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Services for married couples on assistance and pension : a type study of a selected group of cases, Vancouver,… Talker, Elizabeth 1956

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SERVICES FOR MARRIED COUPLES OK ASSISTANCE AND PENSION A type Study of a Selected Group of Gases Vancouver, 1956.  by ELIZABETH TALKER  Thesis Submitted i n P a r t i a l F u l f i l m e n t of the Requirements f o r the Degree o f MASTER OF SOCIAL WORK In the School o f S o c i a l Work  Accepted as conforming t o the standard r e q u i r e d f o r the degree of Master o f S o e i a l Work  School o f S o c i a l Work  1956 The U n i v e r s i t y of B r i t i s h Columbia  ABSTRACT  There a r e many s t u d i e s and r e p o r t s on t h e needs o f t h e Aged. This t h e s i s adopts t h e ''type-study* approach, a n d seeks t o g e t t h e i n f o r m a t i o n a s r e p o r t e d by o l d people thems e l v e s . F o r t h i s purpose i t c o n f i n e s i t s e l f t o {a) p e r s o n s on s o c i a l a s s i s t a n c e , o l d age a s s i s t a n c e o r o l d age p e n s i o n , and (b) m a r r i e d c o u p l e s , age l i m i t s b e i n g f i f t y - f i v e t o seventy-five years. 1  The e i g h t e e n c o u p l e s chosen f o r s t u d y were i n t e r v i e w e d i n t h e i r homes, t h e o b j e c t b e i n g t o g e t f i r s t - i - h a h d knowledge o f t h e i r c i r c u m s t a n c e s and t h e i r own p o i n t o f v i e w o f t h e i r needs. T h i s was a i d e d by a p r i o r s t u d y o f case m a t e r i a l f r o m t h e G i t y o f Vancouver S o c i a l S e r v i c e Department. I t p r o v e d p o s s i b l e , i n t h e main, t o t y p i f y m a r r i e d c o u p l e s a t t h i s age who c o u l d be c o n s i d e r e d " a d j u s t e d " and " u n a d j u s t e d " * T h i s s t u d y p o i n t s up t h e unmet needs o f t h e u n a d j u s t e d t y p e , and s u g g e s t s a m e l i o r a t i o n o f t h e i r p r e s e n t C i r c u m s t a n c e s by e x p a n s i o n o f v o l u n t e e r and housekeeper s e r v i c e s and c e r t a i n k i n d s o f r e c r e a t i o n a l u n i t s . New s e r v i c e s suggested f o r f u t u r e experiment w h i c h would p r o b a b l y a p p l y t o b o t h groups i n c l u d e improvement i n comiminications, s p e c i a l i z e d i n - s e r v i c e s t a f f t r a i n i n g , and e x t e n s i o n o f casework c o u n s e l l i n g s e r v i c e s t o i n c l u d e o l d e r groups n o t i n need o f economic a i d . 1  An attempt has been made t o s t r e s s t h e p r e v e n t i v e and r e h a b i l i t a t i v e a s p e c t s which may prove c a p a b l e o f a v o i d i n g and c o r r e c t i n g a c c e l e r a t e d a g e i n g . The s u b j e c t i s o f S p e c i a l c o n c e r n i n B r i t i s h Columbia t o - d a y , due t o t h e l e n g t h e n i n g span o f o l d age, and growing i n d u s t r i a l i z a t i o n w i t h i t s Concomitant economic and f a m i l y problems.  TABES OF CblTEfitS 1  Chapter I  problems o f t h e O l d e r Age Groups  Changing f a m i l y p a t t e r n s , The economicproblems o f growing i n d u s t r i a l i z a t i o n . Lengthening span o f o l d age* The problem o f p o p u l a t i o n . Primary human needs and t h e needs o f o l d e r c i t i z e n s . The process o f ageing* Some l o c a l s t u d i e s * Focus o f t h i s study* Method and procedure, *, ,*«,,,.*,*,;. *, *.,,,*,:.**.., **...:.*,*•**,*. *, * *. * .• Ghapter 1 |  Eighteen Married  Couples:  Group I , a d j u s t e d couples., Group 1I» unadjusted c o u p l e s , , . . . . . *.*.* •. ,.,«.**. * * . . . . . . . . . . . . , *.*,|,, * r  Ghapter III  Servlceaand  25  Heeds  Mature o f s e r v i c e s p r o v i d e d . Soeial assistance* Casework and C o u n s e l l i n g , Ileal t h s e r v i c e s * C u s t o d i a l care* Nutritionist* Unmet needs i n h e a l t h S e r v i c e s , housing, reassurance and support* Employment*•,,,........ Ghapter I?  1  37  Some P o s s i b l e Developments o f S e r v i c e  type s t u d i e s o f couples i n Groups 1 and II* Some implications* New t r e n d s : M o n - l i n a n c i a l needs, r e s e a r c h , expansion o f e x i s t i n g services.*,, i n t r o d u c t i o n o f new s e r v i c e s * Employment, R e h a b i l i t a t i o n . Improvement o f COBimunications. I n - s e r v i c e t r a i n i n g f o r workers*. The implications of prevention. Provision of s t a f f consultant on s e r v i c e s t o the a g e i n g , * . 5 C o n c l u s i o n * ..*«««.,*  3  »»* .•*.. ......o....««.<>«.«««»«......... *  TABLES ASP CHARTS IN THE TEXT (a) T a b l e 1.  Tables  P o p u l a t i o n o f Canada by age groups* Census y e a r s 1931 - 1951 (showing a b s o l u t e and percentage i n c r e a s e ) ,,.«,.**. *,.«•*••«««.....  7  Table I I .  Comparative i n c r e a s e s i n o l d e r age groups, B r i t i s h Columbia and Canada, 1931 * 1951**....  6  Table I I I ,  P o p u l a t i o n o f B r i t i s h Columbia by age groups. Census years 1931 * 1951 (showing a b s o l u t e and percentage i n c r e a s e s ) . . . . . . . . . . . . . . . . . . . . .  9  (b) Flgi 1  Charts  U n i t boundaries o f C i t y o f Vancouver S o c i a l S e r v i c e Department *  a.**.*,..,,.*.*,,,,**,*'**.*,  21  ACKNOWLEDGEMENTS  1 w i s h t o e x p r e s s my s i n c e r e a p p r e c i a t i o n t o a l l t h o s e who were h e l p f u l i n t h e p r e p a r a t i o n o f t h i s s t u d y *  I  w o u l d l i k e t o pay a s p e c i a l t r i b u t e t o t h e a s s i s t a n c e and i n s p i r a t i o n o f Mrs. H e l e n McGrae o f t h e S c h o o l o f S o c i a l Work U n i v e r s i t y o f B r i t i s h Columbia.  1 am d e e p l y i n d e b t e d t o Dr..  L. C. Marsh, whose wide knowledge a n d p e n e t r a t i n g c r i t i c a l power were o f i n v a l u a b l e h e l p *  B o t h gave g e n e r o u s l y ©f t h e i r  t i m e and e x p e r i e n c e , w h i c h I d e e p l y a p p r e c i a t e . I am g r a t e f u l t o Mr. J . I . Chambers, A d m i n i s t r a t o r , t o M i s s Margaret G o u r l a y , and t o Mr* T . T. H i l l , o f t h e G i t y o f Vancouver S o c i a l S e r v i c e Department, f o r p l a c i n g r e c o r d s a t my d i s p o s a l ; t o M i s s M. McKeana o f t h e M e d i c a l S e c t i o n , and t o t h e S u p e r v i s o r and d i s t r i c t w o r k e r s o f t h e West U n i t o f t h e Department f o r t h e i r v a l u a b l e c o - o p e r a t i o n and h e l p i n s e l e c t i n g t h e cases f o r t h i s s t u d y . My t h a n k s a r e due t o t h e e i g h t e e n c o u p l e s who so w i l l i n g l y s h a r e d t h e i r e x p e r i e n c e s w i t h me i n t h e i n t e r e s t o f improvement i n s o c i a l work programmes.  SERVICES F0& MARRIED CQUPpJS ON ASSISTANCE AND PENSION  A Type Study o f a S e l e c t e d Group o f Gases  Vancouver,  3,916  Chapter I  PROBLEMS OF THE OLDER AGE GROUPS  O l d age h a s been a r e s p e c t e d and p r o t e c t e d c o n d i t i o n o f man t h r o u g h o u t r e c o r d e d h i s t o r y .  In the East, i t i s held i n  e s p e c i a l v e n e r a t i o n and i s t h e symbol o f wisdom and e x p e r i e n c e ^ In  C h i n a , P a k i s t a n and I n d i a i n s t i t u t i o n s f o r t h e aged a r e  unknown, t h e r i g h t f u l p l a c e f o r o l d people b e i n g c o n s i d e r e d as being with the family.  Whether r i c h o r poor, t h e g r a n d p a r e n t s *  share o f t h e f a m i l y l i f e i s always t h e r e , On t h e American c o n t i n e n t , however, t h e p a t t e r n o f culture i s entirely different; t h e o l d e r people  But t h e concern f o r t h e needs o f  i s a s o l d as p u b l i c w e l f a r e i t s e l f ; f o r o l d age  was  one o f t h e c o n d i t i o n s o f man f i r s t t o be r e c o g n i s e d a s d e s e r v -  ing  o f s o c i a l support a l t h o u g h , f o r a l o n g t i m e , o n l y i n a l i m i t e d  way,  vL  T h e e a r l y s e t t l e r s i n A m e r i c a b r o u g h t w i t h them f r o m E n g l a n d  t h e Poor Law c o n c e p t s t i o n i n o l d age. to  o f governmental p r o v i s i o n a g a i n s t d e s t i t u -  The almshouse and poor r e l i e f were i n t e n d e d  only  p i c k up t h e w o r s t c a s u a l t i e s o f t h e p r e v a l e n t system o f  i n c l u s i v e f a m i l y r e s - o n s i b i l i t y , and seem e x t r e m e l y  inadequate  V  a c c o r d i n g t o modern i d e a s o f s o c i a l r e s p o n s i b i l i t y ,  nevertheless,  t h e y were i n r e a l i t y f o r e - r u n n e r s o f p r e s e n t day p u b l i c w e l f a r e concepts.  T h i s h i s t o r i c a l p r o c e s s , though s l o w and i r r e g u l a r ,  needs t o be seen i n p e r s p e c t i v e I n o r d e r t o be  understood.  The e v o l u t i o n o f p u b l i c w e l f a r e and t h e development o f modern i n d u s t r i a l s o c i e t y have r e s u l t e d i n t h e f a c t t h a t t h e j o b  2  o f t h e f a m i l y has become a m a t t e r o f s o c i a l r e s p o n s i b i l i t y , and i s i n c r e a s i n g l y s h a r e d by community and governmental o r g a n i z a t i o n s . W e l f a r e o f t h e o l d e r g e n e r a t i o n i s one such example. The present evidenced  day i n t e r e s t i n t h e l a t e r y e a r s o f l i f e i s  i n many ways.  Thus, new t e r m i n o l o g y has been i n v e n t e d ,  s u c h as " g e r o n t o l o g y " , t o d e s c r i b e t h e s c i e n t i f i c s t u d y o f a g e i n g , and " s e n i o r c i t i z e n " , as a t e r m o f r e s p e c t t o d e s c r i b e o l d e r individuals.  There a r e many c o n f e r e n c e s ,  commissions, r e p o r t s ,  p l a n n i n g and r e s e a r c h p r o j e c t s . Magazines a r e f u l l o f a r t i c l e s on t h e same s u b j e c t .  Y e t t h e f a c t t h a t o l d e r people a r e a l s o human  b e i n g s , w i t h s o c i a l and f a m i l y i n t e r e s t s , does n o t always seem t o be a c c e p t e d .  There a r e many p r o f e s s i o n s and s e r v i c e s w h i c h ,  u n i n t e n t i o n a l l y o r o t h e r w i s e , have t h e e f f e c t o f s e g r e g a t i n g them. And i t i s here t h a t t h e problem o f a g e i n g seems t o have r o o t . T h i s has f o u r f a c e t s : -  Changing F a m i l y P a t t e r n s S o c i a l "bad c o n s c i e n c e " a r i s e s when p e o p l e ' s sense o f e t h i c a l v a l u e s does n o t conform w i t h c u r r e n t s o c i a l r e a l i t y . is  It  c h a r a c t e r i s t i c o f p e r i o d s when s o c i a l arrangements have n o t k e p t  pace w i t h c h a n g i n g i n d i v i d u a l o r group needs. of the e t h i c a l values are s t i l l  Thus, t o d a y , many  c e n t r e d i n a time-honoured way o f  l i f e , i n w h i c h o l d e r people t y p i c a l l y b e l o n g e d t o a l a r g e f a m i l y group embracing s e v e r a l g e n e r a t i o n s .  T h e i r need f o r economic  security, f o r a useful social role, f o r a continuity i n l i f e ' s  3  developmental, p a t t e r n , f o r companionship, s o c i a l p r o t e c t i o n , and a sense o f " b e l o n g i n g " were a l l met w i t h i n t h e s p r e a d i n g f a m i l y circle. But t h e p r e s e n t i s an i n d u s t r i a l economy r a t h e r t h a n the o l d f a m i l y farm. small.  The c i t y houses and apartments a r e o f t e n  There I s f r e q u e n t movement, and t h e economy i s almost  w h o l l y monetary*  Less l a b o u r i s put i n t o m e e t i n g n e e d s  by home  p r o d u c t i o n , more i s bought i n t h e market» and t h e r e i s a t i g h t r a c e between income a n d e x p e n d i t u r e * ;  The c h i l d r e n a r e much more l i k e l y  t o be t h e p l e n a r y f o c u s off f a m i i y l i f e , t o whom heavy o b l i g a t i o n s are  felt. Grandparents cannot always be e a s i l y o r p r o d u c t i v e l y  a s s i m i l a t e d i n such a s e t t i n g *  S i n c e t h e y cannot s e r v e as members  o f a h o u s e h o l d ' s p r o d u c t i v e team, t h e y a r e no l o n g e r an economic a s s e t , but r a t h e r an added change a g a i n s t a l i m i t e d f a m i l y budget* M o r e o v e r , t h e r e a r e f e w e r members off t h e f a m i l y group t o share t h e t a s k off a b s o r b i n g t h e o l d e r g e n e r a t i o n i n t o t h e i r d a i l y l i v e s , and t h e s e f e w may w e l l be s c a t t e r e d a c r o s s t h e c o n t i n e n t *  The f a m i l y  has* i n r e a l i t y , ceased t o be dependable o r s a t i s f a c t o r y as t h e s o l e medium f o r a s s u r i n g economic o r s o c i a l p r o t e c t i o n i n o l d age. Even t h e s o l i d a f f f f e e t i o n a l and s p i r i t u a l v a l u e s i t s h o u l d r e t a i n have been, i n some measure, undermined by t h e c o n f l i c t s w h i c h i n e v i t a b l y r e s u l t f r o m f a i l u r e t o r e c o g n i s e and aocfept i t s c h a n g i n g social function* The f a m i l y i s man's most p r e c i o u s s o c i a l a s s e t and t h e  m a t r i x o f a l l his> s o c i a l i n s t i t u t i o n s . and  in different  tion.  c u l t u r e s * i t has  In f a c t , i t has  been one  But,  s o c i a l unit  of the  blood r e l a t i o n s h i p  of the  community.  marks o f advancing  f o r any  o f f a m i l y t i e s t o the  There i s , t h e r e f o r e , no  group i n the  honourable t o provide d i g n i f i e d , l i v i n g quartern f o r the e l d e r l y  civil-*  s o c i a l interdependence  l o s s o f e t h i c a l v a l u e s i n i u e h a broadening base o f responsibility  Centuries  undergone many changes o f fuhe-  i z a t i o n when concepts of mutual a i d and moved beyond the  over the  population.  comfortable, and  broader  intrinsic  shared  I t i s no  less  independent  r e t i r e d c o u p l e , than t o house them  I n the  o l d spare room o f f the  f a m i l y d i n i n g room on  farm*  i n the urban r e a l i t i e s of modern l i f e ,  the  family  i t i s more s a t i s -  f a c t o r y f o r a l l concerned t o p r o v i d e independent q u a r t e r s , r a t h e r t h a n crowd the  children  onto the l i v i n g room d&y«»bed, i n o r d e r t o  conform t o a f a m i l i a r hut tion*  Similarlyj  a dignified,  the  i m p r a c t i c a b l e concept of s o c i a l  social security  obliga-  program, p r o v i d i n g income  on  s e i f ^ r e s p e C t i h g b a s i s t o r e t i r e d people, r e c o g n i z e s  t h e i r r i g h t t o be f r e e of a degree o f dependence on C h i l d r e n , which c o u l d only c r e a t e c o n f l i c t i n the  their  own  r e a l i t i e s of  modern l i f e * . But  the  a t t i t u d e s o f the  o f adjustment t o t h i s p a t t e r n . fortable  and  Many f i n d themselves i n an uncom-  c r i p p l i n g c o n d i t i o n Of mental c o n f l i c t which hampers  t h e i r enjoyment o f the They may  o l d e r people r e f l e c t t h e i r l a c k  special  p o t e n t i a l i t i e s of t h e i r l a t e r years  s u f f e r a sense o f l o s t p r i d e o r s t a t u s because t h e i r  C h i l d r e n are f a i l i n g t o f u l f i l t h e i r s o c i a l p a t t e r n o f f i l i a l  obligation.  