ED 056 270

AUTHORTITLE

INSTITUTIONPUB DATENOTE

EDRS PRICEDESCRIPTORS

ABSTRACT

DOCUMENT RESUME

AC 012 008

Mason, W. DeanGeriatrc Target - 1980; Education for GeriatricService.white House Conference on ging, _ashington, D.C.18 Mar 7126p.; Paper prepared for National Geriatrics SocietyConference, Washington, c., March 18 1971

ME-$0.65 HC-$3.29Adult Vocational Education olleg Role; CooperativePlanning; Geriatrics; Health Facilities; *HealthPersonnel; *Human services; Job Training; 4:01derAdults; *Paramedical Occupations;*Subprofessionals

Education and training as related to geriatricservices are discussed in terms of present and future needs. Types of

educational programs that have been developed to meet specific needsby various institutions, agencies, and/or individuals are described.

Recommendations made are: (1) Professional groups should view

existing problems and should develop educational programs at everylevel of need; (2) Through involvement in State and Nationallegislative action, the groups can help assure instigation andimplementation of important educational programs; (3) Professionals

in the field should develop an aggressive recruitment program andshould publicize career opportunities; (4) Accurate definitionsshould be developed for aides, assistants, technologists, andtechnicians so that the terminology would be standardized throughout

the country for all allied health and human service fields; (5)

Licensing standards for, institutions and staff personnel should be

standardized; (6) Governmental agencies'should seriously consider the

availability of manpower when establishing criteria and standards for

health facilities that participate in funded programs4 and (7) There

should be a,close working relationship between colleges anduniversities and health care facilities in the development andimplementation of educational and training programs. (Page 10 may

reproduce poorly because of marginal legibility.) (rB)

tducatioeA Paper PreparedNational Geriatrics Society "onfere ce

"Geriatrics .Target 1980"The National Geriatrics Society,in cooperation with the Columbia Univers ty,PuNic Health & Administrative MedicineWa6tungton, D.C., March 18, 1971by - W. Dean MaZon Ed. D.

U.S. DEPARTMENT OF HEALTH.EDUCATION,84 WELFAREOFFICE OF EDUCATION

THIS DOCUMENT HAS BEEN REPRODUCED EXACTLY AS RECEIVED FROMTHE PERSON OR ORGANIZATION ORIG-INATING 11- POINTS OF VIEW OR OPIN-IONS STATED DO NOT NECESSARILYREPRESEN1- OFFICIAL OFFICE OF EDU-CATION PWITION OR POLICY ri

Education

chool of

Roprflted for Distributlofl :Task Force - Section EducationWhite House Conference On AgingWaqhingt0fl, D.C., Nov. 28 De 7

1971 WHITE HOUSE CONFERENCE ON AGING1

414 1. allattit .../14"Acm,

210 W. PIKE STREETMARTINSVILLE, 11401ANA 4 SI

c 1980 Edvk For_ ma5a*I.

Nadonal Ceriatrc Society ConferenceWashington, D. C. . March 18, 1971W Dean Mason, Ed. D

The Council on Trends and Pe

of the United States Chamber

Next 3 Years

S rv ce

.conQx

rce stat

Business ctricl Future, that.=mftM31

Ic nalys'

in a do:u

and St dy Gro

nt, America's

n --w ty

of o ganization known as the look out itutIon which looks ahead Into the

future and seeks to plan for change by anticipating in advance. Such organiza

n are the Institute for the Future, General Electric Tempo and the C

on the Year 2300.

The National Geriatrics Society is thinking about the future in order the

who are involved in work r lated to Gerontology and Gertatrtc might realIze

-that many of today decisions will rest on conjectu es about the future. We see

th

0 davelop a strategy which will give hope fo

may be that we will conc ive of "alternative futures We a

lo k forward to a virtual "revoluti n" in the way people will live, the way they

hy th year 1980 and 1990 We are beginning

prob today and projeet ahead to conceived needs and thus make

a su cee ful tomorrow.

e told that we can

1/40"

AN." 0.1 46h it% %Mr !,

to see revolutionary changes in the s cial st ucture whIch has dire t bean g on

ulation. So

ces

the older adult po

ty, bo

of our p

leis

blems

the ga

poor, environmental decay, housing, health and a

age groups.

What are the prospects for the 70's? The n

11 be conge

the

financial

and the

f roles for all

cade will be ro per us

one so we are told by students of business We are assured that there will be

2

technologic1..advanceand ihe disc .)very of answers to many of our present day

questIons through research. This we will hope for - we will work for answers to

poverty, sickness, war and all forms of human misery.

°Ind like to share so e thoughts concerning our future environment.

The w rld population in thirty yea s is expected to double its p esent figure.

This w uld mean that we would have seven billion people in the wo- ld. We

may ha e 266 million people in America by 1982 and 325 million by 2000.

