WOI: News Clip 216

Senator Jack Miller served as chairman for the hearings that were recently held in Des Moines these were for the United States Special Committee on Aging the emphasis was concerning the [rule?] elderly why this particular subject probably because we haven't concentrated on this particular area of older Americans since the committee was established committee was established about seven years ago and while it has engaged in numerous undertakings through its various subcommittees engaged in a considerable amount of research a lot of reports helped father and passed the older Americans Act and I think generally made progress in the area of older Americans we're now beginning to understand and to concentrate on special problems as far as areas of living are concerned and so it was decided that we hold a series of hearings on the problems of older Americans living in the rural areas whether they're rural non farm areas or rural farm areas and I think the testimony that we received during this hearing here in Des Moines Iowa indicated that there are some problems that are peculiar to older Americans living in those rural areas as against the older Americans living in urban areas now could you identify some of these that are peculiar to the rural area yes I think you might summarize it by saying it's a problem of access access to facilities access to doctors and dentists and even pharmaceutical stores the need for transportation the average older American living in an urban area it does at least have an opportunity to get a taxi or a bus there are many of our little communities where they have no taxi service at an older person who has either no car or has not qualified for a driver's license has no place to go except maybe through a friend or a neighbor and this makes it extremely difficult and in some cases literally forces them to move away now the need for for for service or facilities there may be no hospital no nursing home or no particular type of a nursing home in a particular small community most larger areas have all of them so it's primarily a problem of access and how are you going to organize how are you going to arrange the distribution of facilities within let's say a rural area complex so that perhaps in this town there will be a hospital in this town a nursing home but the facilities will be there where they're more readily available than they are now was there a feeling that perhaps and planning and all different sorts of legislation community planning that perhaps the impact of out-migration or the higher proportion of senior citizen could affect other governmental projects within a community well I think it was well brought out that there are federal programs that are not necessarily pitched to the older people which can have a very great impact on the older people the area of property taxes for example now while this is primarily a state matter this is an example a property tax impact can have a not only effect the younger person but the older person in fact it can have such an effect on the older person as to cause him to lose his home or move away to an apartment and terribly disrupt his pattern of living from a federal standpoint we have many programs education programs for example programs which are calculated to help support education after one normally leaves college or leaves high school the adult education programs there's a need for continuing education among the elderly the thirst for knowledge does not stop at the age of 65 and I think that we can in our federal programs as well as at the state level we can pay a little more attention to the impact that this program will have on this one area of society the older Americans and I think if we do that we can probably come up with a better program than we're coming up with now do you think there is much difference within a city as there is within a rural area as far as the particular needs within different segments of the of the city well on the basis of the testimony that we received today there isn't any question but what there's a substantial difference among the rural areas there are some rural areas where there has been a very high out migration of younger people and as a result you have a very high population density of older people there are other rural areas where this is not so it was brought out for example I think dr. Morris from the Institute of gerontology at Iowa City gave us a chart which shows that generally among the two southern tiers of counties in Iowa you have a very high number of people over 65 where as you get into other areas of Iowa and the number is relatively small that being the case you're going to have a difference in problems you have a different intensity difference in needs for nursing homes and medical care and of course if you have a rural area that is fairly populous as against a rural area that is not you may have to combine four or five or six counties to to get the job done of providing facilities we have what is called the ten code project consisting of ten counties in southern Iowa this was given considerable praise for the way it is organized to meet not only the problems of the older people but the problems of the economy in that area generally speaking so I don't think that we should get into our frame of thinking that we're going to come up with a solution that fits in this county or in this series of two or three counties that's going to be the pattern that should be put to fit some other situation elsewhere within our own state and even more so at the national level we were warned that something tailor-made in Washington is not necessarily going to fit in this particular state or in this particular area of a state we have to do a better job of planning and this brings in local community people perhaps with some guidance from the outside but it's going to definitely involve more people at the local level and I suppose I could summarize what we learned today by having it emphasized again no matter how much money is spent in Washington no matter how much is spent at the state level granted that we need it this isn't going to get the job done unless the people at the local level through service clubs church organizations and other community activities join in getting the objective of a better life for our older Americans I am aware of and I know you're aware of the importance of the Institute of gerontology but I suspect a number of Iowans do not realize that such an institution exists could you comment as to whether you have been able to make use of their information prior to this hearing yes I have every member of the Iowa Legislature of course is familiar with the Institute on gerontology which is a consists of some offices staffed by very able people and dedicated people headed by dr. Morris who's also an assistant dean of the Iowa Medical School and its whole focus of attention is research on the problems of the aging we have I think the best Institute on gerontology of all of the 50 states and the Institute has been called upon by many federal agencies for information and council because of the work that it's done I don't know how long it's been going I would guess it's been going in Iowa City for at least 20 25 years they've they've worked on problems down at our Institute of gerontology before some people in other states ever even heard heard of them so we're well ahead and we should be of course because outside of Florida there are more people over 65 here in Iowa than any other State of the Union per capita and so we have a problem and it's to be expected that we should have the best Institute on gerontology in the nation but it's somewhat satisfying to be able to say that we do too very very briefly which of the areas do you think you would put priority on as far as first solution the economic the health and our transportation or are they all too inner woven they're pretty well interwoven as far as the rural areas are concerned with this one exception the immediate past director of the Commission on Aging for Iowa mr. Ray Schwartz I thought made a very good point when he said that no matter how much money you get no matter how much money is funded out of Washington or out of Des Moines