can only suggest that the answer to your problem is “more money per guest,” just the way that hotels, motels, and even highly endowed colleges meet their mounting operation costs, if they expect to stay in business. It is important that you make every effort to see that any inadequacy of public help is not passed on to other guests who pay their own expenses or have them paid for them by relatives. Regulations and constant inspections will not solve your problem, but merely increase the difficulties of the solution. What these homes need is more dough, and I don't mean in their apple pies.

In the few minutes remaining to me, I will endeavor to demonstrate my theorem, and one good way to do that is by using the analogy of our national public administration.

On Wednesday, February 8, 1939, nearly 23 years ago, I was the first witness called by Chairman Doughton of the House Ways and Means Committee on bill H.R. 2, introduced on behalf of Dr. Townsend. It was in the largest hearing room at the Capitol and the room was filled to capacity, with hundreds unable to gain admittance. Dr. Townsend had told me, the day before, that I would not be allowed to speak on his bill. That wasn't the only thing the good doctor didn't know about our national Congress. He evidently didn't know that John W. McCormack was on the committee. Not only was I the first witness but I was the only witness for the opening session, due to the fact that every member of the 25-member committee wanted to get something into the record. I can assure the committee that I did not once invoke the fifth amendment during my 21,2 hours of testimony.

At that time we had a national debt limit set by the Congress at $55 billion. A member of the committee who may have thought my proposals, if put into effect, might wreck the country, asked me how far I thought the country could go further into debt and be safe. I told him I wasn't the least worried about the financial solvency of the Republic. What concerned me was its moral solvency and that was why I was speaking for a national pension.

Since then, Congress has increased the debt limit, step by step, until it is now $300 billion. We should modernize the process and put it on

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