By 1985 we could have 165 persons for every 100 we have today. Alth ugh

we will have many more pe_ ow; over 65 years of age, we are rapidly moving

the direction of a national population in which half of ovz people will be

under 26 years of age. It is interesting to note that the rising tide of educa

tion has helped transform AmerIca from an economy of goods into a knowledge

economy. We are told that by the late 1970 s the United States ttknowledge

dustries" (which produce a7ad distribute ideas and information rather than

goods) will account for one-half of the total U. S. national produ t. Every

other dollar earned and spent in the Amer _can econo ill be earned by

p.od c_ng and distributing ideas a d information. A process of contintous

learning (life-long learning) re-training and on the job education, post-graduate

education will be accepted and considered necessary.

The next ten years are expected to b mg large and sig ificant changes in

our Nation's system for meeting the health c re needs of the total population.

We find many problems upon us today in this area -h spiraling costs, ma1 -

distribution of personnel and facilities, and many varied opinions as to the

solutions. It is quite w 11 known that medical care expenditures are the

fastest rising item on the consumer price index and current trends show no

3

let up in this pattefn. With ng umber of rl __ore insurance

cov_ age for all age groups and the advent of Medicare and M-dicaid and

shortage of available personnel he-lth care facilities are brought face to

face with some realistic problems. In some cases is the problem of survival.

Again we read _et the U. S. Chamber of Com _erce eport:

"Although U. S. health expenditUres per person are among thehighest in the world and our doctors and nurses are among thebest trained in the world, America faces critical challengesstemming from resentment of higher medical costs, inadequaciesin all types of medical facilities, severe shortages of paramedicalpersonnel, maldistribution of physicians both geographically andby field or type of practice, inadequate medical insurance coverageof the population, and, as one aspect of the poverty problem, inade-quate health care for the disadvantaged."

This report go on to suggest that an exa _ ination of the U. S. in dical care

complex reveals poor planning of hospital and other health facilities, utilization

of h -hly trained personnel to pe.-:fo services _equiring less skill, insufficient

u e of existing advanced technology to improve operation of medical delivery

syste s in hospitals frag entation of health services, and Insufficient lata

on every aspect of the workings of the system. From this it follows that greater

att ntion must be devoted to more effective Jevelopment and util zation of medi-

cal care resources.

This has been a long "preli inary statement to get to my main point - -

that of education and t aining as it relates to geriatric services. I fcel that

it is important that we have this backdr p to our think g.

In light of present and future needs should there be, or is there, a national

priority for training personnel who are and will be working for and with our

older adults? This involves g overnrnent concern at every level Federal, State

and Community, Do we need more financial resources for medical schools.

schools of nursing, cu.rriculum devloçment in State, private and communit

colleges?

ear many figures tossed around regarding health manpower needs. We

are told that present needs are 50,000 additional health pers inel workers

and that we will need an additional 50,000 by 1975-* R slin Fe n of the

Brookings Instit te estimates that the demand for physicians services will

grow by at least 25 percent by the decade 1965-1975. The supply is expected

to grow by about 19 perc nt.

More medicd men are moving out -f gen -:al practice. One of eight medical

scho 1 graduates enter general practice where at the turn of the century seven

of eight did There are acute shortages of nurses, laboratory personnel,

X echnicians, dietitians, therapists, food service personnel and the many

other job r sponsibilities :elated to health care. It is estimated that by 1975

the demand for nurses will exceed the supply by 210,000.

ThIs dvilndllng supply of health personnel poses serious problems that we

need to deal with in a real' tic manner. The sItuatIon is wor e in specific

a eas sueh as the ghetto and rural America. In Mississippi there are 58

physicians in p, v- te practice per 1000 population compared to 134 in the State

of New York. We are going to have to develop mrre t aining programs at every

level of need. This means more and/or expanded medical schools. This means

recruitment of more young people for training programs and the expansion of

curriculum on the college campus dealing with geriatrics, gerontology and

related disciplines. It means financial undergirding of progra: s for educat on

and training. This means legislation at every level of governmant. Through

-,144edically oriented:practitioners, teachers, research and administration.

a variety of prograis he Govern_ flow p than

620 million dollars annually to aid in training and education of health man-

power. In 1967, programs supported by federal funds helped train 224 000

health workers. This was an increase of nearly 100,000 trained workers

over 1966.

Experimentation and innovaLion will be necessary as we s ek to meet the

manpower needs. There are many innovations now being e per ented"

w th in an effort to meet needs. There is an atte pt to shorten the length

of ti e needed for traIning without reducing quality. Physicians are dis-

cus the use of ancillary pe sonnel to help them meet the demands on

their energy and tIme. New training programs are p4oducin "L-id and

"technicians" for many professional groups.