The Economic Problems o f Growing I n d u s t r i a l i z a t i o n Some problems o f t h e o l d e r age groups a r e due t o economic c o n d i t i o n s which have undergone a r a d i c a l change and have a f f e c t e d income and p r o d u c t i v i t y *  When self-employed  on t h e  f a m i l y farm o r i n small f a m i l y e n t e r p r i s e s , t h e continued ment o f o l d e r f a m i l y members was n o t d i f f i c u l t *  employ-  The d i m i n u t i o n  o f t h e i r r e s p o n s i b i l i t y and e f f o r t came about n a t u r a l l y and gradua l l y as the younger f a m i l y p a r t n e r s took over t h e major r o l e ,  With  the s h i f t t o wage employment i n l a r g e * s c a l e i n d u s t r i a l and s e r v i c e e n t e r p r i s e s ^ t h e o p p o r t u n i t i e s f o r .continued employment o f o l d e r people were g r e a t l y diminished*  Moreover-  t  t h i s t r e n d was s e r i o u s l y  aggravated and a c c e l e r a t e d by t h e unemployment o f t h e d e p r e s s i o n years*  Psycholegi<?al,  s o c i a l and economic p r e s s u r e s  a l l combined  t o f o r c e out t h e o l d e r worker i n order t o keep younger men on t h e job.  • • •  The Lengthening Span off O l d Age The  ?'  average span o f l i f e has been i n c r e a s e d by t h e v a s t  s t r i d e s i n t h e s c i e n c e s off medicine and g e r o n t o l o g y . in  Never  before  h i s t o r y hav§ so many people l i v e d as l o n g as they do to-day*  This i s the r e s u l t p a r t i c u l a r l y o f e l i m i n a t i o n o f the diseases o f childhood.  And y e t i t i s l i k e l y t h a t t h e r e w i l l be a g r e a t e r  i n c r e a s e i n t h e l i f e span, due t o t h e f a c t t h a t p u b l i c h e a l t h measures and medical s c i e n c e s a r e now beginning d i s e a s e s and a i l m e n t s  off t h e l a t e r  years*  t o conquer t h e  6  However, this lengthened span or extended period of l i f e expectancy really covers two distinct phases.  One of these  i s the period or condition of continued vigour\ the other i s the potential period of declining v i t a l i t y and health, which a l l who l i v e long enough must ultimately reach.  Sot only are the needs of  the two phases very different, but their potential total span i s actually long enough to embrace not one, hut two generations, e..g. a woman, forced out of work at si^ty, may well join her mother of eighty i n the same "old age gr©up , ,,  Many of the special problems of later years are related to this unrealistic tendency to place a l l people over a particular age ( i t may be anywhere from f i f t y Upwards) into a single pigeon-hole of attitude, policy, and social organization.  Such  sweeping categorization i s always resented, and i n physical, psychological and welfare terms, i t i s often seriously wrong.  The Problem of Population The fourth basic problem peculiar to the older people of the present generation i s their unprecedented numbers* Mot only ar© there more of them altogether* but they represent a steadily increasing proportion in the total population, A glance at the o f f i c i a l census figures for Canada (see Tabl© overleaf) w i l l make this clear:* (a)  In the age group © - 9 , there was no proportionate increase  in 1941, hut a decrease*  This was reflected i n 1951 for the age  T a b l e I . p o p u l a t i o n o f Canada by Age Groups Census Y e a r s 1931— 1951 ( s h o w i n g a b s o l u t e and p e r c e n t a g e i n c r e a s e s )  Age Group  1931 Total  0 - . 92,207,536 IG 19 2,114,250 20 - 29 1,698,189 30. * 39 1,397,930 40 - 49 | 1,231,924 50 - 59 . 1 i 856,140 60-69 1 525,978 70 - 79 I 270,340 80 - 89 I 68,330 90 & e v e r ] 6,169  1941 Total  Increase "'"dumber : P. C.  2,097,674 106,662 2,220,912 301,227 1,999*416 205,440 1,603,370 79,767 1,311,691 242.456 1,098,586 i^o,o97 714, TO":352,796 82,456 30,820 99,15© 1,976 8,145  5.04 17.74 14.70 6.47 28*32 30.50 45.10 32.03  1951 Total  Increase Mumper P. C.  3,119,952 1,022,278 2,188,755 2,219,856 220,440 2,041,867 428,497 1,613,246 301,555 1.233.346 134,750 224,774 150,667 503,464 37,240 136,390 4,778 12,923 •  S o u r c e : Canada -^ear Book 1954 Bureau o f S t a t i s t i c a, Ottawa.  •  ••  48.73 11.03 27.35 22.99 12.27 31.44 42.71 37.56 58.66 -  $ group |Q - 19*  However,.- there was a  gpmt  i n 1911, ehowiiig'^ -p&mem&B® ©f  i n c a s e i n birth© ©fehtr %M£g$ v a ^ i i i n g  e $ i a } » th.is'ah©ul.4 mm£& i a m mm greater Ms©' in the nusber'  of p©r®©«© «*v©r sixty', f i f t y years' fraia mm± •  W  I n the  lm%  iem ag© -«IPottp«#, tlj* $$tiM«agf intr©na@i' isa  ItW. m4 1911 show a asarkM upmM  -  i f ^ n d eve* th©' ©tt*@r  greupt,;. ti©av#rag@ immm®-. Io. tltt $Nu#$ up t o i f - i u %k*„k®$ i n 1941, and  %h®m®w®m  $8s l#$i« . I n the. ag©-groups- fvm 60 upwards,.  immm®  u M*M- m  m i 4t«itfi fa i 9 $ i * ,  ^pp,ulatic?^i Tren.d^^ in^,ffir^j.tit'jft. ffo^utabia it  l  M$m%  %mn& mm mom. s t r o n g l y .  1  - i n M $ £ & f©|us#|# ftl&e* t$& iaisii $to If$1. eosmii f i f t i e s f#r thi® ag©  group i n the j#*r£ji£# *iteif*4 a i » i h «£r9%&$£ Inereas© ever t a § 1%1 figures f o r the; mm® age group. 40 tipwar4ar mm s  I n the higher <gr#up froia  & greater ineretie- 1© -ihotfn dv®r'tii# l@nt ten  year© than cos^araMvB figures f ^ r gfee t@te& danadian population,. Following £» a tibjie tshiefc -gtve}.a a §©5!#$riS©a bett^en th© average tmmm^$ ow,  fcts@  ag® groups* •# * 5 9 , and 6 § and  f©r- .Gana$* and B r i t i s h - Solusteial  Ag® Group •  0 - §9  # Hm  and oir^i  ,  fable I I I overleaf*  9i-*4f  j  -mm-  Table I I I .  P o p u l a t i o n o f B r i t i s h C o l u m b i a b y Age Groups Census Y e a r s 1931 - 1951 (shewing i n c r e a s e s a n d p e r c e n t a g e i n c r e a s e s )  Age Group 0 10 20 30 40 50 50 70 80 90  - 9 - 19 29 - 39 - 49 - 59 - 69 - 79 - 89 & over  1931 Total 111,274 122,391 107,487 98,733 112,494 79.204 41,824 17,147 3*436 273  1941 Total 114,427 127,326 141,149 117,794 100,605 106,056 72,02$  30,680 7,240 559  Increase Number P, G. 3,153 4,935 33,662 19*061; 26,852 30,021 13,533 3,804 286  2.83 4*03 31.32 19*30 33*90 72.21 78.92 110.71 104.76  Total 225,778 148,839 171,416 182,079 143,280 112,144 108,464 58,783 13,357 1,070  S o u r c e : Census o f Canada 1951 V o l . I , T a b l e 19 Dominion Bureau o f S t a t i s t i c s , Ottawa, 1953.  1951 l Increase Number P. C. 111,351 97.31 21,513 16.90 30,267 21.44 64j285 54.57 42,675 . 42.42 6,088 5.74 50.S? 91.60 28,103 6,117 84.49 511 91.4  10 The Heeds  of  Older  The needs  all  of  lessened their  Like  a l l  Of  are  ability  themselves  a minimum o f  has  not  age,  and he  and to  kinds  of  least,  are  the  for  their  movement,  and  possibly  Ihey need t o a  age,  security,  at  allow  have  whatever  make  imposesj  plans  it  being  Older specific  ©motional Certain  live, this due  while  made  sense they  they  of  can  feel  "belonging . 0  need  affection  do a f a i r  cramped and  he  job  inconvenient  such  that  gives  within the be  further  able  to  need  living  of  life,  do  so,  he  should  are  due  to  failing  of  for  himself the  because  against  his  participate  accommodation  those  very  faculties,  shelter,  i f  wherever  way  food,  him,  limitations  his  same a s  is  choose  qualified  and f a i l i n g  Their need f o r  as  to  realistic  is  the  pension  opportunity  change  are  a  at  a^edsthe  Independence  to  also  satisfactions  the  p e r s o n needs He  illness  persons  older  and s e c u r i t y *  to  him*  needs*  the  privately,  must  for  handicaps  comfort  means  necessary  But  level,  s h o u l d have  limitations,  own w i s h e s *  their  all  of  to  and adapt,  and independence  a n d how h e w i l l  personal  in  of  practical  accumulated  environment  of  sureness  emotional  physical  security  important, where  and  t© a d j u s t  to  essentials  modifications  and u s e f u l ,  Given  in  arrangements.  financial he  some  human b e i n g s ,  On a more least  people,  and speed  recognition.  living  old  with  wanted  other  adjusting  of  people,  decreased they  and  needs  strength  that  People  planned  Comforts  other  strength,  adults, loss  of  to and with  ii  employment, e t c , Age b r i n g s w i t h i t many i l l s , t o o o f t e n i n c l u d ing to  h a r d e n i n g o f a t t i t u d e s , and o l d e r persons a r e u s u a l l y  unable  a c c e p t t h e changing f a s h i o n s o f l i v i n g , and become t h e f o c u s o f  Complaint and c r i t i c i s m ,  Y o u n g s t e r s a r e g i v e n a degree o f freedom  t o - d a y t h a t t h e grandmother o r g r a a d f a t h e r might w e l l f e e l  danger-  ous and f o o l h a r d y i n t h e extreme i f t h e y c l i n g t o t h e s t a n d a r d s o f t h e i r own day*  Many manners and customs t h a t a r e d i f f e r e n t c a n  d i s t u r b an o l d e r p e r s o n who has l o s t h i s e l a s t i c i t y ;  The w o r l d i s  moving a t a f a s t e r pace a n d i s f u l l o f b e w i l d e r i n g gadgets a n d new ways o f d o i n g t h i n g s t h a t seem t o be beyond h i s f a i l i n g s t r e n g t h and a b i l i t y t o adapt.  T h i s causes a g r e a t d e a l o f i n s e c u r i t y *  He  needs a maximum o f u n d e r s t a n d i n g f r o m p e o p l e he meets, b u t t o o o f t e n he r e c e i v e s a l l v a r i e t i e s o f r e j e c t i o n , m i s u n d e r s t a n d i n g and impatience* Food, though e s s e n t i a l t o t h e maintenance o f l i f e , a f f o r d s a s p e c i a l source o f p l e a s u r e f o r t h e o l d e r p e r s o n * no l o n g e r a b l e t o e x p e r i e n c e a number o f p h y s i c a l  He i s  satisfactions  e n j o y e d by younger persons andj t h e r e f o r e , f o c u s e s much o f t h e Other l o s t p l e a s u r e s i n e a t i n g .  Food a l s o has a g r e a t  Importance  s o c i a l l y , f o r a person Can e n j o y e a t i n g i n t h e company o f f r i e n d s * But meals o f t h e o l d e r p e r s o n a r e somewhat d i f f e r e n t . FOr example, raw v e g e t a b l e s a r e troublesome t o persons w i t h d e n t u r e s o r w i t h o u t any t e e t h a t a l l , and a r e a v o i d e d by them.  The same i s t r u e o f  f r i e d f o o d s and heavy p a s t r y , b o t h o f w h i c h a r e d i f f i c u l t t o d i g e s t . A g a i n , where l i v i n g arrangements a r e c o n c e r n e d , a f e w  12  i n e x p e n s i v e "gadgets * would make an o l d e r person h a p p i e r j e.g. 1  an e x t r a l i g h t , a f l o o r mat  that i s safe, a hand-rail f o r  support t o get i n t o a bathtub, o r a shower i n s t e a d o f a tub, where t h a t i $ p r e f e r a b l e . happiness and  P h y s i c a l comfort i s a r e q u i s i t e f o r  contentment.  1  The main p o i n t i n a l l the above i n s t a n c e s seems t o be the very important f a c t t h a t t h e o l d e r person needs t o be  "under-  stood** and v a l u e d as a human being; the tendency t o r e g a r d o l d e r persons as a r a c e o r k i n d a p a r t from o t h e r humans s h o u l d be avoided,  fh© e l d e r l y man  o r woman i s simply a man  has l i v e d q u i t e a l o n g time, but who  s t i l l ; has t h e same b a s i c  needs, d e s i r e s and r e a c t i o n s as o t h e r people who as long..  o r woman who  have not l i v e d  Probably many of t h e problems o f t h e o l d e r person would  never a r i s e i f t h e y were not made t o f e e l by the younger persons t h a t they Were hot q u i t e o f t h i s world«  The working world has  no j o b t o o f f e r t o t h e l e s s a g i l e and q u i c k person, whose s t r e n g t h and stamina have decreased w i t h the p a s s i n g y e a r s .  C h i l d r e n have  moved out i n t o homes o f t h e i r own where t h e r e i s no room f o r the o l d e r person, whose own home has perhaps been broken up by death. Stew- i d e a s and methods have come i n t o use f a s t e r ; t h a n he has been a b l e t o apprehend them, and he i s regarded merely a s a n " o l d fogey?* by t h e younger g e n e r a t i o n s , who opinions,  have no d e s i r e t o hear h i s  G r a d u a l l y , I t i s borne i n on him frx»m a l l s i d e s t h a t  1 • Most o f these and the succeeding examples a r e drawn from th© study by Bernic© L e y d i e r .  he  13 is  superfluous.  True, he may be an i r r i t a t i n g and d i s l i k e d  s u p e r f l u i t y , o r a t r e a s u r e d and beloved one, o r perhaps even an amusing one, n e v e r t h e l e s s , he no l o n g e r f e e l s needed i n the scheme of  life, The n a t u r a l r e a c t i o n t o a f e e l i n g o f no l o n g e r  to  the world, o r having  belonging  a r e a l p a r t t o p l a y i n i t , causes SOB® o f  the d i f f i c u l t i e s t h a t a r e met w i t h by those who com® i n c o n t a c t w i t h the s e n i o r c i t i z e n s .  Sometimes they f i g h t back by b e i n g  i r r i t a b l e and o v e r - c r i t i C a l , o r seek a v i c a r i o u s s h a r i n g o f l i f e by b e i n g c u r i o u s and p r y i n g i n t o t h e a f f a i r s o f o t h e r s .  They may  r e t r e a t t o a p o s i t i o n o f s u p e r i o r i t y , from which t h e y watch s u s p i c i o u s l y , and deprecate  e v e r y t h i n g t h a t IS new and d i f f e r e n t ,  T h e i r r e t r e a t may be i n t o a c o n c e n t r a t i o n on themselves and t h e i r Own needs and d e s i r e s .  A few a r e a b l e t o meet the attempt o f t h e  w o r l d t o shelve them by a g g r e s s i v e l y c a r v i n g a p l a c e f o r themselves, l e a r n i n g new t h i n g s , and demonstrating i n some way t h a t they most e m p h a t i c a l l y a r e not "done".  Whatever t h e r e a c t i o n , i t i s l a r g e l y  determined by the degree o f m a t u r i t y reached d u r i n g adulthood and the p a t t e r n o f r e a c t i o n s e s t a b l i s h e d s i n c e t h e n . t h i s stage o f l i f e ,  The c r i s e s a t  t o o , a r e met i n th© same c h a r a c t e r i s t i c  manner.  . O l d e r years and r e t i r e m e n t b r i n g w i t h them d u l l and u s e l e s s days, an u p r o o t i n g from a l l they have known p r e v i o u s l y . I t is  a phase o f l i f e w i t h fewest a d a p t a t i o n p o s s i b i l i t i e s , when t h e  f l e x i b i l i t y o f the person i s d i m i n i s h e d as w e l l as t h e a b i l i t y t o  14  m o d i f y t h e environment. areas of l i v i n g .  There a r e f r u s t r a t i o n s and l o s s e s i n most  There i s decrease i n p h y s i c a l s t r e n g t h , and  f a i l i n g o f f a c u l t i e s , such as s i g h t and h e a r i n g , so t h a t a c t i v i t i e s must be c i r c u m s c r i b e d . Advancing y e a r s b r i n g l o s s o f f r i e n d s and t o many, both f i n a n c i a l and p h y s i c a l dependence i n some degree. P o s s i b l y , t h e most s e r i o u s o f a l l c a l a m i t i e s a t t h i s stage i s e m o t i o n a l s t a r v a t i o n , which comes when a l l t h e o t h e r d i s a d v a n t a g e s a r e making themselves  felt.  