Iowa this isn't going to satisfy the problems in the rural areas of access we're going to have to have access and that is the number one problem for rural America thank you very much senator Miller Senator Jack Miller chaired the hearings held by the United States Special Committee on Aging of the United States Senate and thank you thank you dr. W W Morris is director of the Institute of gerontology at Iowa City he's associate dean of the College of Medicine at the University of Iowa and vice chairman of the Commission of Aging and I think that it is in this capacity that we would like to ask him following the United States Senate Special Committee on Aging hearings in Des Moines some of his impressions as to the priority needs of the rural aging citizen I'm glad you started off with this question of priority needs because if they could go back a moment to one of the sets of testimony from one of the witnesses and older men himself mr. Hoyt Bonham from Montezuma mr. Bonham kept trying to get across the idea that the older people in the state particularly the members of his group called associated groups of elderly in iowa wanted to know something about what their priority was in the thinking of the United States Senate and particularly in the government as a whole as far as programming is concerned and he couldn't get a very good answer I'm not sure why but there are three major areas that keep coming up again and again and again whenever you study talk about research into or whatever you do with aging people be they rural or urban and these three are health income and what I call the twin problems of loneliness and dependency now if you stop and think of this on the face of it these are sensible problems because they're things all of us are concerned about we want to be sure we know where our next dollars coming from so we can buy food and pay the rent we want to know that if we have poor health we can get health care and if we have good health how we can keep it that way for as long as possible because this is related to how long how happy we'll be while we're doing it and man is a social being who must live with other people in order to be happy and find life satisfying and so the problem of loneliness comes in dependency is a problem because of a peculiar paradox all our lives we prepare for being independent and having done a real good job of preparing to be independent at a certain stage of life often sixty five or sometimes younger we find ourselves being pushed into a position of dependency again and this isn't dignified and it isn't very comfortable for most people I think if anything interesting came out of these hearings it was the fact on the one hand that the problems of older people in rural areas are basically the same kind of problems that people experience in urban areas there is a difference however and the difference has to do with such things as demography and the dispersion of people and the ready access to services and information and such elementary things as transportation now a number of things in the report were identified but two I'd like to talk about at the present time one is the planning in the very rural areas that have the out migration and the high proportion of the older individuals compared to the lowof the younger individuals in the in the health area many times these facilities on the one hand however not the personnel or the right type of facilities for the needs and I'm thinking in terms of the long-term bed care beds would you like to comment in this area this this is a tough problem I'm glad to say that the College of Medicine and the whole area division now of Health Services at the University and I know this is true also of the staff and faculty at Iowa State University also are working on this problem because they recognize that it is an important problem basically the problem is almost identical with the problems about migration if you have in the southern two tiers of County not all of them but many of them you have a picture of younger people and middle-aged people leaving to go either to more fruitful areas of employment and living such as cities or on the other hand as some people put it things are getting so bad in the rural areas that younger people and middle aged people who can do it are leaving whatever the cause it's happening now by the same token it's difficult to imagine or to talk a young physician or a young nurse or a young dentist or any other young professional into going into one of these areas because they know about as well as anybody else that these are areas of decline and not upward mobility well because of all of these things it looks pretty almost hopeless for some of the rural areas I don't think it really is and if we wanted to pick out priorities for Iowa state government and for the Commission on Aging I'd like to see us really put our minds and energies to work on how can you reverse this trend if it's possible and I think it is possible and what are the kinds of things that need to be done so that younger and middle-aged people will want to stay or other people move in or young professionals from all the different fields go there to settle down and make their life of practice in those communities I think what its gonna take is a whole restructuring of county government and community government but at the same time I think it's going to take efforts on the part creative efforts on the parts of the College of Medicine for example and the College of Dentistry and College of Nursing and other professional schools to go into some of these areas with demonstration projects to show not only how it can be done and what can be done but the great satisfactions that are likely to come from trying to do it even if they if we were to do this and then rotate some of our professional students while they're still in training through these demonstration units so they get first-hand experience in this kind of an activity this kind of a life I believe a whole almost automatic restructuring of community organization would start to take place people would begin to because of the emphasis that would be put on it to build better schools and to perhaps build a library which they don't have at the moment to do a host of things that add to the cultural values of the community and having done this you then have [done?] the things that say to young people well let's stay around because it looks better and young doctors and others let's move there because things are looking up this is what I think has to be done but that's a hard job to sell in the first place it's an even harder job to do but if we ever want to do it we have to stop talking about it and start doing now often times mentioned was loneliness how does this fit into to the thing that you identified which I did not see identified in the other reports and that was the need for the mental health care well I'm not sure that loneliness and need for mental health care are necessarily that closely related I think the whole emphasis that I tried to make in my oral presentation and I don't think I made it in the long written report this emphasis was that which has to do with doing those kinds of things which will help us keep the older person in mind as an individual human being and not losing now what's happening now is that we run the risk of losing older people because we're just neglecting their interests and their concerns and really not paying attention to them not because we're mean ornery people but because society has so many groups demanding attention as they say of which the [aged are only one?] that it's quite easy to lose them plus the fact that they tend not to complain about their lots and if you don't complain it's easier to neglect that kind of a person even though you should be praised and somebody should pay attention to him but it's like saying that you're in favor of virtue and against sin I guess our guest has been william dr. woodrow morris director of the Institute of gerontology and associate dean of the College of Medicine at University of Iowa he is vice chairman of the Iowa Commission on Aging and was contributing to the United States Special Committee on Aging hearings recently held in Des Moines