You might be interested in the fact that at the beginning of this decade

there were 740,000 general hospital beds and that to maintain the pre ent

bed-population ratio we wl1 have to add only 11,000 beds per year by 1980

but we are actually adding 20,000 beds. There were 685,000 mental hospital

beds and we need to add 10, 000 beds a year by 1980 to keep pace with popu-

lation gro th. This figure will probably drop because of odern programming

and outpatient services.

There were 37 000 tuberculosis hospital beds at the turn of the century.

This figure will decrease bec use of modern discoveries. There were 400,000

beds in extended care facilities. This area of service Is expanding and im-

proving rapIdly. It is esti a _ed that there should be a ratio of three beds

per 1000 population. The current ratio is about Z per 1000. According to

this suggestion there should be an increase of 600 000 beds and by 1980 a

6

p -ojected need of 7Z0 000 beds. I would like to mention here that during

the pa t t o :ecades the Hill-Burton program of federal assistance has

helped more than 3,400 communities build hospitals, nursing homes and

other health care centers. These pr gra have helped to provide 350,000

hospital and ursing home beds.

What is being done toda r to help meet the educational needs of health

care facilities, their administrative personnel, the professional, the

"para-professional", the skilled and unskilled employee? Who assumes

leadership respon- bility for the development and impl-- e tation of educa-

tional and training programs .

I would like to share some data on various educational and training pro-

grams which I believe are a definite part of the answer to personnel nee-

both now and leading to the year 1980.

Clark rbbitts Direc -or Training Grants S aff, Administra io- on

Aging, reported on Manpower Needs In The Field of Aaing in the March-April

1969 issue of Aging. He t 11L:. how the AdminIstration on Aging submitted a

mprehensive study of manpower needs in the fi -1d of Aging to the President

and the Congress in January of 1969. This study "esti _ated that there a e

today perhaps 330,000 persons employed in Institutions, agencies and

organizations serving older people excl ly o prt " This estimate

takes no account of physicians, general hospital personnel, dentists, health

department employees- adult educators and others who serve ag -d people

along with other age groups.

This report also projects needs will increase ove the next decade from

330,000 to a total of a million or more. A projection of special needs

include: a jui p from 300 pe son Sta

in 1980 persons e7_ ployed in managerial positions in Housing for the Aged

in 1968 numbered 4,9 0 and these needs will incr to 8 to 13 thousand by

1970 and between 32 and 43 thousand by 1980. It has been projected that

the 270,000 pe- sons employed in long-term personal and nursing care

facilities --ill have to be increased two or three folcl duri g the next decade.

Home alth-aid ersonnel, now numberi g around 8 000 will face similar

ncreased needs. Dr. Tibbitts r -p- ted an Immediate need for 6,000 nurses

and 9,400 licensed practical nurses, in addition to the 18,000 now employed

in home-health-care organ zations. There are needs for physical and

cupationa. therapists, recreational therapists, teachers in college_ and

vocational programs to provide education and training for th- ie who will

make a career of research, .teaching, administration and provisions of

direct services.

The Older AmerIcans Act of 1965 under TItle V authorized the Secretary

of Health, Education and Welfare "to make grants to, or contracts with,

any public or nonprofit p:ivate age cy, o_ganization, or institution for

the specialized training of persons employed or preparing for e- ployment

in carrying out programs related to the purposes of this Act. "

Congress exp essed their continuing concern through the Older Americans

Act Amendments of 1967 which authorized the Sec_ etary of H. E. Wotto und

take directly or by grant or contract, a study of the immediate and fore

seeable need for trained personnel to carry out progra s related to the

objectives of this Act (The Older Americanr ,%ct of 1965) and of the

availability and adequa y o the educational and traimng resources for

persons preparing to work in such progra (See Table 1)

We note that the Title V grams program from January 1966 through

June 30, 1969 made 52 new, continuation and 15 supple ental awards

through the Ad 'nist_ation on Aging. These awards supported the

following programs;

.15 programs conducted in 17 ins itutions to preparepersonnel for careers in aging

. continuing short term programs

.....16 one-time short-term programs to provide special-ized knowledge of aging Lo employed-personnel andlay older persons.

.13 projects for planning training programs anddeveloping curricula and teaching materials

3 projects to examine the dimensions of the supplyand demand for personnel in the field of aging (See Table)

These programs involved an expenditure of $6, 851,225 in federal funds.

The training g rants a _e based on the types of programs and projects deemed

essential in developing personnel knowledg eable and skilled in serving

older people. The five areas deemed essential are as follo

1. Career trai ing for professional service and teaching

2. Short-term training. Teachers at colleges and univer-sities, as well as professional and semi-professionalpersonnel trained in established fields.

Curriculum planning and development.