O l d e r persons f a c e t h e i r a d v a n c i n g y e a r s w i t h r e l u c t a n c e . T h i s p e r i o d i s r a r e l y a t t r a c t i v e t o o t h e r s o r p l e a s a n t t o thems e l v e s , even when they can pay t h e i r way humour and h e a l t h .  and r e t a i n t h e i r w i t ,  But the f l a v o u r o f l i f e l a s t s a l o n g t i m e , and  t h e y do not w i s h t o be r e g a r d e d as a p a r t f r o m the w o r l d  around  them, n o r t o cease f u n c t i o n i n g as c i t i z e n s and members of f a m i l i e s . N e v e r t h e l e s s , t h e c u m u l a t i v e e f f e c t o f t h e i l l s and  disabilities,  p h y s i c a l , s o c i a l and e c o n o m i c , w h i c h t e n d t o i n c r e a s e w i t h age, a r e g r e a t , and make the achievement c h a l l e n g i n g and d i f f i c u l t  o f a h e a l t h y adjustment  a  one.  The P r o c e s s o f " A g e i n g " Ageing d i f f e r s from i n d i v i d u a l t o i n d i v i d u a l .  This i s  e v i d e n t p h y s i c a l l y , and even more n o t i c e a b l y , p s y c h o l o g i c a l l y . i s a well-known at  f a c t t h a t M i c h a e l Angelo p a i n t e d "The L a s t Judgment"  the a g e o f s e v e n t y .  I n some f i e l d s o f c r e a t i v e t h i n k i n g ,  osophy, m e d i c i n e , music, p o l i t i c s , e t c . , i n d i v i d u a l s , on an may  It  be at t h e i r b e s t i n the l a t e t h i r t i e s o r f o r t i e s .  philaverage,  However, i n  s p o r t s l i k e tennis*, b o x i n g , f o o t b a l l * b a s e b a l l , e t c . , t h e age o f h i g h e s t p^rfortnance i s t h e mie>twenties,  and i n v a r i a b l y t h e  champion i s d e t h r o n e d by a younger man.  I n a sense, t h e a g e i n g  p r o c e s s r e a l l y s t a r t s about t h e age off twenty-ronej b u t l o s s i n one f i e l d i s made up by g a i n i n a n o t h e r , and t h u s i t i s no d i s * advantage,  and i t s e f f e c t s a r e out-weighed  by e x p e r i e n c e .  The c h r o n o l o g i c a l p e r i o d a t w h i c h a g e i n g i s o f s i g n i f i cance v a r i e s w i t h t h e i n d i v i d u a l and h i s l i f e s i t u a t i o n .  While  among the urban and i n d u s t r i a l p o p u l a t i o n t h i s may f a l l somewhere between f o r t y and  ffiffty,  i n the r u r a l or farming population i t  comes much l a t e r *  I t c o u l d even be s a i d t h a t a g e i n g b e g i n s w i t h  c o n c e p t i o n and o n l y ends w i t h d e a t h .  Fixing a limit i s arbitrary,  and t h e r e i s no s i n g l e c h r o n o l o g i c a l age a t which people b e g i n t o f e e l old*  Such l i m i t s may, off c o u r s e , be s e t f o r purposes o f  r e s e a r c h * l e g i s l a t i o n , e l i g i b i l i t y , a n d so on*  Although a l l  i n d i v i d u a l s show a c e r t a i n l o s s o f e l a s t i c i t y off t h e s k i n * off t h e l e n s i n t h e , eye j, a n d off t h e b l o o d v e s s e l s , y e t t h e r e a r e i n d i v i d u a l d i f f e r e n c e s i n degree o f t h e s e o r g a n i c a l t e r a t i o n s *  Psychologi-  c a l l y ^ t h e i n d i v i d u a l d i f f e r e n c e s a r e even g r e a t e r , and i n e m o t i o n a l l i f f e ^ a g e i n g may be v i r t u a l l y a b s e n t .  This i s a very important  p o i n t f o r i n d i v i d u a l s between 55 and 70, f o r , d u r i n g t h i s p e r i o d t h e y may be more p a t i e n t and t o l e r a n t , f o r example, than many i n d i v i d u a l s a t any age i n t h e i r l i v e s .  Some may be c a p a b l e off  b r a n c h i n g o u t s u c c e s s f u l l y i n t o new and c r e a t i v e f i e l d s off endeavour. The t r u t h off t h i s statement i s b e a u t i f u l l y e x p r e s s e d by t h e famous B e n g a l i poet, Eabihdranath  Tagore;  16  " I t h o u g h t t h a t my voyage had come t o i t s end a t t h e l a s t l i m i t o f my p o w e r — t h a t t h e path b e f o r e me was c l o s e d , t h a t p r o v i s i o n s were e x h a u s t e d , and t h e time come t o t a k e s h e l t e r i n a s i l e n t o b s c u r i t y , "But I f i n d t h a t Thy w i l l knows no end i n me* And when o l d words d i e out on t h e tongue, new m e l o d i e s break f o r t h f r o m t h e h e a r t ; and when t h e o l d t r a c k s a r e l o s t , new c o u n t r y i s r e v e a l e d w i t h i t s wonders." I f t h e l a t e r y e a r s , t h e r e f o r e , a r e t o be t h e " h a r v e s t " years—years  o f p e r s o n a l f u l f i l m e n t and o f s o c i a l h o n o u r — t h e  community must o f f e r t h i s age a sense o f s e c u r i t y , an o p p o r t u n i t y t o f u l f i l p o t e n t i a l i t i e s f o r growth and s e l f - e x p r e s s i o n i n c r e a t i v e a c t i v i t y , , o f p a r t i c i p a t i o n i n a group.  They s h o u l d be a c c e p t e d on  t h e i r own m e r i t s as members o f t h e t o t a l community  Some L o c a l  Studies I t i s t o be e x p e c t e d t h a t i n r e c e n t y e a r s i n B r i t i s h  C o l u m b i a , g r o w i n g i n t e r e s t has l e d t o s e v e r a l s t u d i e s o f t h e problems o f t h e o l d e r age groups.  I n 1945 t h e Community Chest and  C o u n c i l o f t h e C i t y o f Vancouver p u b l i s h e d a r e p o r t c o v e r i n g t h e problem i n v e r y wide terms.2*  T h i s s t u d y , w h i c h was r e v i s e d i n 1948,  included consideration of several f i e l d s of c a r e and accommodation, h o u s i n g , ments, and r e c r e a t i o n .  medical  interest—maintenance,  care, other h e a l t h r e q u i r e -  The Committee on t h e Care o f t h e Aged has  Community Chest and C o u n c i l , Study o f t h e S i t u a t i o n o f t h e Aged i n ^ V a n c o u v e r . R e p o r t o f t h e S p e c i a l Committee Of t h e Committee on t h e Care o f t h e Aged, Vancouver, 1948,  17  developed many sub-committees i n c o n t i n u i n g i t s work over the y e a r s , and has i n i t i a t e d a number o f p r o j e c t s . f o u r S t u d i e s , undertaken by students Columbia School concerning  In addition,  o f the U n i v e r s i t y o f B r i t i s h  o f S o c i a l Work, have d e a l t w i t h s p e c i f i c problems  t h e care o f ageing c i t i z e n s *  Leydier* appraised  A study by Bernice  c o n d i t i o n s i n l i c e n s e d boarding  homes i n  Vancouver, w i t h an a n a l y s i s o f t h e i r l i m i t a t i o n s , and made recommendations f o r f u t u r e p l a n n i n g .  A t h e s i s by M. B. M c K e n z i e  2  i n c l u d e d a comprehensive s u r v e y o f t h e f a c i l i t i e s f o r the care o f t h e o l d e r war veterans  i n Shaughnessy H o s p i t a l *  A critical  evalu-  a t i o n o f T a y l o r Manor, a l a r g e Vancouver i n s t i t u t i o n f o r o l d people was t h e theme o f t h e Guest t h e s i s . ^  A study o f the v a l u e s and  l i m i t a t i o n s o f f o s t e r home care f o r t h e Dependent Aged was mad© by R. M. D e i l d a l i n 1955*^  Other t h e s i s s t u d i e s , while n o t concerned  p r i m a r i l y w i t h s e n i o r c i t i z e n s * have g i v e n c o n s i d e r a t i o n t o v a r i o u s aspects  o f t h e i r problems, and have c o n t r i b u t e d t o t h e g e n e r a l body  o f knowledge on t h e same problems.  The N a t i o n a l C o u n c i l o f Jewish  Women o f Canada p r o v i d e d a f e l l o w s h i p t o t h e School  o f S o c i a l Work,  t o be used f o r the study o f the r e c r e a t i o n a l i n t e r e s t s a n d a c t i v i t i e s o f the aged i n Vancouver*  The r e p o r t o f t h e study which was  ^ L e y d i e r , B e r n i c e . Bearding Home C a r e _ f o r t h e Aged. Master o f S o c i a l Work T h e s i s , U n i v e r s i t y off B r i t i s h Columbia, 1948* 2. McKenzie, M.B., The Care o f an Ageing and D i s a b l e d Group i n a Veterans* R e s p i t a l • Master o f S o c i a l Work T h e s i s , U n i v e r s i t y off B r i t i s h Columbia, 1950. 1  ^Guest* D. f * , T a y l o r Manor, A Survey off the F a c i l i t i e s off Vancouver»s Home,for t h e Aged. Master o f S o c i a l Work T h e s i s . U n i v e r s i t y off B r i t i s h Columbia, 1952* ^ D e i l d a l , R.M*, F o s t e r Home Care_©ff the Dependent Aged. Master off S o c i a l Work T h e s i s * U n i v e r s i t y off B r i t i s h Columbia, 1955.  18  i s s u e d i n mimeographed form i n 1954  includes a d e s c r i p i l o h of  the e x i s t i n g r e c r e a t i o n a l f a c i l i t i e s f o r s e n i o r c i t i z e n s , w i t h recommendations f o r f u r t h e r r e s e a r c h p r o j e c t s * ^ Housing A s s o c i a t i o n has old  The Vancouver  h e l p e d t o p u b l i c i z e many p r o j e c t s f o r  persons* housing, and i s s u e d a v a l u a b l e compendium on  the  s u b j e c t i n 1948*  Focus of Present Study  •  The age group 55 * 75 s p e c i f i c reasons*  Due  chosen f o r t h i s study f o r  t o t h e lengthened l i f e span, " o l d age"  c o v e r s two d i s t i n c t phases: of  was  55  t o '75,  and 75  and over*  The f i r s t  these p e r i o d s i s one of continued v i g o u r when, more or l e s s *  a l l p h y s i c a l and mental powers are i n t a c t , w i t h the added v a l u e of  experience.  As h i s t o r y has shown, t h i s i s the p e r i o d when  p o l i t i c i a n s , p o e t s , s c u l p t o r s , p a i n t e r s and o t h e r s have shown t h e i r best t a l e n t s *  P s y c h o l o g i c a l l y , i t can be  a creative  age;  and i f t h e o l d e r c i t i z e n s are helped a t t h i s time t o f u l f i l  their  p o t e n t i a l i t i e s f o r s e l f - e x p r e s s i o n , not o n l y w i l l i t be a s e r v i c e t o them, but a l s o a g a i n t o s o c i e t y .  This i s very relevant f o r  s o c i a l work, and f o r sympathetic understanding o f o l d people* Secondly, t h i s has a b e a r i n g ©n the p r e v e n t i v e and i l i t a t i v e aspects* who  rehab-  P u b l i c Concert Can not be l i m i t e d t o those  a r e a l r e a d y " o f f i c i a l l y * * aged, i * e . s i x t y - f i v e o r over, when the  1Grant, Joan, R e c r e a t i o n a l I n t e r e s t s a n d _ A c t i v i t i e s f o r S e n i o r C i t i z e n s i n Vancouver, c h o o l o f S o c i a l Work. U n i v e r s i t y o f B r i t i s h Columbia, August 1954. e  19 problem h a s become a c u t e , and when any a c t i o n taken i s l i a b l e to be on an emergency b a s i s .  I t i s n e c e s s a r y t o go down the age  s c a l e t o t h a t v a r i a b l e p o i n t a t which t h e problems o f ageing originate*  P r e v e n t a t i v e programmes must be o r g a n i s e d w h i l e  persons a r e i n v i g o r o u s mental h e a l t h ? even i f , they may be d i s a b l e d p h y s i c a l l y .  i n Some eases*  With a p p r o p r i a t e s e r v i c e s ,  s e n i l i t y may be avoided, o r a t l e a s t put o f f f o r a c o n s i d e r a b l e time, and t h e o l d e r c i t i z e n s p r o v i d e d w i t h i n s p i r a t i o n * i n f o r m a t i o n and i n t e r p r e t a t i o n , and made t o f e e l themselves t o be u s e f u l members o f S o o i e t y * M a r r i e d couples on a s s i s t a n c e were chosen f o r t h i s  study,  as none o f t h e p r e v i o u s s t u d i e s had d e a l t with t h e problems from t h e i r s p e c i a l angle*  B e i n g on a s s i s t a n c e , t h e i r a c t i v i t i e s a r e  l i k e l y t o be l i m i t e d because o f the l i m i t e d means a t t h e i r d i s p o s a l . On the o t h e r hand, some o f t h e i r problems may n o t be so acute* F o r example, the problem o f l o n e l i n e s s , which takes h o l d o f so many S i n g l e persons, would n o t be s o severe i n the case o f m a r r i e d couples.  A t t h e same time t h e r e might be a tendency t o remain  house*bOUnd and not mix w i t h t h e o u t s i d e world. t o o b t a i n a room for  Again, i t i s e a s i e r  a couple than i t i s f o r a s i n g l e person, while  t h e problem o f r e n t i s a l s o eased.  Couples, t o o , would p r e f e r t o  stay a t home, r a t h e r than r e c e i v e i n s t i t u t i o n a l car©* problems thus appear t o be l e s s complex*  Their  I t was t h e r e f o r e thought  f e a s i b l e t o s e l e c t married couples f o r purposes ©f study* approaches t h e problem from t h r e e p o i n t s o f view*  The study  Firstly, i t  20 attempts t o a r r i v e d i a g n o s t i c a l i y a t t y p i c a l s i t u a t i o n s In which the couples  are p l a c e d .  Secondly, i t t r i e s t o view t h i n g s from  the angle of the c i t i z e n s themselves; and,  t h i r d l y , i t attempts  t o i n d i c a t e the s e r v i c e s needed, by a n a l y z i n g the  services  already available. In B r i t i s h Columbia, f i n a n c i a l a s s i s t a n c e r e c e i v e d between the ages o f 55 and 75 a c c o r d i n g t o the age  can ho of t h r e e d i f f e r e n t  o f the r e c i p i e n t .  p r o v i d e d through S o c i a l A s s i s t a n c e . ©Id  Age  kinds,  Between 55 and 64,  Between 65 and 69,  A s s i s t a n c e , and from 7© onwards i t i s O l d Age  i t is  i t is  Security. 3  A f t e r d i s c u s s i o n w i t h t h e W e l f a r e S i r e e t o r , i t was decided  t o l i m i t the study t o a s e l e c t e d number o f couples  o f the f o u r u n i t a r e a s i n t o which the C i t y S o c i a l S e r v i c e meat i s o r g a n i z e d .  West U n i t was c h o s e n {see  F i g . 1),  S u p e r v i s o r and d i s t r i c t workers o f t h i s U n i t p r o v i d e d nineteen  couples  j u r i s d i c t i o n , who (a) |b| ic)  Method and  i n one depart-  and  the  a list  of  out o f the t o t a l number o f cases under t h e i r f u l f i l l e d the f o l l o w i n g c o n d i t i o n s * ^  A l l were between the ages of 55 and 75; A l l were r e c e i v i n g a s s i s t a a c e of some k i n d ; They were couples l i v i n g alone-.  Procedure T h i s study has been o f an e x p l o r a t o r y nature and,  such, no attempt has been made t o present  as  s t a t i s t i c a l measure*  5-The terms and C o n d i t i o n s under which these forms o f maintenance are g i v e n are s e t f o r t h i n t h e beginning of Chapter I I I .  CITY OF VANCOUVER  F i g . 1.  SOCIAL SERVICE DEPARTMENT Unit Boundaries  UNIT OFFICES CENTRE 1530 West 8th Ave. Ba. 5727 SOUTH 41st & Fraser F r . 2717 & F r . 2512 EAST 2610 V i c t o r i a Dr. Ha. 4512 WEST 1530 West 8th Ave. Ba. 5727  22  meats o f any k i n d *  An attempt  h a s been made t o i n d i c a t e t h a t  the needs e x i s t , e s p e c i a l l y i n t h e t y p i c a l s i t u a t i o n s o f the unadjusted couples.  On t h e b a s i s o f th© i n f o r m a t i o n o b t a i n e d ,  s u g g e s t i o n s have been made f o r t h e a m e l i o r a t i o n o f the p r e s e n t c i r c u m s t a n c e s by expansion o f e x i s t i n g s e r v i c e s and i n t r o d u c * t i o n o f new ones. p a r t i c u l a r care was e x e r c i s e d i n p r e p a r i n g t h e couples to  p a r t i c i p a t e i n t h e survey.  