STANDARD #8 The nurse assists older persons to obtain and utilize devices which help them attain a higher level of functioning and ensures that these devices are kept in good working order by the appropriate persons or agencies. Rationale: Devices are essential supportive measures to facilitate functioning. An inoperable or defective device is potentially dangerous. To help older persons be more independent, the nurse teaches them to secure, to use, and to maintain their devices. Older persons have a proportionately greater need for one or more assistive devices to facilitate functioning; therefore, the nurse needs to be well informed about resources for obtaining and maintaining these devices. Example: If a hearing aid is required, the nurse considers the problem of cost and, if necessary, contacts a community agency. When a hearing aid is fitted for the older person, the nurse assists him in his adjustment to it by recognizing fatigue and the time it takes to get used to it. STANDARD #9 The nurse seeks to resolve her conflicting attitudes regarding aging, death, and dependency so that she can assist older persons, and their relatives, to maintain life with dignity and comfort until death ensues. Rationale: If the nurse does not recognize and seek to resolve conflicts regarding aging, death, and dependency, functioning can be impaired and personal satisfaction not be achieved from her work. These conflicts are resolved to enable the nurse to enlarge her capacity to express empathy and compassion. Dying and death are common emotional and stressful experiences. Preparation for death is an imminent developmental task of old age. The older person is more frequently exposed to dying and death. The nurse needs to assist older persons, personnel, relatives, and other persons who are experiencing dying, death, and bereavement to express their feelings, thoughts, and rituals. Rituals provide a socially acceptable way of coping with emotion; therefore, the nurse enables the older person to participate in rituals meaningful to him. Example: The nurse recognizes that many of her own attitudes concerning death and dying are learned from the culture of the society in which she lives. 79-239 O- 72 - 30 Sister SCHWAB. S. 3076 proposes the establishment of a gerontological research center, to be headed by a five-member board. S. 3181 proposes the establishment of an Advisory Council on the Aging, to be composed of 15 members. It further proposes that these members shall be appointed so as to be representative of older Americans, national organizations with an interest in aging, business, labor, and the general public. The American Nurses Association urges that these older Americans are truly representative of the consumer interest. The American Nurses Association also recommends that the composition of the Advisory Council on Aging and/or the board be multidisciplinary. We further recommend qualified nurse researchers in fields related to gerontology such as physiology, biology, biochemistry, sociology, be appointed to the board of the Gerontological Research Center. The American Nurses Association is concerned about a proliferation of more programs, and we urge this committee to place high priority on conscientious coordination of all efforts and activities related to the aging as you continue to consider this most important legislation. Thank you very much for this opportunity to present our views to you. Senator EAGLETON. Is it your position that we need both a national institute on aging and also the concept contained in S. 3076 of the gerontological research center, headed by the five-member board? Do we need both agencies proceeding separately but simultaneously, or do we need one or the other? Miss Moon. Miss Moon. We have not taken a stand on either one, and I think what we have said is that we are just afraid of a proliferation of many programs, and want conscientious consideration of coordinating what is currently there, but we have not taken a stand one way or the other which one would be best at this point. Senator EAGLETON. It is just my surface impression that if we are trying desperately to focus more attention on research in aging, trying to elevate aging to a national institute coequal in terms of bureaucratic rank with heart, cancer, etc., and likewise created at the same time another agency called the gerontological research center, we will be splitting up an already meager pie into too many pieces. I may be all wrong on that, but it is just my impression. Senator EAGLETON. Do you have anything to add to Sister Schwab's statement? Miss MOON. No. Senator EAGLETON. Our final witness this afternoor was to be Mr. Jack Donahue, executive director, Council for the Advancement of Psychological Professions and Sciences. He is not here. That will complete this afternoon's hearings on the Older Americans Act. The committee will stand in recess. (Whereupon, at 3:50 p.m., the committee adjourned.) OLDER AMERICANS ACT AMENDMENTS OF 1972 WEDNESDAY, JUNE 7, 1972 U.S. SENATE, SUBCOMMITTEE ON AGING OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE, Washington, D.C. The subcommittee met, pursuant to notice, at 10 a.m., in room 6226, New Senate Office Building, Senator Thomas F. Eagleton, presiding. Present: Senators Eagleton, and Kennedy. Staff present: James J. Murphy, counsel. Senator EAGLETON. The Subcommittee on Aging of the Senate Committee on Labor and Public Welfare is now in session to continue its hearings on the Older Americans Act. We are pleased to have with us today four excellent representatives of the administration. Hon. Stephen Kurzman, Assistant Secretary for Legislation of the Department of Health, Education, and Welfare; Hon. John D. Twiname, Administrator of the Social and Rehabilitation Service; Hon. John B. Martin, Commissioner, Administration on Aging; and Mr. Donald Reilly, Deputy Commissioner, Administration on Aging. Mr. Kurzman, are you the leadoff hitter? Mr. KURZMAN. Yes; I am, Mr. Chairman. Senator EAGLETON. Proceed as you may wish. I hope we can avoid this, but apparently there will be some votes this morning which may necessitate some time out. STATEMENT OF STEPHEN KURZMAN, ASSISTANT SECRETARY (LEGISLATION), DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE; ACCOMPANIED BY JOHN D. TWINAME, ADMINISTRATOR, SOCIAL AND REHABILITATION SERVICE; JOHN B. MARTIN, COMMISSIONER, ADMINISTRATION ON AGING, AND DONALD REILLY, DEPUTY COMMISSIONER, ADMINISTRATION ON AGING Mr. KURZMAN. Mr. Chairman, I will just add, on my immediate left is Mr. Richard Verville, Deputy Assistant Secretary for Congressional Liaison. I would like to point out specifically that Mr. Reilly is making his first appearance before the subcommittee. He has been newly appointed as Deputy Commissioner on Aging. Mr. Secretary, when Secretary Richardson appeared before subcommittee on March 23, he discussed the philosophy behind S. 3391, introduced by Senator Beall, which is the administration's proposal to amend and extend the Older Americans Act of 1965. However, as you will recall, there was no opportunity for detailed discussion of our proposal at that time. As a result, we very much appreciate this opportunity to return and to discuss our proposal more fully and in greater detail. Because if we are truly to strengthen and expand the Older Americans Act, which so many older Americans rightly consider landmark legislation, all of the proposals pending before the subcommittee deserve very careful consideration. In order to allow us as much time as possible for your questions, Mr. Chairman, I ask permission at this point to submit for the record a detailed statement of how we would propose to administer S. 3391 with the system embodied in it to be enacted by the Congress. Senator EAGLETON. The statement will be made a part of the record. (The prepared statement of Mr. Kurzman follows:) PREPARED STATEMENT OF HON. STEPHEN KURZMAN, ASSISTANT SECRETARY (LEGISLATION), DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE THE DEVELOPMENT OF A COORDINATED, COMPREHENSIVE The major thrust of S. 3391 is the restructuring of the Title III Program to effect a change in the service delivery system in States and communities across the Nation, in order that needed services can be made available and accessible to older persons in a coordinated, comprehensive fashion. The following detailed discussion will illustrate how S. 3391 will be implemented to effect the above-mentioned change in the service a change which will benefit States, communities, delivery system and older Americans throughout the Nation. Department of Health, Education and Welfare June 7, 1972 |