4. Preparation of teaching materials.

5 Studies of personnel needs.

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The National Institute o

10

al Health, establi hed in 1946, is involved

in many important progra s directly related to education and training for

personne,. working with our aged. At the present time a major proportion

of their training grants are being used f r teaching grants and t ainee

stipends at soc-ial work schools. S y five wcipends were given in the

year 1969 to social work students. They also have a program of supporr

designed to expand and Improve trainIng in the fi ld of psychiatric nur ing,

grants for undergraduate training, doctoral, graduate and training in

special areas. The National Institute of M ntal Health plans, admini ters

and coordinates a program. for inservice t aining, staff development, post-

graduate education and adult education to upg ade the efficiency of personnd

currently employed in mental health agencies (See Table 2)

An excellent paper, Allied Health Pe sonnel:Some Problems as

presented at the Gerontological Society meeting in Toronto last October.

This was a study done by Sara Harris and Selma .Axelrod. They interviewe

thirty administrators of health agencies and hospitals in Albany and Ren-

sselaer counties in Ne York in order that they might determine the

feasiaility of developing educational progra s to train mature wo e

including the disadvantaged, in the health and human services field.

"The authors were seeking to determine the specific jobopportunities in certain allied health careers for whichexisting curricula and facilities at Hudson Valley Commun-ity 0311ege could be utilized:also what further role thecommunity college might assume in recruiting and train-ing individuals for these positions. H (Cf. P.1 of mimeographeddocument)

The interviews revealed a number of problems which hindered the

recruitment, training and placement of health care per o-nel essential

1

the care and treatrnont of the aged. These ob included, poor

coordination of planning, narrow and specific curricula, bureaucratic

rigidity, limited career advance ent opportunities and ambiguity in

nomenclature. Harris and Axelr3drecommend the development of bette r

co -munication between educator and c ployer, wiser utilIzation of State

and Federal funds to coordinate v- ious progra re-evaluation of cer -

tifica on and civil service require ents, inc re, Jed use of older women,

b-tter career ladder goal structure and better regional planning agencies

to serve as central resource agencies.

I would like to emp asize a point thai Harris and Axerod make concerning

ambiguity in nomenclature which c eates difficulties in structuring curricu.La.

We come confused as to the level of "aides" "t chnicians'', "as ant "7

With the dev 1 p ent of formal job class ficati ns the.t help determine pay

scales as well as status within the hierarchy, un form job titles se to be

desirable. They suggest, and I agree, that terminology be standardized for

all allied health and human service fields. As a suggestion they offer the

following definit ns: "technologis ould equal a four year degree program;

hnicia -" would equal a two year associate degree progra "assistant"

would equal a one year or less certification program and "aide" --ould equal

on-the-job training.

Another siiggestion which I heartily endorse and seek to implement in

my work is cooperative educati nal and training prog a bet een colleges

and unive- sities with hospitals nursing home, long tern care facilities and

govern_ ent agencies. These p og can be housed in instttut ns (health

12

care facil es) where greater participati3ri is cured aad knowledge can be

gained through the application of geront logical prit, iple

Michael J. Stotts, Harold E. Jose=hart and Murray Berg members of the

Illinois Educational Opportunities Planning Committee in 1968, prepared and

presented a statement to the National AdvIsory C u cil on Nursing Home

AdmInistration on September 13 1968 in ALlantic City, New Jersey. This

statement elaborated on the development of an Educational Program for

Administrators of Long Term Care Facilities and areas of concern regarding

the licensure of Nursing Home Administrat -s. Stotts, Josehart and Berg

stated that efforts had b en made for many years to pro ote academic p ograms

in the long term care fi ld in colleges and universitIes only to be met with

failures. The Hospital Planning C uncil for Metropolitan Chicago invited a

group of representatIve persons to partic pate in 1-ying the foundation for

an educational program in Septe ber of 1967. The College o f D uPage became

deeply Involved in the concerns and thus developed care content for five separate

courses, hopefully a part of a continuing education curriculum.the

will illustrate sev- _1 approach s to/problem of developing educational

programs which are helping to meet specific needs and which need to be,

after testing and valida 70n, expanded or changed. The educational needs vary

h different job resp n ibilities. The types of persons involved vary, not

only with differe t jobs but with availability of persons to assume and be

challenged by a pa ticular task. The per ho need and participate in

learning experiences begin at many levels of educatIonal attainment and reveal

numerous motIvatioai responses. Some people want to learn, to grow in their

w rk, to become more skillful, while others are concerned only with "getti g by.