The caseworkers c a r r y i n g the  c a s e s v i s i t e d eaoh couple and gave them a b r i e f e x p l a n a t i o n o f t h e purpose o f t h e study, and asked them i f t h e y were w i l l i n g to  0©*operate*  I t was made q u i t e c l e a r t h a t i t was e n t i r e l y  v o l u n t a r y on t h e i r p a r t t o do s o . but one agreed.  Of t h e n i n e t e e n c o u p l e s , a l l  As t h i s was p u r e l y v o l u n t a r y on t h e i r p a r t ,  t h i s one couple had t o be l e f t o u t o f t h e study group. A thorough  study was made o f a l l a v a i l a b l e I n f o r m a t i o n  f o r the eighteen couples.  Case r e c o r d s were examined v e r y c a r e *  f u l l y , and when more than one worker had handled t h e case, each worker's v i e w p o i n t and s o e i a l r e p o r t were s t u d i e d .  After this  case-study, t h e c o u p l e s were v i s i t e d i n t h e i r homes by t h e writer. At t h e outset} i t was made q u i t e c l e a r t o t h e c o u p l e s t h a t t h e i n t e r v i e w was s t r i c t l y c o n f i d e n t i a l , and t h a t no names would be r e v e a l e d .  Each i n t e r v i e w l a s t e d , on an average,  See Appendix A.  about  23  t h r e e - q u a r t e r s o f an hour.  The couple were allowed t o t a l k  f r e e l y , but the i n t e r v i e w was study*  guided i n t o r e l e v a n t channels o f  Apart from th© statements mad© by the c o u p l e s , the s t a t e  o f t h e i r home, t h e i r h e a l t h and p e r s o n a l i t y make-up and areas o f s o c i a l c o n t a c t , as w e l l as the way a l l revealed a great d e a l . independent  they e x p r e s s e d  themselves,  The w r i t e r has t r i a d t o form  an  p i c t u r e o f t h e i r p e r s o n a l i t i e s , not i n f l u e n c e d by the  d i s t r i c t workers* i m p r e s s i o n s . I t was  n e c e s s a r y t o make one more p o i n t c l e a r t o each  c o u p l e , v i z . t h a t t h i s study was  b e i n g e a r r i e d out q u i t e  independ-  e n t l y o f the C i t y S o c i a l S e r v i c e Department, t h a t i t s main f o c u s was  t o g e t t h e v i e w p o i n t o f the o l d e r c o u p l e s , and was  going to affect t h e i r s o c i a l assistance.  i n no  way  This, i n addition to  it© c o n f i d e n t i a l i t y , made t h i m f e e l f r e e t o express  themselves  and t o o f f e r whatever s u g g e s t i o n s they had t o make. Taking notes d u r i n g t h© i n t e r v i e w was  kept a t a minimum,  so as t o make t h e c o u p l e s f e e l a t ease and f r e e t o t a l k l o s i n g the t h r e a d of t h e i r speech.  T h i s was  f a c t t h a t the " f a c e - s h e e t " i n f o r m a t i o n was  without  mad© p o s s i b l e by the  already c o l l e c t e d  from  the case records and had o n l y t o be checked f o r i t s c o r r e c t n e s s . There was  a minimum amount o f d i r e c t i o n .  Qeneral  areas  were opened up f o r d i s c u s s i o n , a s k i n g the couples t o r e l a t e t h e i r own  experiences*  D i r e c t q u e s t i o n s were used as s p a r i n g l y as  p o s s i b l e and, i n most i n s t a n c e s , were r e s e r v e d f o r th© purpos© o f f i l l i n g i n d e t a i l s , and f o r keeping  the i n t e r v i e w w i t h i n th©  2k  a r e a o f i n q u i r y by p r e v e n t i n g the i n t e r v i e w e e from g o i n g o f f a t a tangent i n any p a r t i c u l a r area.*"  I t was  noteworthy t h a t  most o f the couples responded w i t h a keen i n t e r e s t *  Indeed,  the degree o f c o - o p e r a t i o n shown exceeded t h e w r i t e r ' s ations.  See Appendix  B.  expect-  Ghapter  II  EIGHTEEN MARRIED COUPl&S  The e i g h t e e n couples who  were i n t e r v i e w e d are a l l  known t o the C i t y o f Vancouver S o e i a l S e r v i c e Department by v i r t u e o f t h e f a c t t h a t t h e y are e i t h e r on S o c i a l Allowance,  or  r e c e i v e O l d Age A s s i s t a n c e o r O l d Age S e c u r i t y , which I s accompanied by a bonus, p r o v i d e d f o r people who B r i t i s h Columbia  f o r t h r e e y e a r s p r i o r t o th© time o f a p p l i c a t i o n .  T h e i r ages v a r y from 0 and f o r women, 66.  t o 75*  the median ag© f o r men  being  70,  They a l l l i v e by themselves, mostly i n r e n t e d  rooms, a t t i c o r basement s u i t e s . their  have r e s i d e d i n  Only two couples own homes o f  own. The o b j e c t of t h e i n t e r v i e w was t o get a g e n e r a l i d e a  o f t h e i r circumstances, t h e i r p h y s i c a l and mental c o n d i t i o n , degree  of adjustment.  The  c h i e f purpose was t o get t h e i r  and  own  views on the s u b j e c t o f s e r v i c e s a l r e a d y g i v e n , and t h e need, i f any, f o r more s e r v i c e s , and the t y p e s o f those s e r v i o e s . I n some i n s t a n c e s , i t was  found t h a t the couples were  unable t o a r t i c u l a t e t h e i r needs, w h i l e o t h e r s were unable t o v i s u a l i s e whether t h e r e c o u l d be f u r t h e r s e r v i c e s beyond f i n a n c i a l support and medical s e r v i c e s .  I n almost a l l cases they were com-  p l e t e l y s a t i s f i e d w i t h t h e medical s e r v i c e s j but as regards ecenes&e a i d * w h i l e a l l were g r a t e f u l f o r what they got, they were a l l agreed t h a t they had t o be c a r e f u l w i t h every cent*  26 A f t e r spending oa f o o d and r e n t , "nothing was o r o t h e r items, was  a f r e q u e n t comment*  the r e c e n t i n c r e a s e o f |5.00 a month: s i n g l e person,  l e f t f o r clothing"  They were g r a t e f u l f o r Though v e r y l i t t l e f o r a  t h i s meant more f o r a c o u p l e ; i . e . , an i n c r e a s e  o f §10.00 a month. The statements  made by a l l the couples, i n the t h r e e  C a t e g o r i e s o f a s s i s t a n c e , ware c a r e f u l l y weighed, and i t was found t h a t they f e l l ©roup i i  i n t o two groups o r t y p e s :  Those couples t h a t were f a i r l y w e l l a d j u s t e d t o t h e i r p r e s e n t circumstances*  ^hd appeared t o be mature  i n d i v i d u a l s w i t h an o p t i m i s t i c o u t l o o k , i n s p i t e o f p h y s i c a l handicaps,  fen  i n some cases*  couples  i l l u s t r a t e t h i s group. Group I I ; Those couples t h a t mm  not so a d j u s t e d , t h e i r d i s s a t i s -  f a c t i o n and i n s e c u r i t y f o r m i n g a background t o t h e i r o u t l o o k on every aspect o f l i f e *  E i g h t couples  i l l u s t r a t e t h i s group*  Group I > A d j u s t e d 1.  goupies  Ife. a n d Mrs* A T h i s couple a f f o r d s an e x c e l l e n t example of how  even a  s e v e r e l y d i s a b l i n g d i s e a s e need not prevent a good adjustment t o prevailing conditions.  The woman has s u f f e r e d from muscular  atrophy f o r t h e past e i g h t e e n y e a r s , and has been bed-ridden f o r fourteen years.  S t a r t i n g w i t h h e r f e e t and l e g s , t h e  c o n t i n u e d t o s t e a l on h e r very s l o w l y , t i l l  now,  disease  a f t e r eighteen  27  y e a r s , she has o n l y a s l i g h t use o f h e r l e f t arm and can t u r n her head and neck o n l y ; y e t she has an amazing h o l d on l i f e . She  i s serene,  did  most o f t h e t a l k i n g , w h i l e t h e husband seemed anxious and  depressed.  calm and m e n t a l l y a l e r t .  During the i n t e r v i e w she  She i n v i t e d t h e w r i t e r t o v i s i t again, thus showing  a need f o r home v i s i t i n g s e r v i c e . The to  adjustment o f t h i s couple  i s due i n l a r g e measure  t h e care and a t t e n t i o n they r e c e i v e from t h e i r o n l y daughter.  T h e i r housing  problem i s a l s o s o l v e d by r e n t i n g t h e basement o f  t h e i r daughter's house. Even under such circumstances, take Mrs.  the husband and daughter  A f o r aa o u t i n g , by c a r r y i n g h e r i n a C h a i r t o t h e i r car*  At home she l i k e s t o l i s t e n t o th© r a d i o , and reads the d a i l y papers and magazines*  As th© couple  i a unable t o a t t e n d  church,  the p a s t o r v i s i t s them a t home. fhe couple ar© w e l l - a d j u s t e d . th© medical Department*  They a r e s a t i s f i e d  car© and a t t e n t i o n r e c e i v e d from the S o c i a l S e r v i c e They have a f e w good f r i e n d s , and the f i l i a l  o f t h e i r daughter i s a g r e a t Comfort and a source 2.  with  devotion  of strength.  Mr. and Hrs. B H e r © , too, Mrs. B i s Under d o c t o r ' s c a r e , hut h e r ailment  i s n o t as d i s a b l i n g as t h a t o f Mrs. familial ties,  A.  and a number o f f r i e n d s .  The Couple have good They have r e n t e d t h e  meat o f t h e i r daughter's house; t h i s makes them f e e l s e c u r e .  baseBoth  28  have a good d e a l of l e i s u r e - t i m e a c t i v i t i e s , and t h e i r needs a r e met.  religious  Although t h e y miss h a v i n g a c a r , which they had t o  g i v e up, t h e y a r e , on the whole, a s a t i s f i e d c o u p l e . 3.  Mri  and  B P S .  6  Mr. 6 has had f o u r s t r o k e s , and i s bed*ridden. s u f f e r s from a h e r n i a , and has a c a t a r a c t on one eye.  He  also  Mrs. C i s i n  f a i r l y good h e a l t h , but h e r day i s f u l l y o c c u p i e d w i t h n u r s i n g c a r e . T h e i r house i s l a r g e and t h e r e n t i s h i g h . it  In addition,  i s q u i t e dark, so t h a t they have t o keep the l i g h t s en a l l day.  T h e i r daughter, who  i s s e p a r a t e d from h e r husband, s t a y s with them.  She pays f o r her board, and has h e r own  t e l e v i s i o n set*  The  board  money goes towards paying f o r t h e h i g h r e n t off t h e house, w h i l e t h e t e l e v i s i o n s e t h e l p s t o pass the l e i s u r e  hours*  $5rs* G i s f o n d o f k n i t t i n g and does t h i s whenever she spare time*  S i n c e t h i s couple are unable t o a t t e n d c h u r c h , they  b e l i e v e i n the motto, B e n  good, do good"*  couple a r e p o s i t i v e on a l l p o i n t s except  4*  Mr.  has  The r e a c t i o n s off t h i s housing*  and Mrs. D T h i s i s a happy Couple, mature and w e l l - a d j u s t e d t o the  changed s i t u a t i o n *  Once they were r i c h , owned a house, a c a r , f i n e  clothes and l u x u r i e s . with t h e i r l o t *  Now  everything i s l o s t .  But both a r e content  $tr* B commented, •'The taxpayers are p r o v i d i n g f o r  Us, and can g i v e us o n l y the bare n e c e s s i t i e s ; we s h o u l d not expect more*"  He added, B. G* w e l f a r e s e r v i c e s a r e the b e s t i n Ganada." ft  29  Mr* D has p h l e b i t i s , y e t walks to t h e beach, which i s not f a r from the house.  Mrs, D has Parkinson's d i s e a s e , which  has b a d l y a f f e c t e d h e r l e f t hand, tongue, and Speech* They have no  They a r e f a i r l y w e l l housed a t p r e s e n t .  c h i l d r e n , but have a l a r g e c i r c l e o f f r i e n d s , who drop i n "every o t h e r day, almost". C l o s e t o them*  They a l s o have r e l a t i v e s who a r e f a i r l y  l o t h a r e f o n d o f r e a d i n g ! they l i s t e n t o t h e r a d i o  and watch t e l e v i s i o n .  They are f o n d o f dogs and own two.  Mr. D  does gardening i n h i s spare time, $t  Mr* a n d Mrs.,. E. T h i s i s a couple w i t h a p o s i t i v e o u t l o o k ,  They f e e l  t h e y have enough and want n o t h i n g more, except t h a t Mrs* E s t a t e s she c o u l d do w i t h a l i t t l e more money.  They a r e both i n good  h e a l t h , except t h a t Mr. E s u f f e r s from h e r n i a .  They own t h e house  i n which t h e y l i v e and have r e n t e d a p o r t i o n o f i t t o t e n a n t s . They have three C h i l d r e n , a l l married, who v i s i t them q u i t e o f t e n * T h e i r l e i s u r e time i s spent i n r e a d i n g and l i s t e n i n g t o the r a d i o . Mr* E was t h e o n l y man o f a l l t h e couples who c o u l d express an O p i n i o n on Canada's e x p o r t p o l i c y and the i n f l a t i o n o f prices. 6*' Mr. and Mrs* F f h i s i s a f a i r l y well-adjusted ritis*  couple*  Mrs, F i s I n moderately good health*  H r . t has a r t h -  They occupy a basement  s u i t e , which i s overcrowded w i t h a r t i c l e s so t h a t t h e r e i s h a r d l y Space t o move about i n * However much t h e y would l i k e t o move t o  30  another house, t l e y cannot do so because they would have t o a h i g h e r r e n t a l and would have t o buy a new cannot a f f o r d .  s t o v e , which t h e y  . . . . . .  They have s i x c h i l d r e n , who daughter l i v e s w i t h them.  visit  them o f t e n , and  ©he  They have a number o f f r i e n d s t o o .  Apart from t h e u s u a l l e i s u r e - t i m e a c t i v i t i e s , Mr. hobby*  pay  F p a i n t s as a  Mrs* F i s an a c t i v e member off a church group and  takes  p a r t i n a r r a n g i n g t e a s , bazaars, e t c . 7.  Mr.  and Mrs.  G  T h i s i s d e f i n i t e l y a happy c o u p l e .  For both t h i s i s a  second unionj t h e y are a t t a c h e d t o each other* h e a l t h problems as Mr.  G has hardening  They both have  of the a r t e r i e s j  affecting  h i s l e g s , w h i l e Mrs. Q i s under the d o c t o r ' s care f o r h e a r t nerves*  She has had an o p e r a t i o n f o r a g a l l b l a d d e r  and  complaint*  They have a b r i g h t , sunny s u i t e on the main f l o o r ,  and  are f o r t u n a t e i n h a v i n g one m a r r i e d daughter l i v i n g i n another S u i t e i n the same b u i l d i n g . t h e apartment a l l them*  T h e i r g r a n d c h i l d r e n a r e i n and out off  day l o n g and the grandparents  They spend t h e i r l e i s u r e time i n watching  are v e r y f o n d off television  and  i n r e a d i n g books and magazines. 8 . _ Mr.  and Mrs* H i n s o f a r as h e a l t h i s concerned,  plications*  Mr*  H has s e v e r a l com-  He has had pneumonia s e v e r a l times and a l s o s u f f e r s  from h i g h b l o o d p r e s s u r e .  H i s eyes are a f f e c t e d and so a l s o i s  31 one o f h i s l e g s .  He cannot see beyond s i x f e e t o r so* and i s  under t h e d o c t o r ' s c a r e .  However, Mrs. H i s a h e a l t h y , a c t i v e  woman • They have t h r e e c h i l d r e n and some g r a n d c h i l d r e n , who v i s i t them o f t e n and t a k e them o u t f o r d r i v e s i n t h e i r c a r . M r s . H i s an a c t i v e member o f a c h u r c h group and t a k e s p a r t i n t e a s * d i n n e r s and b a z a a r s . w e l l met.  They s a i d t h a t t h e i r s p i r i t u a l needs a r e  They a r e s a t i s f i e d w i t h t h e i r house, and make good use  of t h e i r l e i s u r e hours, 9.  Mr.- and M r s . I T h i s i s a second m a r r i a g e f o r b o t h Mr. and M r s . I . Mr.  I s u f f e r s from k i d n e y t r o u b l e , f o r which he h a s t o t a k e  sulpha  d r u g s , and a l s o has s i n u s t r o u b l e . ' M r s . I c o m p l a i n s o f poor memory, b u t i s i n f a i r l y good h e a l t h . T h e i r rooms a r e on t h e main f l o o r and t h e r e n t a l i s f a i r . They have a few f r i e n d s , a n d t h e i r o n l y d a u g h t e r , who l i v e s i n Saskatchewan, c o r r e s p o n d s w i t h them r e g u l a r l y .  