"friendly visitors." After these, priorities become less
specific: "increase use of volunteers," "use of volunteer
groups.

Tax Assistance. About half the groups mentioned the
need for tax assistance for the elderly. The most common
priority was "property tax relief" although there were
calls for "general tax relief” and “elimination of any sales
tax on food and on health care." Several groups seemed
to think solutions lay more in information about current
tax relief than in new tax breaks: "tax counseling and
assistance" and "better information on property and per-
sonal taxes.'

Recreation. Considerable diversity can be found in this
category. One group called for "recreation areas for the

Education. As mentioned earlier, most priorities envision
education as a cultural experience, rather than as training
for a job or second careers; for example: "get seniors in-
volved in life enrichment programs." Keeping down costs
of education to the elderly was another concern. One
group advocated no tuition for senior citizens.

Mental Health. This subject received very little atten-
tion. Those groups that mentioned mental health services
seemed most interested in expanding outreach services.
One group, however, took a comprehensive view:
"psychological security against crime, attitudes, and
other mental health problems."

aged"; another for "recreation opportunities for all Rural Problems

"

people." Other priorities: "better arts and crafts,' 'more
meaningful social activities," "more physical fitness
programs, "cultural stimulation,' "planned
recreational activities," and "free or lower price tickets to
ball games, concerts, etc.'

Crime Prevention. "Involve police department in senior
programs," "escort services," "surveillance and protec-
tion of elderly at nutrition sites," "provide victim coun-
seling to older victims of crime," "consumer fraud
protection." Such were the priorities of about half the

groups.

A growing problem is the inability of rural counties to
muster sufficient administrative expertise or political in-
fluence to participate fully in many state and federal
programs. The following priorities indicate how many
programs are affected by this problem:

"rural priorities in federal programs,"
•"more equitable distribution of doctors and health
care facilities,'

"

"practical transportation for rural areas,' ⚫"housing in rural areas,' ⚫"legal aid in rural areas,

"

14

Support Activities

at

Most attention in this category was directed educating the public-both young and old-about aging and the elderly.

"

A strong concern for public acceptability of services to the elderly was expressed in priorities such as "community acceptance of universality of service needs," "overcome reluctance of elderly to receive services," and "better public relations for existing services.' Politics. As might be expected of elected officials and program administrators, political involvement was seen not only as a means to obtaining helpful services, but also as a desirable activity for the elderly in itself. As one group put it: "increase self-worth among the elderly (political participation).'

Other political priorities included “a formal structure
to advise county commissioners about elderly's needs,'
“legislative committees of elderly," "bringing groups in-
to a coalition for advocacy and impact.'

One west coast group had two seemingly contradictory
goals: "higher visibility of seniors to elected officials"

and take senior legislation out of partisan politics."
About a quarter of the groups turned their attention
directly on the elected county official:

⚫"involvement of elected officials in total planning
and implementation of programs for seniors,'

• "more aggressive and concerned attitude on part of
local board of supervisors,"*

•"county commissioners' use of their clout to force
cooperation between programs funded by different
federal titles.'

"

Priorites included:

•"promote improved medical school awareness of elderly's illnesses and problems,'

"train geriatric nurses and practitioners so that enough are available,'

⚫"more training for nurse's aides in nursing homes," •"training and licensing for paraprofessionals (paramedics, and conservators),"'

⚫"volunteer training.'

The need for more education and training was also a major point in the speech delivered at the Washington

"

"commissioners, *Among the titles of elected county officials with legislative powers are "supervisors,' "judges," "squires,' "chosen elected as well. freeholders," and "legislators." County administrators are sometimes

John (Chubby)
Caldwell,
commissioner,
Jefferson County,

Pa.. introduces a
panel of officials
who will discuss
housing.

transportation,
employment and
financial counseling

of the elderly.

conference by Dr. Robert N. Butler, director of the
National Institute on Aging and the Pulitzer Prize win-
ning author of Why Survive? Being Old in America.
Dr. Butler pointed out that in the majority of this
nation's 114 medical schools there is no "routine
systematic exposure" to the needs and problems of most
elderly people.

According to county officials, however, training should
include more than an understanding of geriatrics. Several
groups called for "recognition of problems caused by
racial and ethnic differences.

The preceding sections list what counties want to do to
improve services for the elderly. This section describes
how they think it can be done.

Two kinds of recommendations were produced: recom-
mendations for action by the National Association of
Counties (NACo), which is the official spokesman in
Washington for county government; and recommen-
dations for individual counties that can be undertaken
without federal assistance.

The former were offered as resolutions at the associa-
tion's annual convention in July, 1977, and were approved
by the board of directors and ratified by over 2,000 coun-
ty officials. (See Appendix D for resolutions.)

A selection of the other action steps follows. All recom-
mendations appear as they were stated at the confer-
ences. The number of action steps varies because certain
areas--administration, health, housing, jobs, trans-
portation-drew much more discussion than other areas.

16