Basic n- -ds which are evident _nd which motivate administrators and

educators to develop learlin °pp :unities, include the need for personliel

at eve y level to be introduced to their job and to be oriented in the f

mentals cluding philosophy) ula ob p nsibil y the need

fo special information and training in both the manual and behavio al

skills associated with their job or what might be called, skill tr ining;

the need to develop leadership and manage ent abilities and the need for

continuing investi

Annice Miller So-

Vol. 7, June 1959)

I will illustrate

f the r al potentialities of their job (See Ma

ents on Inse vice Education, Nurs ng Outl-

types of Educational programs which have been developed

to meet specific needs at every level and by various institutIons, agencies

and/or individuals. We have seen how the Federal Government has respo d d

o educational needs thr ugh the w rk of the Administration ,n Ag ng and the

National Institute of Mental Health working with colleges, universities,

Gerontologlcal Ccntcrs, Schools of Medicin_ ) Nursing Schools, Schools

Social Work, National Professional Societies, H3spitals, Teachers, Stude

Practitioners and Researchers.

State Government has had involvemeia in helping to meet Educational

needs through programs related to Title III of the Older Americans Act,

Title I of the Higher Education Act and the educational and training programs

St te Boards of Health, State Licensing Board::: and State .tiducati nal Boards.

The Indiana State Board of Health is involved tn Educational Programs

which speak to Geriat ics 1980. They offer consultant services in a field

training settIng. They report that the needs for training are exceeding the

ii

availability f staff time. One g up is studying paramedical education

education in the state to determine the kind, n ber -.,nd quality _f

auxiliary health personnel training programs, and to d scover the scope

of the training of age cies groups and individuals involved.

Health ca e facilities ope ated b the varIous states are involved in

educational and training programs. They are concerned i.Jpout expanding

needs, personnel deficie- cies, recruitment and conservation of staff. I was

excited when I read of the Psychiatric A. tendant Education P °gra_ at

Central State Hospital in IndianapolIs in the Su day paper several weeks

ago. In making inquiry concerning this program, the AssIstant Director

of Nursing Education Informed _.e that the program ted in 1953

involved 160 ho _rs of basic i struction which spans the nursing care 0. the

physically and en ally ill, administration of medications, the Red C oss

emergency and first aid course as well as some theory of growth and

development, communication, and behavioral patterns. They have an

advanced program for attendants which follows the State of Indiana, Deparl

ment of Mental Health course outline, which is standard for all State

Hospital Educational systems with the needs and pr fe ences of the

individual hospital cons"dered. Miss Belinda Puetz , ssIstant Director of

Nurs ng Education says, "It is our feeling here at Central State Hospital

that the psychiatric attendant is an integral part of the patient's treatment

program and efforts are ing made to increasingly educate the attendant

to function responsibly in this role.

15

Educational programs are being developed by National Voluntary Groups

faced with a maze of personn 1 ne ds. The DivisIon of Social Service of

he A e- ican Lutheran Chujch iplement conti uing education programs

for administr -tive and supervisory personnel and nursing s-,,tff.

Health Facilities in va -ious part: of the Nation are developing educa-ion

programs either independently or in cooperation with educational institutions

or governmental agencies. The Riverside G=riatric and Convalescent

Center of Charle t n, South Carolina works with tho College of Nursing

of the Medical University of South Carolina. The College of Nursing suppli- s

clinical instructors and students who go to the Convalescent Center for

clinical experIence in geriatric and long term nursing. The Convalescent

Center also has a similar agreement with the School of PractIcal Nursing

under the School of Allied Science at the Medical Unive

The Lutheran Homes of Fort Wayn , Indiana initiated a training program

for "geriatric technici ans" in cooperation ith the Fort Wayne Co

Schools. This program involves six months of specialized training - - the

pre-clinical training pe iod of sIx weeks, with the student spending an

average of six hours per day in the classroom and laboratory under the

direction of an in_ tructor, and two hours per day in the library in study

and preparation of assignments. The foll w ng sixteen weeks are spent

th a clinical assignment in a health facility. It was my privilege to speak

for the first class of eight ladies who comple' d this course on February

22, 1970.

16

make no apology a personal reference, as I tell you briefly how we

at the Ke Tiedy MenAoriai Home - GeriatrIc Servi 7e and Research Center,

have and are approaching some of the e problems, using resources

have and resources of those who j in with us in helping develop learning

experi _n- --s. W- --he Kennedy Home have always (si ce our beginning in

1957) been concerned with programs which might help in the discovery of new

approaches to the physiological, sociological and psychological needs of oar

aging population. Such cone- n involves the Institution, the administration,

the staff wIth their need for personal growth and knowledge and the olde, :

resident or pat ent.

Dr. H. Mason Atwood, of The Bureau of Studies in Adult Education of

Indiana UniversIty, gave leadership for our first educational program which

involved both staff and residents. The primary purpose was to "investigate

the possibility of developing a program of adult education fo: restdents of

Homes for the Aged. This was an attempt to extend educational oppo tunities

to a segment of the adult population for which very little, if any, provision

had been made. It was my personal feeling, as well as Dr. Atwood's, that

might open a whole new concept of educational therapy for Homes for

the Aged." This first involvement was conducted as developmental research.