Unfortunately,  t h e y do n o t read much due t o weak e y e s i g h t , n o r do t h e y b e l o n g t o any c l u b s .  Mr. 1 has s t r o n g o p i n i o n s t h a t t h e o l d e r p e r s o n s h o u l d  be a l l o w e d t o work and earn money w i t h o u t b e i n g " p e n a l i z e d " .  10.  Mr. and Mrs.  .4.  Mr. J has a weak h e a r t , c o r o n a r y t h r o m b o s i s and an a f f e c t e d l e f t hand.  He i s n o t a b l e t o go o u t much.  Chronic a r t h r i t i s o f ankle and s p i n e .  M r s . <J has  They l i v e i n a basement  s u i t e , f a i r l y s a t i s f a c t o r y as r e g a r d s r e n t and accommodation.  32  T h e i r f i v e c h i l d r e n a r e a l l s e t t l e d i n l i f e and v i s i t them o f t e n . They take Mr, and Mrs* 4 out f o r d r i v e s and f o r supper*at homes* t o which t h e couple l o o k forward w i t h p l e a s u r e . r e a d i n g , Mrs. J k n i t s and c r o c h e t s , i s convener  o f a m i s s i o n a r y group*  their  Besides  She i s member o f a c l u b and T h e i r s p i r i t u a l needs, they  m a i n t a i n , a r e met.  Group I I •* Unadjusted 11*  Souples  Mr* and Mrs. K Mr. K has been i n t h e army, h a v i n g served i n both  World Wars* good h e a l t h .  He i s now s u f f e r i n g from n e u r a s t h e n i a .  Mrs. K i s i n  They l i v e i n a r e n t e d a t t i c s u i t e , have no c h i l d r e n , 1  no f r i e n d s and no r e c r e a t i o n a l s a t i s f a c t i o n s , n o r a r e t h e i r r e l i g i o u s needs met* housing problems,  T h e i r s p e c i a l areas o f i n s e c u r i t y a r e t h e i r  s i n c e they have t o put up w i t h many inconven-  i e n c e s , and t h e economic i n s e c u r i t y w i t h r e g a r d t o Mrs. K s f  social  12.  allowance.  Mr. and M r s . L Mr. L has a p a r a l y z e d l e g and s u f f e r s from deafness.  Mrs, L has h a d an o p e r a t i o n f o r Cancer o f t h e b r e a s t . They l i v e on the second f l o o r , which i s v e r y i n c o n v e n i e n t f o r t h e i r age and s t a t e o f h e a l t h *  Added t o t h i s , t h e house has  been s o l d and t h e y have been asked t o move*  T h i s has c r e a t e d a  f e e l i n g o f c o n s i d e r a b l e a n x i e t y on t h e i r p a r t *  B e s i d e s t h e worry  o f s e a r c h i n g f o r a new home, t h e r e i s t h e f e a r o f n o t f i n d i n g one t o s u i t t h e i r economic circumstances*  33  I t i s u n f o r t u n a t e t h a t they have l o s t t h e i r c h i l d r e n and have no f r i e n d s ^ e i t h e r * l i s t e n t o the r a d i o .  F o r amusement t h e y p l a y c a r d s and  They have no s o c i a l c o n t a c t s off.any k i n d  and t h e i r r e l i g i o u s needs a r e n o t met.  They f e e l v e r y i n s e c u r e  i n meeting t h e i r need ffor c l o t h i n g , e t c .  13.  Mr. and Mrs. M Mr. M i s under d o c t o r ' s t r e a t m e n t f o r h e a r t t r o u b l e .  Mrs. M i s w e l l .  They have r e c e n t l y moved i n t o t h e i r p r e s e n t  tenement but i t c o s t s them $$0.00 a month.  A neighbour,  an o l d  b l i n d l a d y , a l s o on p e n s i o n , but w e l l - t o - d o , h e l p s them w i t h t h e r e n t i n r e t u r n ffor s e r v i c e s .  The c o u p l e a r e a n x i o u s about pay-  ment o f r e n t , s h o u l d a n y t h i n g happen t o t h e o l d l a d y . Mr, and M r s . M have no c h i l d r e n and v e r y few f r i e n d s . They spend t h e i r l e i s u r e i n the u s u a l manner but t h e r e s t o f t h e i r needs a r e n o t met and t h e y f e e l a g r e a t d e a l o f i n s e c u r i t y . M had two s u g g e s t i o n s t o offfer:  "Age depends on h e a l t h . "  Mr. There-  f o r e , (a) t h o s e w i t h c h r o n i c d i s e a s e s s h o u l d have t h e p e n s i o n a b l e age reduced;  (b) those who a r e h e a l t h y and a b l e t o work s h o u l d be  a l l o w e d t o do so w i t h o u t s e t t i n g any age l i m i t .  T h i s would keep  t h e b a l a n c e f o r those who d i d n o t own t h e i r homes.  14.  Mr. and Mrs. N Mr. N i s stone deaf and M r s . N has a h e a r t c o n d i t i o n .  There i s a d i f f e r e n c e off e l e v e n y e a r s between t h e i r ages b u t they appear v e r y much a t t a c h e d t o one a n o t h e r .  They own t h e i r  ffive*  roomed house, on which t h e mortgage has been p a i d up, so t h e y have t o pay t a x e s o n l y *  Mr. N b u s i e s h i m s e l f around t h e house  now  34 with the chores, v i s i t them.  They have no c h i l d r e n  t  but have f r i e n d s  who  T h e i r r e l a t i v e s , who I i v e i n E n g l a n d , send t h e m  books and magazines w h i c h Mrs. H, i n t u r n , passes on t o o t h e r s . They a l s o l i s t e n t o t h e r a d i o and r e a d t h e d a i l y p a p e r s . a r e v e r y f o n d o f t h e i r pet  They  dog.  T h i s c o u p l e appear t o be v e r y i n s e c u r e .  Mrs, H seems  t o have some g u i l t f e e l i n g s around a c c e p t i n g s o c i a l a l l o w a n c e . She i s v e r y s e l f - c o n s c i o u s about w e a r i n g g l a s s e s s u p p l i e d by the Department, because t h e y a r e a p a r t i c u l a r u n i f o r m c o l o u r , aad be r e c o g n i z e d by t h e p u b l i c as b e i n g f r o m t h e Department. s u g g e s t i o n was  may  Her  t h a t the g l a s s e s s h o u l d be v a r i e d i n C o l o u r and  shape l i k e t h o s e on t h e market, so t h a t c o n f i d e n t i a l i t y about r e c e i p t o f a s s i s t a n c e might be p r e s e r v e d .  Mrs. U shows the need  f o r i n t e n s i v e casework.  15.  Mr. and Mrs.  0  Mr. 0 s u f f e r s f r o m h e a r t t r o u b l e , w h i l e Mrs, 0 i s i n good h e a l t h .  They l i v e i n a housekeeping  room on t h e main f l o o r .  The r e n t i s r e a s o n a b l e and t h e room i s b r i g h t , but s m a l l and cramped.  A m a r r i e d daughter c o r r e s p o n d s w i t h them, but t h e y do  n o t mix s o c i a l l y w i t h o t h e r p e o p l e ,  Mr, 0 s a i d , T o u cannot H  f e e l secure when someone e l s e t a k e s care o f you,"  Their leisure  i s spent i n r e a d i n g , l i s t e n i n g t o t h e r a d i o and g o i n g f o r s h o r t walks.  16.  Mrs* 0 does much c r o c h e t work.  Mr. and Mrs. P D i s s a t i s f a c t i o n i s the key-note o f t h e l i f e o f t h i s  Couple.  Mr. P S u f f e r s f r o m a r t h r i t i s i n h i s l e g and from eye-  trouble*  Mrs* P, who has lumbago and i s o v e r w e i g h t , i s under  35  the d o c t o r ' s c a r e .  T h e i r rooms a r e i n a tenement* s i t u a t e d i n  an i n d u s t r i a l a r e a .  I t i s n o t c o n s i d e r e d a " s a f e " l o c a l i t y by  them f o r Mrs* P t o go out a l o n e . marketing  Shops a r e d i s t a n t , so  i s not easy. There a r e no c h i l d r e n by t h e union, but, by a former  marriage  Mrs. P has two c h i l d r e n .  n o t h i n g t o do w i t h t h e i r mother. no hobbies, except hours*  They are now m a r r i e d and have The couple have no f r i e n d s and  t h a t Mr* P does c a r p e n t r y i n h i s l e i s u r e  There i s no l i n k w i t h t h e o u t s i d e world and i n t e n s i v e  casework s e r v i c e s a r e i n d i c a t e d . 17.  Mr* and Mrs* Q Mr* Q has rheumatism and an a r t i f i c i a l l e g .  has a r t h r i t i s , b r o n c h i t i s and h i g h b l o o d p r e s s u r e . the d o c t o r ' s c a r e .  Mrs. Q  She i s under  They l i v e i n a r e n t e d basement s u i t e i n a  house b e l o n g i n g t o Mr. Q's b r o t h e r .  E v i d e n t l y they a r e not  s a t i s f i e d w i t h t h e i r rooms, f o r , when w r i t e r v i s i t e d them, she was r e c e i v e d by them i n t h e l i v i n g room Of t h e owner o f t h e house. There a r e no c h i l d r e n o f t h e i r marriage, c h i l d r e n by a p r e v i o u s marriage. with t h e i r parents.  but each has  Hone, however, has any Contact  L e i s u r e time i s spent i n r e a d i n g and i n  l i s t e n i n g t o the r a d i o .  Mrs* Q does some embroidery.  Unfortu*  n a t e l y , t h e y have no o u t s i d e c o n t a c t s and f e e l v e r y l o n e l y * 18*  Mr. and Mrs* R, Mr* R s u f f e r s from h e r n i a *  r i g h t , l e g and ankle*  I n 1952,  he f r a c t u r e d h i s  Mrs* R has had o p e r a t i o n s f o r v a r i c o s e v e i n s .  Over a l o n g p e r i o d she has been t a k i n g p i l l s ordered f o r h e r by  36  h e r d o c t o r , and I s wondering i f so many p i l l s a r e good f o r h e r health.  She wanted t o knOw i f she c o u l d change h e r d o c t o r , n o t  h a v i n g c o n f i d e n c e i n h e r p r e s e n t one. The C o u n s e l l i n g s e r v i c e s o f a case worker are necessary  i nthis  case.  Mr. a n d Mrs. R l i v e i n two a t t i c rooms.  There a r e a  good many s t e p s t o c l i m b and t h e t o i l e t f a c i l i t e s and t e l e p h o n e a r e on t h e f l o o r below.  The whole arrangement i s t o o i n c o n v e n i -  ent f o r p e r s o n s o f t h e i r age a n d s t a t e o f h e a l t h . c h i l d r e n , no f r i e n d s o r a c q u a i n t a n c e s . do t h e y a t t e n d c h u r c h .  They have no  They seldom go o u t , n o r  Their only l i n k with the outside world  i s t h e d a i l y paper and t h e r a d i o .  T h e i r problems a r e many and  v a r i e d ; i t i s n o t s u r p r i s i n g t h a t t h e y a r e d i s c o n t e n t e d and unhappy,  , ••  <  -  Chapter I I I  SERVICES AND NEEDS  As a l r e a d y e x p l a i n e d , th© o l d e r c i t i z e n s o f Vancouver i n need o f a s s i s t a n c e f a l l i n t o t h r e e  categories:  (a)  S o c i a l Assistance  (below 65 y e a r s )  (b)  O l d Age A s s i s t a n c e  (c)  O l d Age S e c u r i t y o r P e n s i o n (70 and o v e r )  (between 65 and 69 y e a r s )  F o r each o f the above programmes, t h e terms and cond i t i o n s o f e l i g i b i l i t y are d i f f e r e n t , as a l s o types o f s e r v i c e o f f e r e d by t h e C i t y o f Vancouver S o c i a l S e r v i c e Department. These ar© d e s c r i b e d (a)  S o c i a l Assistance The  was  below:Programs  B r i t i s h Columbia A c t t o provide S o c i a l A s s i s t a n c e  passed i n 1945*  I t d e f i n e s v a r i o u s terms, and t h e c o n n o t a t i o n  o f t h e t e r m " s o c i a l a s s i s t a n c e " i s t o be n o t e d .  A p a r t from f i n a n -  c i a l assistance, assistance i nkind, i n s t i t u t i o n a l , boarding,  nursing,  o r f o s t e r home e a r e , i t a l s o i n c l u d e s c o u n s e l l i n g  service, health services, occupational  training, re-training,or  t h e r a p y f o r i n d i g e n t p e r s o n s and m e n t a l l y  o r p h y s i c a l l y handi-  capped p e r s o n s , and, g e n e r a l l y , any form o f a i d n e c e s s a r y t o r e l i e v e d e s t i t u t i o n and s u f f e r i n g .  I t i n c l u d e s " a i d i n money o r  i n k i n d t o m u n i c i p a l i t i e s , b o a r d s , commissions, o r g a n i s a t i o n s o r persons p r o v i d i n g a i d , care, o r health s e r v i c e s t o i n d i g e n t , s i c k  3$  o r i n f i r m persons, and i n r e i m b u r s i n g  expenditures made by  them*'*  1  The f i n a n c i a l a s s i s t a n c e i s g i v e n on a means t e s t b a s i s t o those who a r e d e s t i t u t e and unemployable, and who have r e s i d e d r  i n t h e Province  o f B r i t i s h Columbia f o r one y e a r  continuously.  The cost o f p r o v i d i n g t h i s a s s i s t a n c e i s shared by t h e P r o v i n c i a l Government and t h e M u n i c i p a l i t i e s on an 80/20 b a s i s .  The cash  allowance f o r ©ne person, which was #45*00 p e r month, has been i n c r e a s e d t o |50*00 p e r month, as from A p r i l 1, |b)  1956.  O l d Age A s s i s t a n c e Under the O l d Age A s s i s t a n c e  A c t , p r o v i s i o n i s made f o r  cash allowances, s u b j e c t t o a means t e s t , f o r t h o s e c i t i z e n s who are between the a g e s off 65 and 69* and who have r e s i d e d i n Canada f o r twenty years*  O l d Age A s s i s t a n c e  i s p a i d a t the r a t e off  |40*00 a month, shared e q u a l l y by the P r o v i n c i a l and F e d e r a l Governments*  To t h i s t h e P r o v i n c i a l Government adds a bonus up  t o $20.00 a month t o B r i t i s h Columbia r e s i d e n t s , (c)  O l d Age S e c u r i t y The O l d Age S e c u r i t y A c t p r o v i d e s ffor a cash allowance  off 140*00 p e r month, without a means t e s t , t o persons seventy y e a r s o f age a n d over, who have r e s i d e d i n Canada f o r twenty y e a r s ,  ^ A r t i c l e 2, Chapter 310 o f t h e A c t t o p r o v i d e Assistance,  Soeial  39  The cost i s borne entirely by th© Federal Government* To supplement Old Age Security, the Province provides a cost-of-living bonus up to #20*00 per month, on a means test basis, to those who have resided i n British Columbia for three years immediately preceding the date of application. Thus, the cases of the older citizens known to the Public Welfare Department are only of those who are in receipt of the bonus, and who thus become entitled to th© other services mentioned i n the Old Age Assistance Act, viz* By friendly tt  advice, assist the recipient in any matter relating to th© assistance and th© expenditure thereof The Vancouver Social Service Department does not have direct authority over the administration of Old Age Assistance programmes, which are financed by the Federal and Provincial Governments.  The local department, however, provides only  v i s i t i n g services to such cases and prepares annual f i e l d service reports. Man does not l i v e by bread alone, but he does need to have bread*  He must also have clothing, a roof over his head, and  the other basic necessities of l i f e .  The society which hopes to  Old Age Assistance Act, Chapter 55 of the Statutes of Canada 1951, article (g).  40  g i v e a g e i n g p e o p l e an o p p o r t u n i t y t o l i v e out t h e i r o l d e r y e a r s i n c o m f o r t and h a p p i n e s s ,  has t o l o o k t o economic needs f i r s t .  I n a d d i t i o n t o economic a i d , o t h e r s e r v i c e s a r e a v a i l s a b l e t o t h e group on S o e i a l A s s i s t a n c e , as mentioned i n t h e S o c i a l A s s i s t a n c e A c t , g i v e n above, t h e c h i e f o f t h e s e  being  casework and c o u n s e l l i n g s e r v i c e s and s e r v i c e s t o meet h e a l t h needs.  Casework and C o u n s e l l i n g S e r v i c e s Some e l d e r l y p e o p l e who  come t o p u b l i c w e l f a r e  a r e a b l e t o cope w i t h t h e problems o f d a l l y l i v i n g  agencies  reasonably  w e l l , i f t h e y can be p r o v i d e d w i t h a decent l e v e l o f  subsistence.  