Government policy now forces unwilling elderly persons from their homes into nursing institutions, Rep. Claude Pepper (D-Fla.), chairman of the House Select Committee on Aging, concluded recently. This seems to be true primarily because of the requirement of prior hospitalization before receiving public health care.
A general Accounting Office report released earlier this year advocated a national policy for home health care and pointed out that only 17 percent of the nation's over-65 population could be cared for less expensively in institutions than at home. "Until older people become greatly or extremely impaired, the cost for home services, including the large portion provided by family or friends, is less than the cost of putting these people in institutions."
Labeling the existing policy both "callous and costly," Pepper observed, "The human cost in tearing older persons from their homes and communities is incalculable."
To improve this situation is one of Pepper's declared legislative goals for the current year. In prospect also is President Carter's proposal, included in the welfare reform package, to create 200,000 public service jobs particularly for home health care.
While improvement in provisions for home health care are anticipated, some very useful services are now available through private and public agencies.
For older persons who can travel, there are senior clinics assessment centers which make comprehensive health assessments, develop health care plans and offer recommendations for appropriate health care. Home health care services for seniorsgenerally are provided by the adult dealth divisions of a county's health department and usually in cooperation a social service department.
Senior day-care centers, while not strictly health service centers, do provide health-related services. Such centers are designed for older adults who are not able to remain active or independent without assistance. Educational, recreational and therapeutic activities are part of the daily schedule.
For the homebound, there are various home-care services and programs. An example is provided by Homemaker Health Aide Service of the National Capital Area, Inc., which recruits, trains and supervises homemaker aides. Homemaker Health Aides give personal care and assist in such tasks as meal preparation, home cleanliness and general home management. Aides can, for example, show elderly persons how best to manage their daily activities in spite of difficulties caused by arthritis or other disabling ailments. Specific health aid is provided under private medical supervision.
In addition to home care, there are various support services such as Meals on Wheels, which provides home-delivered meals for persons unable to cook for themselves, and the Friendly Home Visitors program, which provides companionship and a helping hand.
Some nutrition program sites, where nutritious meals are served for a nominal suggested donation, have health appraisal nurses who provide participants with health-related services including screening counseling, health education and referral. Several sites also have physical fitness specialits who conduct exercise sessions and share information on physical fitness.
From time to time communities schedule comprehensive health fairs. One of these was recently held at the Forest Glen Senior Citizens Center in Silver Spring. Hundreds of area residents availed themselves of this opportunity. There was no charge except for laboratory work in blood test analysis. Volunteers manned various stations to check blood pressure vision and other health-related conditions. The American Red Cross provided a consultation service after screening had been completed. Findings, including laboratory tests, are shared with participants and their personal physicians.
Professional home-care services are available through the extended-care programs of some area hospitals. Arrangements are usually initiated by a patient's own physician. Services include intermittent skilled nursing care, home health aide visits and therapy sessions.
The Visiting Nurse Association is an established organization that provides professional health care at home in the District of Columbia, Montgomery County and Prince George's County. Services are provided under direction of a patient's own physician. Services include skilled nursing, therapy, instructions to patients in self-care and to families who are caring for patients. There are established fees, but arrangements allow fees to be based on the clients' ability to pay.
Free health information designed to help individuals remain healthy, recognize early signs of illness and adjust to an existing illness is available by telephone. This service, called Tel-Med, is not designed to replace personal physicians and dentists. In Prince George's County, Tel-Med is sponsored by the Prince George's General Hospital and Medical Center, the Health Department and the Memorial Library system in cooperation with the county Medical Society and the Dental Society of Southern Maryland.
This Tel-Med program has more than 200 tapes, any of which can be heard by calling 345-4080. Complete lists of tapes available can be obtained from any public library in prince George's. Topics include arthritis and other pains, heart, dental Care, alcohol and drugs, cancer, first aid and safety and mental health.
A similar program operates in the District of Columbia telephone 5619500. Lists will be mailed to those who call public relations, 574-6646.
There are numerous other service available to help the elderly deal with health needs without institutionalization. Many agencies participate, offering these services free of charge or requiring payment of established fees. In Montgomery County, it took a 23-page booklet prepared by the Commission on Aging to list and briefly describe home health-care services. Perhaps the best initial inquiry is made by contacting the local office on aging for information, material or referral.