We have continued to have an exciting working relationship with the Bureau

of Studies in Adult Education.

The second program was an Adult Education Institute for Administrative

Personnel of Congregate Facilities for the Aged. This was an outgrowth of

a doctoral tern hip for a gradua e student. The intern hip cove d a

17

25 week pe iod in 1967 and involved working with administrators of 25 other

cong cgate facilities. It was seeking to determine what the educational

needs of these administrators were including s ch areas as program

planning, inservice training, infor ation relative to the learning capabilities

a%d interest of the aged, ways of helping older adults f nd new inte e ts and

goals in life and ways to help residents adjust to the Home environment.

The culmination of this program was to bring together 20 per ons from

Indiana1 Illinois for a five-day Re idential Institute on the Campus of

Ind ana University. A graduate class (D-163) from the Bureau of Studies

Adult Educatton of Indiana University made a diagnostic study in Adult

Education in an effort to identify the r al adult educational needs of an

individual group, institution or corn uni y. This study, made during the

spring semester of 1969, involved group acti ities a d progra borne-

conimunity relationships, staff training and the educational programs related

to the total institution. The results of thIs study led to two internship pro-

grams. The one intern had the responsibility of developing inservice

training progra s for health facility per onnel. The second intern helped

dev lop an effective commun .t d adult education program in the Home.

We have also had a cooperative relationship wIth the Health and Recreation

Department of Indiana Univer ity wherein graduate and senior students have

developed and directed recreational and acti P grams in cooperation with

the residents of the Home. We have been involved in a language demonstra-

tion program related to aphasia and the older person.

18

A Food Service Workshop was sponsored by the Kenn dy Home in

cooperation with the Cooperative Extension Division of Purdue University

in 1968. This Workshop was seeking to determine whether a number of

health facilities could sha e in a lea ning experience which would help

train personnel workIng in the area of food service.

A Professor of Opto _etry and a no ied German Scientist were grateful

for the response of our residents as they cooperated with them in a study

of pigm nt spots tn the cornea.

A very effective lea fling experience was d v loped through our cooperative

relationship with the County Health Nurse in a training program for n t-uc-

tors of nursIng t chniques for he lth facilities through a well e _ tablished

Red Cross program. This involved six sessions and we e -e able to recruit

15 persons from four health f cilities to share in this learning expe__ ence.

We have sponsored, under our own initiative a short course in the A r

of Aiding the A.ging, for supervisory personnel of health facilities. This

was a five-day Residential Seminar with participants from three states and

was held in our Home. We are now field te ing' a nurse aide training

program developed through our internship prog -ith the hopes that

the guidance materials might be used by other health facilities.

It is very evident that many persons institutions and agencies are conscious

of the pr blems which we have been discussing and are seeking to find answers.

It is r ther interest rig that last week (Thursday, March 11 1971) when I was

going to a meeting in Chicago, the daily papers froi Indianapolis and Chicago

carried the following reports.19'

19

The lndianapoli Star for Thu ay morning, March 11, 19 1 lad a,headline

across the top of page 19 which read as follows:

"Bill To License Doctors' Aides Dies In Public Safe

Briefly the artIcle st-ted that:

ee"

"A bill which would allow for the licens ng of physicians'assistants i.s dead in the Senate Public Safety Committee.The Indiana State Medical Association backed the bill butit met specific criticism from State Associations of Nurs --sand Optometrists. Programs of training and licensing arein effect in the States of Virginia and Washington, and Dr.M- 0. Scamahorn, President of the State Medical grouptole the committee that the assistants have increased con-siderably the treatment physicians have been able to provide,with favorable public reaction."

m ediately under this article on the same page was the following outline:

"Medical Education Pr gram Bill is Pass d Unanimously In House"

"The Ind ana House of Representatives last night passed 79 -0and sent to the Senate a bill which would establish a statewidemedical education program in seven Indiana communities.Under the measure, H. B. 1430, such programs would be estab-lished in Gary, Fort Wayne, Terre Haute, Lafayette, Evansville,South Bend and Muncie. The medical education programs wouldmake use of existing medical and educational institutions in eachcity instead of requiring appropriation of state funds to build newphysical facilities. "

"Representative Eugene H. Lamkin, Jr. (R-Indianapolis), aphysician and sponsor of the bill, described the proposed pro-gram as an innovative one which has received favorable atten-tion outside the United States. (Dr. Eugene Lamkin, Jr. is amember of the Board of Directors of the Kennedy Memorial Home).

On the same day I picked up a copy of the Chi ago Tribune (Thursday,

March 11, 1971) and discovered the following headline on an inside page:

"Daley Asks Nurse Home Change " This article stated that:

c _prehensive ordinance to improve the education andtraining of nursing home aides and attendants was introducedin the City Council yesterday by Mayor Daley. The proposedchanged in the City Nursing Home Code would require all

20

persons seeking employment as aides, orderlies or techniciansfirst to complete a training program sponsored by the Board of

Education.