F o r a s u b s t a n t i a l number, however, t h i s i s not t r u e ; when t h e y Come t o p u b l i c w e l f a r e a g e n c i e s , t h e y b r i n g w i t h them a wide v a r i e t y o f p e r s o n a l problems w i t h w h i c h t h e y need h e l p *  The  w e l f a r e department, by a s s i s t i n g w i t h t h e s e needs, w h i c h a r e o v e r and above the p r o v i s i o n o f economic a s s i s t a n c e , i s making an important  c o n t r i b u t i o n t o the w e l l - b e i n g of i n d i v i d u a l s i n t h i s  group. F o r some p e o p l e , t h e v e r y n a t u r e o f a g e i n g and i t s e f f e c t upon p h y s i c a l and mental a b i l i t i e s make i t n e c e s s a r y  that  t h e y have h e i p , not o n l y w i t h t h e i r f i n a n c i a l , but a l s o w i t h t h e i r p e r s o n a l problems.  Sometimes t h i s k i n d o f h e l p comes f r o m t h e  f a m i l y , but o f t e n t h i s i e not p o s s i b l e . or are u n w i l l i n g to help.  F a m i l i e s may  O f t e n t h e problems a r e  he s c a t t e r e d  beyond t h e i r  41  understanding  and a b i l i t y t o S o l v e .  As a r e s u l t , a g r e a t amount  o f t i m e i s spent C o u n s e l l i n g and a d v i s i n g them, t o h e l p them t o s o l v e t h e problems o f d a i l y l i f e .  D i s c e r n i n g , warm-hearted  c a s e w o r k e r s g i v e s p e c i a l l y needed s e r v i c e s t o t h e human b e i n g s w i t h whom t h e y a r e w o r k i n g . The n a t u r e  of t he w e l f a r e w o r k e r s * c o n t a c t s v a r i e s f r o m  simple, f r i e n d l y v i s i t i n g to complicated u n w e l l , f e a r f u l o l d e r p e r s o n may  casework.  The l o n e l y ,  d e r i v e g r e a t b e n e f i t f r o m the  knowledge t h a t a younger, h e a l t h y , f r i e n d l y p e r s o n , r e p r e s e n t i n g an agency w i t h r e s o u r c e s , i s k e e p i n g i n t o u c h w i t h him and has interest i n h i s well-being* way  Such knowledge a l o n e may  an  go a l o n g  t o w a r d g i v i n g t h e o l d e r p e r s o n Courage t o t a e k l e and. s o l v e  h i s problems. .©Ider p e o p l e o f t e n need h e l p i n t h i n k i n g t h r o u g h t h e i r own  s i t u a t i o n s , and i n making p l a n s f o r the f u t u r e *  Sometimes  t h e y need t o be h e l p e d t o f a c e t h e changes which have been t a k i n g place w i t h i n them-*physieal,  mental and e m o t i o n a l *  Outside  c o u n s e l l i n g i s f r e q u e n t l y n e c e s s a r y around t h e i r r e l a t i o n s h i p s w i t h t h e i r f r i e n d s and f a m i l y .  Not o n l y do c h i l d r e n sometimes  f a i l t o see c l e a r l y t h e i r r e s p o n s i b i l i t i e s t o t h e i r p a r e n t s , a l s o the o l d e r p e o p l e , t h e m s e l v e s , need h e l p i n d e v e l o p i n g relationships with their children*  but new  M i c h can be a c c o m p l i s h e d  t h r o u g h w o r k i n g W i t h the f a m i l i e s of o l d e r p e o p l e * The p r o v i s i o n o f s e r v i c e s off t h i s k i n d on t h e p a r t o f an agency e n t a i l s a c e r t a i n amount off p l a n n i n g *  The  activities  42 must be v i s u a l i z e d as a d e f i n i t e p a r t o f t h e agency j o b . l o a d s must be p l a n n e d w i t h t h i s i n mind.  Case  The l a r g e r t h e case  l o a d s , t h e l e s s chance the agency has f o r meeting t h e s e i m p o r t a n t i n d i v i d u a l needs.  T h i s i s , i n f a c t , t r u e of Vancouver  to-day.  W h i l e t h e f i r s t group, v i z . t h e S o c i a l A s s i s t a n c e c a s e s , a r e r e c e i v i n g some b e n e f i t o f t h e casework and c o u n s e l l i n g no such p r o v i s i o n i s made f o r t h e r e m a i n i n g two  services,  groups*-those  r e c e i v i n g O l d Age A s s i s t a n c e and O l d Age P e n s i o n ,  These two  groups a r e e n t i r e l y d e p r i v e d o f t h e s e s e r v i c e s (except t h o s e receiving i n s t i t u t i o n a l care). each worker  T h i s i s due t o t h e f a c t t h a t  has an average c a s e l o a d o f two thousand.  The o n l y  t h i n g t h e worker can do i s t o p r e p a r e a n n u a l r e p o r t s t o e s t a b l i s h e l i g i b i l i t y f o r economic a i d i n each c a s e , make f r o m f i v e t o e i g h t v i s i t s p e r day*  "District  visitors  B o a r d i n g and n u r s i n g  home cases a r e v i s i t e d monthly t o d e l i v e r comfort a l l o w a n c e checks and o b t a i n endorsements on o l d age a s s i s t a n c e , s e c u r i t y and bonus checks.  P e r s o n s t o whom monthly checks a r e m a i l e d  (about h a l f o f s o c i a l a s s i s t a n c e c a s e s ) a r e v i s i t e d o n l y once e v e r y t h r e e months t o o b t a i n income s t a t e m e n t s .  C e r t a i n cases  a r e , o f c o u r s e , g i v e n much more a t t e n t i o n , and b r i e f o f f i c e c o n t a c t s may be made monthly w i t h c l i e n t s who c a l l f o r t h e i r checks.  N o r m a l l y , o l d age a s s i s t a n c e r e c i p i e n t s a r e c o n t a c t e d  once a y e a r , so t h a t a n n u a l f i e l d s e r v i c e r e p o r t s may be  completed.  One-tenth o f the O l d Age S e c u r i t y bonus cases a r e supposed t o be v i s i t e d each y e a r , but t h i s programme, l i k e t h a t o f O l d Age  Assist-  43  ance cases i s lagging because of l a c k of s t a f f * " * Workers must be of a c a l i b r e able to deal with some of  the very dif.floult problems with which they might be faced*  t h i s means a careful job of s e l e c t i o n on the part of the agency* In t h i s respect, Vancouver i s very fortunate: of  "Administration  these services i $ being c a r r i e d ©ut by a s t a f f of c i t y and  p r o v i n c i a l employees who,  by comparison with many other public  welfare j u r i s d i c t i o n s , are well prepared and trained f o r t h e i r jobs* and who are devoting themselves to t h e i r work With i n t e l ligence, diligence, and excellent s p i r i t * " 2 Agency p o l i c i e s must be c l e a r as to just what i s expected of the v i s i t o r s , insofar as casework services are concerned*  There i s more or l e s s general agreement that provision  of these services i s a basic part of the public welfare job.  Services to Meet Health Heeds These a r e g i v e n to a l l t h e t h r e e c a t e g o r i e s a l i k e , as need a r i s e s . Medical care i s provided f o r a l l recipients of a s s i s t ance by the B.G*  College of Physicians and Surgeons,  An agreement  provides that the P r o v i n c i a l Department of Health and Welfare  From the Report on an Adtaiaistrative Survey of the Municipal Government^- C i t y of Vancouver* B r i t i s h Columbia, b y Corcoran. Jacob!, M i l l i a r d and others,'(Public Admihistration Service, Chicago) page 111. A  2  I b i d . page 113,  44  s h a l l pay t h e C o l l e g e a p e r c a p i t a amount p e r annum p e r r e c i p i e n t , and t h e C o l l e g e s h a l l pay i t s i n d i v i d u a l  practitioners  for  the services they render.  T h i s system a s s u r e s adequate  Care  for  a l l r e c i p i e n t s e x c e p t t h o s e i n need o f n u r s i n g home Care*  The S o c i a l S e r v i c e Department i s w e l l o r g a n i z e d f o r meeting t h e problems o f n u r s i n g home needs o f i t s c h a r g e s . E v e r y p e r s o n , once h i s e l i g i b i l i t y f o r a s s i s t a n c e i s e s t a b l i s h e d , i s given a medical i d e n t i t y card* to his  complete m e d i c a l Coverage,  This e n t i t l e s him  The p e r s o n c a n go t o any d o c t o r o f  c h o i c e , and any m e d i c i n e s o r drugs n e c e s s a r y i n h i s case  ( p r o v i d e d t h e y a r e mentioned i n t h e B.G* F o r m u l a r y l ) a r e s u p p l i e d to  him, f r e e o f c h a r g e , on t h e recommendation o f h i s d o c t o r . I f ,  however, a p a r t i c u l a r d r u g p r e s c r i b e d i s n o t mentioned i n t h e F o r m u l a r y , a committee, s e t up f o r t h e purpose, l o o k s i n t o t h e m a t t e r t o determine t h e n e c e s s i t y f o r t h e drug i n t h a t p a r t i c u l a r case. I n a d d i t i o n t o d r u g s , a p p l i a n c e s such a s g l a s s e s , d e n t u r e s , a r t i f i c i a l l i m b s and e y e s , o r t h o p a e d i c a p p l i a n c e s ( b o o t s and b r a c e s ) a r e a l s o S u p p l i e d f r e e o f c h a r g e . The procedure i n such eases i s f o r t h e d o c t o r t o send the  o r d e r t o t h e department.  situation. are  I n v e s t i g a t i o n i s made I n t o t h e  I f t h e r e i s any o t h e r r e s o u r c e , such a s r e l a t i v e s , t h e y  asked t o pay f o r t h e needed a r t i c l e ; o r , i f t h e p e r s o n has a  A c o m p i l a t i o n o f common drugs used i n t h e p r a c t i c e o f medicine. X  45  f a i r amount I n t h e bank, he i s e x p e c t e d t o p r o v i d e i t , u n l e s s t h e r e a r e e x t e n u a t i n g c i r c u m s t a n c e s . I f , however, t h e r e q u e s t f o r an a p p l i a n c e i s not r e a l i s t i c , such as f o r a h e a r i n g a i d i n the  case o f an o l d e r p e r s o n who w i l l t a k e a l o n g t i m e t o a d j u s t  t o i t , t h e a p p l i c a t i o n i s r e j e c t e d on t h o s e grounds.  On t h e  o t h e r hand, i f p r o v i s i o n o f an a p p l i a n c e would a i d r e h a b i l i t a t i o n , t h e r e i s v e r y l i t t l e t h a t cannot be s u p p l i e d .  C u s t o d i a l Gare^ I t i s t h e r e s p o n s i b i l i t y o f t h e department t o p r o v i d e c a r e f o r people s u f f e r i n g f r o m c h r o n i c d i s a b i l i t i e s and o l d age. To t h i s end, t h e r e have been e s t a b l i s h e d i n the community approximately f o r t y p r i v a t e l y operated c u s t o d i a l i n s t i t u t i o n s or B o a r d i n g Homes, w h i c h p r o v i d e g e n e r a l Care t o about 500  patients.  These i n d i v i d u a l s a r e a m b u l a t o r y , b u t , e i t h e r because o f age o r d i s a b i l i t y , cannot car© f o r t h e m s e l v e s i n t h e i r own homes.  Both  S o c i a l w o r k e r s and n u r s e s i n t h e department v i s i t t h e s e p e o p l e , i n response t o r e q u e s t s f r o m the p a t i e n t h i m s e l f , o r f r o m h i s doctor, r e l a t i v e s , or landlady, the  A d e c i s i o n i s made as t o what i s  best plan f o r t h e person's f u t u r e care.  Sometimes i t i s  c o n s i d e r e d more e x p e d i e n t , p a r t i e u l a r l y i n the case o f an e l d e r l y man  and w i f e l i v i n g t o g e t h e r , t o p r o v i d e p a r t - t i m e o r f u l l - t i m e  housekeeping s e r v i c e s * r a t h e r than i n s t i t u t i o n a l care. department employs the s e r v i c e s o f a p p r o x i m a t e l y 35  The average c o s t i s f r o m |65 t o f$5  The  housekeepers  a month p e r p e r s o n *  46  a t a l l t i m e s , e i t h e r on a p a r t - t i m e o r f u l l - t i m e b a s i s .  The  r a t e o f pay f o r t h i s s e r v i c e i s f r o m s e v e n t y - f i v e c e n t s an hour t o 16.00  a day f o r an e i g h t - h o u r  day.  I f , however, more e x t e n s i v e c a r e i s r e q u i r e d , i t may necessary  t o place the p a t i e n t i n a chronic h o s p i t a l .  department may  Such i n d i v i d u a l s u s u a l l y  r e q u i r e very extensive nursing care.  The  the  use a p r i v a t e h o s p i t a l o r a p u b l i c i n s t i t u t i o n ,  such as t h e P r o v i n c i a l I n f i r m a r y ,  o r bed*ri4den.  Or  be  They may  be semi-ambulatory  The r a t e o f c a r e v a r i e s f r o m #150  department has a p p r o x i m a t e l y  t o $210  a month.  f o u r hundred s u c h c a s e s ,  and  t h e r e i s a w a i t i n g l i s t f o r c a r e , v a r y i n g between t w e n t y i n t h e , summer months t o sometimes as h i g h as one hundred i n the w i n t e r . One  o f t he most o u t s t a n d i n g needs i s p h y s i o t h e r a p y  o c c u p a t i o n a l t h e r a p y f o r t h i s group o f p a t i e n t s , a l t h o u g h i s a s m a l l u n i t o f f i f t y beds where t h i s i s a v a i l a b l e . p a t i e n t s a r e a l l a t t e n d e d by d o c t o r s o f t h e i r own  and  there  These  c h o i c e , and  are  v i s i t e d a t r e g u l a r i n t e r v a l s by s o c i a l w o r k e r s and n u r s e s o f t h e S o c i a l S e r v i c e Department, The n u r s e s e n c o u r a g e the t o improve the maintained  operators of the  standards o f accommodation and  institutions  c a r e , and  these  a t a d e f i n i t e l e v e l by l e g i s l a t i o n and l i c e n s i n g ,  e f f o r t i s made t o keep the  personnel  off t h e t i m e s by e d u c a t i o n a l t r a i n i n g * l i m i t e d and i n t h e p r o c e s s  o f the  An  i n s t i t u t i o n s abreast  This i s s t i l l  o f development.  are  quite  47  The m e d i c a l s e c t i o n a l s o makes p r o v i s i o n f o r p s y c h i a t r i c e x a m i n a t i o n o f the c l i e n t e l e b y p r i v a t e p s y c h i a t r i s t s , o r t h r o u g h c l i n i c s ; and a f o l l o w - u p indicated*  t r e a t m e n t i s a v a i l a b l e when  I f n e c e s s a r y , c o m m i t t a l s are a r r a n g e d t o t h e  Provin-  c i a l Mental H o s p i t a l , short-term p s y c h i a t r i c c l i n i c s , o r the Home f o r t h e Aged ( s e n i l e c a s e s ) * I t i s a l s o a f u n c t i o n o f the medical s e c t i o n t o a s s i s t s o c i a l w o r k e r s i n o b t a i n i n g u p - t o - d a t e m e d i c a l h i s t o r i e s and r e p o r t s on a l l c l i e n t s , w i t h a v i e w t o the e s t a b l i s h m e n t o f good general  health. Where i n d i c a t e d , r e h a b i l i t a t i o n s e r v i c e s c a n be p a i d  f o r , a s , f o r example, i n the Western S o c i e t y f o r R e h a b i l i t a t i o n . R e - t r a i n i n g c o u r s e s f o r handicapped people can be a r r a n g e d a l s o .  The N u t r i t i o n i s t A n u t r i t i o n i s t , who i s on the s t a f f o f t h e  Metropolitan  H e a l t h Department, i s a s s i g n e d t o t h e C i t y S o c i a l S e r v i c e D e p a r t ment.  She g i v e s s e r v i c e s t o the B o a r d i n g and N u r s i n g Home  o p e r a t o r s i n the c a p a c i t y o f c o n s u l t a n t .  She a l s o g i v e s  part-time  a s s i s t a n c e , on n u t r i t i o n a l problems, t o a l l s o c i a l workers i n the f o u r u n i t s of t h e  G i t y o f Vancouver S o c i a l S e r v i c e Department*  Unmet Needs H e a l t h Needs The  h e a l t h s e r v i c e s o f f e r e d b y the department t o i t s  48  c l i e n t e l e a r e v e r y comprehensive and among th© b e s t on t h e continent* 1.  Y e t , some f u r t h e r needs a r e indicated:»  "The most s e v e r e problem o f t h e m e d i c a l s e r v i c e s e c t i o n i s l a c k o f s u f f i c i e n t c a p a c i t y i n t h e B o a r d i n g and N u r s i n g Homes under i t s c o n t r o l . " •  L  2.  Heed f o r more p h y s i o t h e r a p y and o c c u p a t i o n a l t h e r a p y .  3.  Urgent need f o r more homes a t v a r i o u s l e v e l s ,  particularly  an a c t i v e u n i t , o p e r a t e d by t h e department o r some o t h e r o f f i c i a l body, where a r e h a b i l i t a t i o n programme c o u l d be e f f e c t i v e l y introduced. 