"The mayor's pr posed ordinance changes for nurse' aides andattendanti:i would require the employe to have at least eightyears of schooling or equivalent education and a two-yearresidency requirement. The applicant also would have to showevidence of employment for the previous two years and be ableto speak English. The proposed code change also would re-quire such employes to have a knowledge of such general skillsas bathing, grooming, and feeding patients before they could

be hired.

"Tribune Task Force reporters working in many nursing homesfound many nurses' aides and orderlies had been hired without

any experience and received no training before they were placedin charge of helpless and elderly patients. "

CONCLUSION: I am making recommendations which I feel are apropos

the situation regarding education for G- iatrics-l980.

Professional groups, such as the National Geriatrics Society, The

American Dietetic Society, the Adult Education Association of the

U.S.A. and others should not only view the problems as they exist

today, related to education and the aging, but they should bedeveloping educational programs at every level of need. Thereshould be clear lines of communication among such organizationswherein they can compliment one another and avoid duplication.

We need to be Involved in legislative action on both the State and

National level. This could help assure instigation and implemen-tation of important educational programs. As an illustration, do

we understand the implications of Senate Bill 3604-Older AmericansCommunibr Service _._mployment Act of 1970 sponsored by SenatorEdward M. Kennedy and Senator Harrison Williams? This billmodeled on the successful Senior Aides programs, proposes anexpanded employment program on a continuing basis across thecountry for low-income elderly. This bill could help, as we seekto meet a critical shortage of professional persons in the serviceoccupations, by providing supplemental services performed by a

corps of sub-professional and para-professional, properly trained

to supplement and facilitate the work of professionals. S-3604authorizes an expenditure of 35 million dollars for the fiscal year1971 and 60 million dollars for the fiscal year 1972.

21

I would like to suggest that it would be useful for professionals,through their organizations, nursing home and hospital adminis-trators, long-term care Home administrators, governmentagencies, colleges and universities and organizations such asthe National Geriatrics Society, to develop an aggressive programof recruitment and to publicize career opportunities for individualsin all types of work related to aging.

I would like to suggest, with Harris and Axelrod, that we take stepsto help eliminate the "ambiguity in nomenclature." In this we woulddevelop accurate definitions for aides, assistants, technologists,technicians, wherein the terminology would be standardized through-out the country for all allied health and huma,A service fields.

I would like to suggest that licensing standards, both for instit tions,and for staff personnel, be "equalized" throughout the country_

Evidence of poor planning in this area is shown in the many differenttypes of requirements for administrators of health facilities invarious states. These -ducational requirements should be standardized.

Governmental agencies should consider seriously the availability ofmanpower when establishing criteria and standards for health facilitiesparticipating in funded programs.

There should be a close working rela ionship developed by collegesand universities and health care facilities throughout the nation inthe development of, and implementation of educational and trainingprograms.

I am constantly hearing of the need for "coordi ated tforts and "better

communication" by in t tutions, organizations and govern ental age c e

Many excellent programs have been developed to assist the older person

through better trained health care personnel but there Is a lack of knowledge

as to who has developed them and where they are available.

In closing I would like to use he w rde which our friend, Dr. Donald

Kent used in concluding one of his keynote addresses to the Executives of

State Co Issions on Aging several years ago in Washington:

IL has been said that &very speaker advocating truth should adjur. :,

his hea _rs as did Socrates his in Athens. "If you will be persuaded

o the trutl- andby pay l attention to but much ore

if I appear to you to say a ything true assent to it, but if no

oppose me th all your might, taking good care that in my zeal I

do not deceive both .. -nyseif and you, and like a bee depart, leaving

my s_ ng behind." A decade later, his pupil, Plato, softened this

a bit and these di are applicable today; "Truth is the beginning

of every good thing, both in heaven and on arth; and he who would

bless d and happy should be from the fi s_ a pa = aker of truth,

then he can be t u t d. "

REFERENCES

Chamber of Commerce of The rjnited S ates, Washington. D. C. , MajorHealth Issues Of The Seventies, Economic Analysis and Study.

Chamber of Commerce of The United States Council on Trends andPerspective Economic Analysis and Study Group, America's Next30 Years, Business And The Future.

2Lice_tg2 Sun-Times, "Ogilvie names health deputy to spur nursing homeprobe," Thursday Marzh 11, 1971, p. 20.

Chicago Tribune, "Daley Asks Nurse Home Change, " Thursday March 11, 1971.

Geriatric Service and Research UnitS, Kennedy Memorial Christian Home,Martinsville, Ind. 46151 - For Immediate Release, (Mimeographeddocument describing Home-Communi_y and Home-University involve-ments in research and training).

Harrie, Sara and Selma Axelrod, Allied Health Personnel:Some Problems,A paper preented at the 23rd Annual Gerontological Society scientificmeeting, Toronto, Canada, October 1970.

Inse vice Education for Hospital Nu_r_sing Personnel, published by Dept.f Hospital Nursing, National League for Nursing, co-sponsored by

American Hospital Association.

Indiana Health Careers, A brochure published by Indiana Health Careers,Inc. 2940 N. Pennsylvania, Indianapolis, Indiana.

Lee, Anne Natalie, "The Train ng of Nonprofessional Personnel", NursingOutlook, Vol. 6 April 1958

Long, M. K Motivating Personnel for Inservice Education " NursingOutlook. Vol. 7. June 1959.

Long Term Care, Published b the Long Term Care Program, SouthCarolina Hospital Association, Vol. II, No. 2-

Mason, W. Dean, Ed. D. "Geriatric Technician Possible Answer to Hea th

Personnel Shortage," Geriatric Institutions Jul -August 1970, Vol. 17 No. 4

Mason, W. Dean, Ed. D. "Inservice Training:Important? Impera ive!" Paperpresented in St. Louis, Missouri December 11, 1970.

McClelland, Malcolm J., "Short-T rm Training Part I", The indiana StateBoard of Health Bulletin November 1970, pp. 6-8.

24

24

McClclland, imalcolm J. "Short-Term Training Par II", The Indiana StaBoard of Hcalth Bulletin, December 1970; pp. 13-15.

1 Mary mice, "Some Comments On Inservice Education", Reprintedfrom Nursing Outlook, Vol. 10, August-November 1962, Distributed by

National League for Nursing, Inc. , 10 Columbus Circle, New Y3rk, N. Y.(Code ii20-1049)

Mu vey, Dr. Mary C. Statement For Hearing on Sources of Community Supportfor Federal Programs for Serv Older Americans, before U. S. SenateSpecial Committee on Aging, Wa hington, D.C. Tuesday, June 9, 1970,(Mimeographed)

:,::_roposal for a_ Pilot, Experirrienta1 and:Demonstration Program_to _Train.Geriatric Technic ians, submitted to the Indiana State Board of Health

_

and The Indiana Health Facilities Council by the Fort Wayne CommunitySchools and The Lutheran Homes, Inc. (Mimeographed Document)

vice With Vision, "A Training Institute for Nurse Aides in GriatServices ( Mimeographed Document-Kennedy Memorial 1-1, me.)

Stotts, M. 3., N. E. Josehart and Murray Berg, The IllinoisxEerience,Illinois Testimony Before National Advisory Council on The LicensureNursing Home Administrators, Sept. 13, 1968, on behalf of the IllinoisEducational Opportunities and Planning Committee and the College ofDuPage at Chicago, Illinois (Mimeographed Document)

The Determination of Adult Educational Needs at the Kennedy Me lorialChristian Home, A Diagnostic Study Completed by Students in D-"The, Diagnostic Procedure in Adult Education", - graduate course in

Adult Education-Indiana University (Mimeographed Document-availablefrom Kennedy Home

The Gerontolo ,ist. Volume 10, Number 1, Spring 1970, "Education and

Training in Gerontology-1970" Part 1, pp. 53-56.

The Gerontologist, Volume 10, No. 2, Summer 1970, 'Educatjon andTraining in Gerontology-1970", part 2, pp. 153-155.

The Indianapolis Star, Thursday, March 11, 1971, "Bill to License DoctorsAides Dies In Public Safety Committee" -"Medical Education ProgramBill. is Passed Unanimously In House. "

Tibbitts, Clark, .e_c ingi Nos. 173-174, Ma c 132- 1969, "Manpower NeedsIn The Field of Aging, H pp. 3-5.

Tra_ining,and Continuing .Educaton, Hospita1.__Repearch a.rid Educational Trust,840 North Lake Shore Drive, Chicago, Illinois 60611.

Personal Co -respondence:

Jacobs, H. Lee, Ph.D., A sociate Professor, Institute of Gerontology,Th University of Iowa (February 19, 1971).

Knudsvig Adrian S. , Services to the Aging, The American LutheranChurch, Division of Social Service, Minneapolis, Minnesota,(November 5 1970).

Puetz, Belinda, E., R.N. Assistant Director, Nursing Education,Central State Hospital, Indianapolis, Indiana (March 8 /9 71).

Rabe, Henrietta F., Associa e, Education for Aging, The State EducationDepartment, Albany, New York (February 1, 1971).

Sto s, Michael J. , Associate Director, Association of Univers ty Programsin Hospital Administration, Washington, D.C. (February 3, 1971).

26

MC aearingh.

DEC 1 1971

on Adult Education