4.  A d d i t i o n a l n u t r i t i o n s t a f f t o e n a b l e t h e H e a l t h Department t o g i v e more s e r v i c e on f o o d needs t o B o a r d i n g and N u r s i n g Homes.  Group I I i n d i c a t e d a sense o f i n s e c u r i t y i n o t h e r d i r e c t i o n s , some o f w h i c h ar© d e s c r i b e d below:* Housing A t t h e p r e s e n t t i m e t h e r e i s an urgent need f o r t h e e s t a b l i s h m e n t o f a p p r o p r i a t e accommodation, a t r e a s o n a b l e c o s t , f o r o l d e r persons i n normal h e a l t h , so as t o f a c i l i t a t e  their  c o n t i n u i n g a normal home l i f e a s l o n g as p o s s i b l e . Some o f t h e  ^Prom t h e Report on an A d m i n i s t r a t i v e S u r v e y o f t h e M u n i c i p a l Government y C i t y o f Vancouver. B r i t i s h Columbia* by C o r c o r a n , J a c o b i , M i l l i a r d and o t h e r s ( P u b l i c A d m i n i s t r a t i o n S e r v i c e , C h i c a g o ) page 111.  49  c o u p l e s i n t e r v i e w e d a r e l i v i n g i n u n h e a l t h y basements; o t h e r s a r e i h a t t i c s , o r on t h e second f l o o r and have two f l i g h t s o f S t a i r s t o c l i m b , w h i l e t h e t o i l e t f a c i l i t i e s a r e on t h e l o w e r floor.  T h i s i s an undue h a r d s h i p i n t h e e v e n i n g of  life,  e s p e c i a l l y when t h e r e i s a p h y s i c a l d i s a b i l i t y as W e l l .  Even  when housed on t h e main f l o o r , t h e rooms a r e s m a l l and cramped, and t h e r e i s no space i n w h i c h t o move about.  I n e v e r y case t h e  r e n t i s h i g h and, t o t h e o l d e r c o u p l e s , w i t h t h e i r i n e l a s t i c and meagre incomes, t h e y a r e exorbitant. 'j  Over and above e v e r y t h i n g , two o f t h e Couples had been g i v e n n o t i c e t o v a c a t e a s t h e house had been s o l d .  They were a t  a l o s s t o know where t o f i n d a n o t h e r p l a c e w i t h i n t h e i r l i m i t e d means.  The t r i a l s a n d t r i b u l a t i o n s o f h o u s e - h u n t i n g a r e w e l l  d e s c r i b e d by W i l l i a m MacEachem, i n h i s a r t i c l e s i n t h e Toronto D a i l y Star,-*"  O l d people a r e n o t p o p u l a r as t e n a n t s and are v e r y  o f t e n r e f u s e d accommodation on t h e grounds off age a l o n e .  They  a r e l i k e l y t o have t o pay h e a v i l y f o r t h e p o o r e s t accommodation. The p r e j u d i c e o f t h e l a n d l o r d s a g a i n s t o l d people as l o d g e r s comes, perhaps, f r o m the f a c t t h a t t h e y need e x t r a h e a t , and o f t e n e x t r a s e r v i c e s i n k e e p i n g rooms c l e a n . O l d e r p e o p l e , who a r e p a s t t h e peak o f t h e i r e n e r g i e s , cannot f a c e t h e problem o f h o u s e - h u n t i n g w h i c h , i n a c i t y such as  MacEachem, W i l l i a m : F o u r t e e n Days as an O l d Age P e n s i o n e r (The T o r o n t o D a i l y S t a r ) pages 3 t o 5,  50:  Vancouver, c a l l s f o r a l m o s t u n l i m i t e d energy a n d s t a m i n a . need h e l p i n s e c u r i n g a s a t i s f a c t o r y house.  They  F o r them t h e problem  assumes l a r g e p r o p o r t i o n s ; and i t i s a c o m p l i c a t e d and d i f f i c u l t matter f o r s e v e r a l reasons.  F o r most o l d e r persons t h e f a m i l y  p a t t e r n has changed m a t e r i a l l y s i n c e t h e i r m i d d l e y e a r s , t h u s n e c e s s i t a t i n g a change i n l i v i n g h a b i t s .  Economic c i r c u m s t a n c e s  a r e d i f f e r e n t , and t h e i r own needs have changed.  They need a  p l a c e t o l i v e t h a t w i l l n o t p l a C e heavy e x a c t i o n s on t h e i r s t r e n g t h ; w i l l n o t s u b j e c t them t o undue h a z a r d s ; w i l l make p o s s i b l e t h e i r p a r t i c i p a t i o n i n s o c i a l and o t h e r a c t i v i t i e s , and w i l l a s s u r e t h e a v a i l a b i l i t y o f such s e r v i c e s , companionship and s u p p o r t i v e h e l p t h e y may r e q u i r e .  F o r most o l d e r p e o p l e s e g r e -  g a t e d h o u s i n g i s n o t t h e s o l u t i o n , s i n c e t h e y d e s i r e t o be p a r t of normal community l i f e . for  An u r g e n t need i s t h e r e f o r e apparent  low-rent housing s u i t a b l e f o r r e t i r e d couples.  Employment Some c o u p l e s i n Group I I i n d i c a t e d t h a t t h e y would l i k e p a r t - t i m e employment o r s p e c i a l j o b s .  Assistance i n finding  t h e s e would be g r e a t l y a p p r e c i a t e d by them. boost t h e i r morale.  Such a c t i v i t i e s would  The s u p p l y i n g o f m a t e r i a l needs c o s t s money,  and f i n a n c i a l s e c u r i t y i s , i n i t s e l f , a need o f t h e a g e d .  One o f  t h e s o l u t i o n s t o t h i s problem i s f u l l employment f o r t h o s e o f w o r k i n g a g e , combined w i t h a d e f i n i t e p o l i c y o f r a i s i n g t h e upper l i m i t o f t h e w o r k i n g age group.  T h i s would r e s u l t i n f i n a n c i a l  51 s e c u r i t y , depending  on t h e i r own a b i l i t y t o s u p p o r t  themselves  t h r o u g h c o n t i n u e d employment, The l o n g e r a p e r s o n works, t h e s h o r t e r t h e r e m a i n i n g y e a r s f o r w h i c h he has t o p r o v i d e ,  Any system o f O l d Age  Assist-  ance t h a t d i s c o u r a g e s s a v i n g , as does t h e p r e s e n t system i n Canada, i s a s h o r t - s i g h t e d p o l i c y ,  Why  s h o u l d a man  pay  an  i n s u r a n c e premium f o r twenty y e a r s , i n o r d e r t o o b t a i n an a n n u i t y of  1 4 0 , 0 0  a month, when, by d o i n g s o , he p r e v e n t s h i m s e l f f r o m  g e t t i n g O l d Age A s s i s t a n c e ?  I n the words o f the o l d people them-  s e l v e s , " I am n o t a l l o w e d t o e a r n " * o r , " I f I work, my a s s i s t a n c e w i l l be c u t o f f , *  These a r e some examples o f the e f f e c t o f t h e  c u r r e n t r u l e s and r e g u l a t i o n s i n r e g a r d t o exemption o f e a r n i n g s i n establishing e l i g i b i l i t y ,  A u n i f o r m and r e a l i s t i c  policy  s h o u l d be e s t a b l i s h e d f o r exemption o f earned income, I n k e e p i n g w i t h modem c o s t o f l i v i n g , and i n such a way as t o promote t h e i n c e n t i v e t o earn*  Counselling Service The inadequacy o f t h e p r e s e n t casework and c o u n s e l l i n g programmes i s apparent f r o m t h e heavy c a s e l o a d s o f workers ing of  o l d age c a s e s , as has a l r e a d y been commented upon. a f f a i r s l e a d s t o a g e n e r a l sense o f i n s e c u r i t y .  carry-  This state  Almost a l l o f  t h e c o u p l e s i n Group I I showed t h i s i n s e c u r i t y i n many d i r e c t i o n s , d e m o n s t r a t i n g t h e need f o r s e r v i c e s o f r e a s s u r a n c e and s u p p o r t . These c o u p l e s have no c h i l d r e n o f t h e i r own, and f r i e n d s are few. L o n e l i n e s s i s h a r d t o overcome and, w i t h one o f t h e p a r t n e r s bed-  52  r i d d e n o r s u f f e r i n g f r o m some c h r o n i c i l l n e s s , t h e o t h e r i s a l s o house-bound most o f t h e t i m e .  G r e a t need i s shown i n such  i n s t a n c e s f o r some c o n t a c t w i t h t h e o u t s i d e w o r l d - - f o r someone who  c o u l d v i s i t and make them f e e l he o r she i s i n t e r e s t e d i n  them f o r t h e i r own  sakes.  The c o u p l e s would a l s o welcome  g u i d a n c e i n s u c h m a t t e r s as g e t t i n g a house, s h i f t i n g t o a n o t h e r house, a i d i n s e c u r i n g a j o b , and a t h o u s a n d and one like  things of  nature. Where t h e i n d i v i d u a l s a r e not a b l e t o go f a r , i t would  h e l p i f t h e y b e l o n g e d t o a c l u b o r a day c e n t r e i n t h e  vicinity,  where t h e o l d e r p e r s o n c o u l d e a s i l y w a l k o v e r and mix w i t h individuals.  Many p e r s o n s , who  other  a r e p h y s i c a l l y a b l e t o g e t about  i n t h e community, have withdrawn f r o m a l l s o c i a l c o n t a c t s  and  a c t i v i t i e s , even though t h e y f e e l l o n e l y and have a need f o r s o c i a l r e l a t i o n s h i p s * The g r e a t e r the t i m e s p e n t by an  indiv-  i d u a l a l o n e i n h i s s o l i t a r y room, t h e more he becomes prone t o physical ailments and hasten the onset of  r e g r e s s i v e behaviour, senility.  and t h e s e , i n t u r n ,  Chapter IV  SOME POSSIBLE DEVELOPMENTS OF SERVICE  The c o u p l e s t h a t were i n t e r v i e w e d f a l l n a t u r a l l y i n t o two t y p e s - - t h O s e t h a t a r e a d j u s t e d t o t h e i r p r e s e n t s i t u a t i o n , and t h o s e t h a t a r e n o t s o a d j u s t e d * T y p i c a l Adjustment P a t t e r n s A c o u p l e i n Group I i s a c o u p l e w e l l - a d j u s t e d t o t h e i r present circumstances.  They have l i v e d a s a t i s f y i n g l i f e ,  e n j o y e d l i v i n g and f e e l t h a t l i f e has been w o r t h - w h i l e .  have  They a r e  c o n t e n t w i t h what t h e y have h a d . They have few r e g r e t s and l i t t l e f e a r o f the f u t u r e .  They a r e s e c u r e and c a n f a c e o l d age  w i t h e q u a n i m i t y and a f e e l i n g o f w e l l - e a r n e d r e s t , , The c h i l d r e n t h e y have r e a r e d a r e now w e l l - s e t t l e d i n life.  They v i s i t them, t a k e them o u t , and, i n t i m e o f i l l n e s s ,  a r e a s o u r c e o f s t r e n g t h and s u p p o r t . They have no h o u s i n g d i f f i c u l t i e s *  The home i s e i t h e r  owned by one o f t h e c h i l d r e n , o r a m a r r i e d s o n o r daughter as a n e x t - d o o r n e i g h b o u r , a l w a y s a t hand.  lives  The g r a n d c h i l d r e n  come i n and o u t o f t h e house, and ar® a s o u r c e o f e t e r n a l j o y w i t h t h e i r t o d d l i n g and l o v i n g l i s p i n g s .  I t compensates f o r a l l t h e  i l l - h e a l t h ; f o r t h e y f e e l t h e y a r e wanted and l o v e d by t h e i r c h i l d r e n and g r a n d c h i l d r e n , and t h e r e i s t h e sense o f b e l o n g i n g , i n t h e f u l l e s t meaning o f t h e term.  Nothing else matters*  54  Grandpa c a n p l a y w i t h th© k i d s , and grandma c a n k n i t and mend, and t h e day p a s s e s m e r r i l y and t h e r e i s a sense o f complete s a t i s faction.  T y p i c a l PhadJustment P a t t e r n s A couple i n t h i s group i s a n i n s e c u r e , a n x i o u s  couple.  They a r e v e r y much aware t h a t t h e y no l o n g e r have t h e i r f o r m e r p h y s i c a l s t r e n g t h o r mental a g i l i t y . w i t h t h e immediate f u t u r e .  T h e i r f e a r s a r e concerned  The S o c i e t y on t h e American  g l o r i f i e s independence and s e l f * s u f f i c i e n c y .  Continent  The couple f e a r  dependence upon p e o p l e who w i l l now r e g a r d them a s a n u i s a n c e . The  p o s s i b i l i t y o f f a i l i n g , body and mind, o f p a i n and o f h e l p -  l e s s n e s s p r e y s upon them.  I l l - h e a l t h makes them i r r i t a b l e ;  a n x i e t y and f e a r make them n e r v o u s ; u n c e r t a i n t y e i t h e r makes them r i g i d i n t h e i r i d e a s , i n a s t u b b o r n attempt t o prove t h e m s e l v e s r i g h t , o r i t may make them i n d e c i s i v e , own minds. ambitions  The f r u s t r a t i o n  unable t o make up t h e i r  o f f a i l i n g f a c u l t i e s , and t h e t h o u g h t o f  t h a t w i l l n e v e r now be r e a l i z e d , may make them j e a l o u s  o f younger p e r s o n s .  The u n s o l v e d  problems o f t h e i r l i v e s come  out i n t o t h e open; f o r m e r l y c o n t r o l l e d s h a r p l y , now, i n p a r t r e l e a s e d f r o m i n h i b i t i o n , the o l d persons may f e e l t h a t i f ever t h e y had a r i g h t t o c o m p l a i n , t o demand, t o s a y what t h e y t h i n k i s r i g h t , now i s t h e t i m e . A d o l e s c e n c e i s c o n s i d e r e d t o be a s t r u g g l e between t h e dependency o f c h i l d h o o d and t h e independence o f a d u l t h o o d ,  a  h o l d i n g back w i t h r e g r e t s f o r t h e i r r e s p o n s i b i l i t y o f younger  55  years, up.  and a s t r i v i n g f o r t h e g r e a t e r r e s p o n s i b i l i t y ©f growing  O l d age may be c o n s i d e r e d ,  i n r e v e r s e , as a s t r u g g l e  between t h e Independence, r e l a t i v e s e l f - s u f f i c i e n c y and v i g o r o u s p h y s i c a l and mental a c t i v i t y o f adulthood, and t h e i n c r e a s i n g dependence o f o l d age*  What t h a t s t r u g g l e means t o each person,  how u p s e t t i n g t h e i n e v i t a b l e b i o l o g i c a l development i s , depends upon t h e way each problem has been met b e f o r e , it  i n i t s successive  as l i f e  brought  stages.  Some I m p l i c a t i o n s In d e s c r i b i n g the e x i s t i n g s e r v i c e s , some gaps became evident, for  and a f u r t h e r used f o r s e r v i c e s was f e l t  the type o f couples i n Group I I ,  insecure*  i n some d i r e c t i o n s  T h i s i s the type t h a t i s  These couples have no c h i l d r e n , few f r i e n d s , and a r e  housebound*  The casework s e r v i c e s o f the Department do not  reach them although t h e i r f i n a n c i a l needs a r e met.  There i s a  s e r i o u s d i s p a r i t y here between the broad concept of p u b l i c  welfare  f o r t he ageing t h a t we t a l k about i n conference and committee meetings, and t h e s e r v i c e s a c t u a l l y p r o v i d e d  i n the l o c a l  offices*  Casework has been t e s t e d by time and experience and i s known t o produce good r e s u l t s . therapy.  I t has proved i t s e f f i c i e n c y i n terms o f  And y e t a s e c t i o n o f the o l d e r community groups cannot  get i t * Every s u b s t a n t i a l geographic a r e a has o l d people who are lonesome» f r i g h t e n e d and f r a i l i n mind and body.  Clearly,  s o c i a l a c t i o n i s necessary, and i t i s a matter f o r t h e l e a d e r s o f the  community t o see t h a t , i n the near f u t u r e , these s e r v i c e s a r e  f u l l y restored t o a l l categories of senior  citizens*  56  E x t e n s i o n o f Housekeeper S e r v i c e I t was mentioned  b e f o r e ( C h a p t e r I I ) , t h a t t h e Depart-  ment engages about t h i r t y - f i v e housekeepers.  T h i s number i s  q u i t e i n a d e q u a t e , i n v i e w o f t h e l a r g e number o f p e r s o n s need s u c h s e r v i c e .  who  A l s o , the number o f b o a r d i n g and n u r s i n g  homes have an e v e r - i n c r e a s i n g number o f p e o p l e on t h e i r w a i t i n g lists.  Beds i a c h r o n i c h o s p i t a l s must be used f o r t h e most  urgent cases.  And even i f such f a c i l i t i e s were a v a i l a b l e , t h e r e  S t i l l would be many people who would be u n w i l l i n g t o a c c e p t them. As s t r e n g t h and h e a l t h f a i l w i t h a d v a n c i n g y e a r s , and  people  become s e p a r a t e d from f a m i l y and f r i e n d s , f a m i l i a r s u r r o u n d i n g s and p o s s e s s i o n s become more a n d more i m p o r t a n t t o them.  It is  n a t u r a l f o r e l d e r l y p e o p l e , e s p e c i a l l y m a r r i e d c o u p l e s , t o want t o l i v e i n accustomed, p l a c e s and among t h e i r own b e l o n g i n g s *  In  most s i t u a t i o n s i t i s s o c i a l l y and e c o n o m i c a l l y d e s i r a b l e t o keep them t h e r e *  Many o f t h e s e c o u p l e s can manage v e r y w e l l i f t h e y  a r e p r o v i d e d w i t h some day h e l p w i t h t h e i r h o u s e h o l d  duties.  I n v i e w o f t h e s e f a c t s , t h e housekeeper s e r v i c e s h o u l d be c o n s i d e r a b l y expanded. The second a s p e c t o f d i s p a r i t y between t h e o r y and p r a c t i c e i s t h e absence o f programmes w h i c h a r e w i d e l y d i s c u s s e d and assumed t o be w o r t h w h i l e ; ©*g,, f o r o l d e r persons*  employment, and  rehabilitation  Such programmes Can be d e f i n i t e l y r e m e d i a l ,  dynamic and c o n s t r u c t i v e *  These s e r v i c e s a r e made a v a i l a b l e t o  younger c l i e n t s and t o t h e b l i n d and d i s a b l e d .  They c o u l d be  57  extended t o t h e e l d e r c i t i z e n s w i t h a l i t t l e more e f f o r t  and  expense*  Employment Most p e o p l e m a n i f e s t l i t t l e hope o f g e t t i n g j o b s f o r people who  a r e o v e r 55  o f most employers.  y e a r s o f age*  This i s a l s o the a t t i t u d e  I f work p o s s i b i l i t i e s a r e c o n s i d e r e d a t a l l ,  t h e y a r e i n terms o f p a r t - t i m e o c c u p a t i o n o r s h e l t e r e d workshops* These do  have t h e i r r i g h t f u l p l a c e i n t h e o v e r a l l scheme, and  d e s e r v e a l a r g e p l a c e too.  l u t i t i s not r e a l i s t i c t o t h i n k t h a t  t h i s i s as f a r as w e l f a r e can go i n promoting employment f o r t h e elderly.  S h o u l d t h e p o s s i b i l i t i e s o f work f o r t h e o l d e r c i t i z e n  be n e g l e c t e d ?  And must h i s d e s i r e t o be u s e f u l be s a t i s f i e d o n l y  through voluntary, c i v i c , or f a m i l y a c t i v i t i e s ? s h o u l d have a r o l e to for  Public welfare  p l a y i n expanding employment o p p o r t u n i t i e s  the a g e i n g , e i t h e r t h r o u g h s t i m u l a t i o n o f o t h e r a g e n c i e s  or  t h r o u g h o p e r a t i n g g u i d a n c e , t r a i n i n g and placement s e r v i c e s w i t h i n the P u b l i c Welfare Organization*  A l a r g e number o f workers  and*  o v e r 65  c o n t i n u e t o be c a p a b l e w o r k e r s  keep on  w o r k i n g ; w h i l e d o c t o r s r e p o r t that t h e r e i s a d e c r e a s i n g  r a t e of  p h y s i c a l ageing*  S h o u l d not  f u r t h e r m o r e , want t o  T h e r e f o r e , employment o p p o r t u n i t i e s  be o v e r l o o k e d , e s p e c i a l l y i n y e a r s t o come, when  i n f l a t i o n c o n t i n u e s t o r e d u c e t h e adequacy o f s a v i n g s , and a s s i s t a n c e payments*  pensions  W i t h the i n c r e a s e i n t h e number off o l d e r  p e o p l e , i n the y e a r s ahead, t h e r e w i l l be t o o much p r e s s u r e t o keep p u b l i c e x p e n d i t u r e s down, and a g e n c i e s . c a n n o t o p p o r t u n i t i e s to  n e g l e c t any  r e t u r n t h e o l d e r p e r s o n t o the l a b o u r market*  58  Encouragement o f R e c r e a t i o n and A c t i v i t y Programmes 1.  G o l d e n Age C l u b s These s h o u l d g i v e s p e c i a l i z e d s e r v i c e f o r o l d e r  c i t i z e n s , o f f e r i n g r e c r e a t i o n and Companionship t h r o u g h  club  a c t i v i t y i n a s many g e o g r a p h i c a l p a r t s o f t h e C i t y as p o s s i b l e . The agency's r o l e would be t h a t o f s t i m u l a t i n g a n d e n c o u r a g i n g e x i s t i n g o r g a n i z e d groups t o a c t a s Sponsors f o r new c l u b s . S e r v i c e s p r o v i d e d w o u l d be: (a.)  A place, comfortably f u r n i s h e d , having very few steps  t  0  c l i m b * warm, w i t h good l i g h t i n g and a p i a n o ; f o r senior eitlzens love to sing* (bj  L i g h t r e f r e s h m e n t s , f o r people a r e n ' t s t r a n g e r s a f t e r "breaking bread" together*  (c)  T r a n s p o r t a t i o n f o r t h o s e p h y s i c a l l y u n a b l e t o use p u b l i c f a c i l i t i e s , o r who cannot pay f o r them*  (d)  Leadership, u s u a l l y a v o l u n t e e r worker. The advantages o f t h e s e programmes a r e t h a t t h e s e n i o r  c i t i z e n s b e g i n t o i d e n t i f y , g a i n r e c o g n i t i o n , make friends§ become i m p o r t a n t t o o t h e r s a n d t o t h e m s e l v e s ^ - i n s h o r t , t h e y a r e no l o n g e r t h e " w a l k i n g dead", f o r i t i s f u n t o be a l i v e a g a i n *  It  a l s o tends t o c o r r e c t t h e t e n d e n c y o f m a r r i e d c o u p l e s t o remain house-bound* 2.  Say C e n t r e s The management o f t h e s e would be s i m i l a r t o t h a t o f t h e  Golden Age G l u b s .  The purpose would be t o p r o v i d e a d a i l y ,  59  p r o f e s s i o n a l l y s u p e r v i s e d , planned a c t i v i t y programme f o r o l d e r Citizens.  The programme would o f f e r i t s members t h e o p p o r t u n i t y  f o r t h e p r o d u c t i v e and s a t i s f y i n g use o f the f r e e day-time  hours,  the empty and l o n e l y hours, p r e v i o u s l y o c c u p i e d by employment, b u s i n e s s , household d u t i e s a n d f a m i l y r e s p o n s i b i l i t i e s *  Essen-  t i a l l y , i t i s a mental h e a l t h and a d u l t e d u c a t i o n programme which promotes the s o c i a l and emotional adjustment o f t h e o l d e r person, g i v i n g him companionship  and a c t i v i t y i n an environment  f a v o u r a b l e t o h i s c o n t i n u a l growth*  I t i s a programme based on  the r e c o g n i t i o n t h a t p h y s i c a l , mental and emotional a c t i v i t i e s are primary human needs, and fundamental i n p r e s e r v i n g p e r s o n a l i t y * The c o n t i n u a l use o f a b i l i t i e s a n d experience through an a c t i v i t y programme o f such a Centre p r o v i d e s e s s e n t i a l f e e l i n g s o f adequacy, accomplishment  and u s e f u l n e s s *  The Programmes  T h i s s h o u l d comprise d i v e r s e a c t i v i t i e s  s u i t a b l e f o r the i n t e r e s t s a n d c a p a c i t i e s o f the members.  It  s h o u l d i n c l u d e some such a c t i v i t i e s as t h e f o l l o w i n g : 1.  Large group a c t i v i t i e s ( f o r p a r t i c i p a t i o n by t o t a l membership), such a s : P a r t i e s * f o r b i r t h d a y s , h o l i d a y s and o t h e r s p e c i a l occasions Outings - p i c n i c s , boat r i d e s , bus e x c u r s i o n s L e c t u r e s , f i l m s , guest e n t e r t a i n e r s C o n c e r t s and entertainment programmes p r e s e n t e d by membership through music and dramatic groups Paneing Callisthenics (limited) Games - b i l l i a r d s , s h u f f l e b o a r d , checkers, chess, cards, dominoes, horseshoe p i t c h i n g .  60  2.  S m a l l group a c t i v i t i e s { s p e c i a l i n t e r e s t groups) (i)  Classes  and  d i s c u s s i o n groups:  Lsjaguages, I n c l u d i n g E n g l i s h Nutrition Health C u r r e n t events G e n e r a l d i s c u s s i o n groups, o r any special interest.  t o p i c of  ( i i ) Music: Music a p p r e c i a t i o n C h o r a l group Rhythm band I n s t r u c t i o n on musical instrumehts O r c h e s t r a o r small ensemble 3*  A r t s and  Crafts Painting Ceramics and s c u l p t u r e Needlework - sewing, k n i t t i n g , c r o c h e t i n g , rug-making, e t c * Woodwork * c a r p e n t r y , wood-carving Basketry Weaving - f l o o r , t a b l e and hand looms Metal work - a r t metal, wrought i r o n Jewelry  4*  Dramatics  5*  P o e t r y and c r e a t i v e w r i t i n g ( p u b l i c a t i o n o f Centre p e r i o d i c a l , library service). Through the C e n t r e , o l d e r persons have o p p o r t u n i t i e s  community work, whereby t h e i r own accomplishment are r e i n f o r c e d . w e l f a r e i n h o s p i t a l s , o l d age institutions*  f e e l i n g s of usefulness  for  and  They can c o n t r i b u t e t o community homes, n u r s i n g homes and  They can prepare bandages and d r e s s i n g s ,  children's feed  h o s p i t a l p a t i e n t s , e s c o r t the b l i n d , p r o v i d e companionship  and  61  performvarious services f o rshut-ins.  The music and c h o r a l  groups c o u l d e n t e r t a i n o u t s i d e the Centre.  They C o u l d make and  r e p a i r t o y s f o r C h i l d r e n and g i f t s f o r d i s a b l e d v e t e r a n s *  They  c o u l d a l s o share t h e i r knowledge and s k i l l i n the v a r i o u s a r t s and  c r a f t s groups o f younger members. The €entr© can be e s p e c i a l l y e f f e c t i v e i n p r o v i d i n g  a c o u n s e l l i n g s e r v i c e f o r i t s members.  In a friendly,  permissive  and f a m i l i a r atmosphere, t h e member moves more e a s i l y t o t h e c o u n s e l l o r when f a c e d w i t h an u n r e s o l v e d  personal  problem.  C o u n s e l l i n g s h o u l d be an i n t e g r a l p a r t off t he t o t a l C e n t r e programme* Improvement i n Communications T h i s i s n e c e s s a r y b o t h i n e x p a n s i o n o f s e r v i c e s and i n i n t r o d u c i n g new s e r v i c e s .  The s t a f f s h o u l d know t h e l a t e s t  developments i n o t h e r p r o v i n c e s  i n Canada, and i n o t h e r  s u c h as t h e U n i t e d S t a t e s o r t h e European c o u n t r i e s *  countries,  Publications  o f committees and c o n f e r e n c e s , w h i c h c o n t r i b u t e t o t h e s p r e a d o f knowledge about w e l f a r e and a g e i n g , s h o u l d r e a c h t h e s t a f f .  They  s h o u l d know about t h e programmes t h a t work, and about t h o s e t h a t have f a i l e d *  There Should be more c o - o r d i n a t i o n and p l a n n i n g  between d i f f e r e n t d i v i s i o n s a n d between d i f f e r e n t l e v e l s o f o p e r a t i o n concerned w i t h s e r v i c e s t o t h e a g e i n g c i t i z e n s .  Attractive,  i n t e l l i g i b l e r e p o r t s s h o u l d be made a v a i l a b l e t o everyone on t h e staff*  E f f e c t i v e communication cannot be s e c u r e d w i t h on© o f f i c e  copy g o i n g around*  A u d i o - v i s u a l a i d s would be v e r y u s e f u l i n t h i s  62  eoaaeetioa, as a l s o attendaae© at conferences and j o i n t planning meetiags with other CoMmuaity organlzationa,''  Specialized.!^©^  •  - the inevitatoi© programme developmeats o f the f u t u r e w i l l necessitate aa ©xteasive re-tooling of s t a f f s k i l l s ,  t h i s can  oaly he don© by ©xpaadlag, i n t e n s i f y i n g , and r©~©ri©ntiag t r a i n i n g programmes, 1,  there ar© two reasons f o r t h l s i  The need f o r s p e c i a l i z e d Courses has not so f a r been recog-  nized, whether they r e l a t e t o casework, group work j or coiwjaaity organization.  The workers who ar© doing s p e c i a l i z e d work with th©  ageiag hay© had to add to t h e i r basic knowledg© through a strenuous and lengthy process of self*©dueatioa* 2.  Secondly| th© majority of.workersdealing with.older.citizens  hay© been compelled t o focus oa the mechanics of determining and rC-checking e l i g i b i l i t y , and oa meeting emergency situations, s u c h as transfers t o a h o s p i t a l or nursing home,  This has discouraged  Interest, imagination a n d Constructive work, T© provide adequate services, t r a i n i n g must r e v i t a l i z e appreciation•of t h e ' O l d e r c l i e n t as a precious human'being, a person with potentials* :  and  t h i s w i l l revive •interest, i'maginatioa,  a positive approach to the problem,  ©oatiaued; S;uryeys;.aM,Research Plaaaiag f o r the proper car© of the ageing c i t i z e n s i s  6|  a matter I n which the C i t y S o c i a l S e r v i c e Department and  the  S o c i a l Welfare Branch o f the P r o v i n c i a l Government should  play  prominent p a r t s * but which, p r i n c i p a l l y * i s a matter of t o t a l community concern*  Plans f o r meeting the nee4 must not  l o o k the value of prevention* invalidism.  e s p e c i a l l y prevention  over-  of c h r o n i c  Such p r e v e n t i o n might be a t t a i n e d through e a r l y  d i a g n o s i s and treatment* planned r e h a b i l i t a t i o n , and  intensified  research i n g e r i a t r i c s . The o l d e r person who will*  needs h e l p and  cannot get i t  i n many cases, e v e n t u a l l y c o s t the community more than i f  competent guidance were made a v a i l a b l e t o him i n i t i a l l y . h o l d i n g o f r e h a b i l i t a t i o n may  With-  r e s u l t i n expenses f o r i n s t i t u -  t i o n a l CSJFO'.. P u b l i c w e l f a r e w i l l , t h e r e f o r e , have t© develop a i  comprehensive s e r v i c e programme a v a i l a b l e t o a l l o l d e r people as w e l l as t o those r e q u i r i n g p u b l i c a s s i s t a n c e . Can  only be s o l v e d by r e s e a r c h i n the s e r v i c e s now  the workers t o t h e o l d e r r e c i p i e n t s . up?  The  What i s done about them?  e f f o r t and s k i l l are required? visits?  What does the S e r v i c e  Who  being given  by  What k i n d of problems come  does i t ?  How  problem  How  much time,  many l e t t e r s , phone c a l l s *  cost?  This kind of information i s e s s e n t i a l i f public i s t o be prepared t o meet the coming development.  welfare  A service  programme o f t h i s nature w i l l r e q u i r e a r e * o r l e n t a t l o n o f the t o t a l agency programme, as w e l l as the most e f f i c i e n t o f s k i l l s and procedures.  refinement  I t must be remembered t h a t the change  6k w i l l be very gradual. planned New  There w i l l be s u f f i c i e n t time f o r a  transition.  Trends The n o n - f i n a n c i a l needs Of t h e e l d e r l y are even more  Important than the f i n a n c i a l needs.  An o l d e r person may not be  i n need of the bonus or t h e c o s t - o f - l i v i n g allowance, and yet  may  have problems around l i v i n g arrangements, medical care, f a m i l y r e l a t i o n s h i p s * and a great v a r i e t y of other p e r p l e x i t i e s , w i t h which he or she may need h e l p .  The numbers of persons i n t h i s age  group i s expected t o continue t o i n c r e a s e , p r i n c i p a l l y because of the lengthening of l i f e through new medical d i s c o v e r i e s .  This  makes I t necessary t o p l a n f o r the f u t u r e as w e l l as f o r immediate present needs.  Such planning would i n v o l v e :  (1)  a study off the present needsj  (2)  an e v a l u a t i o n of the resources c u r r e n t l y a v a i l a b l e t o meet such need, and  (3)  the development of a comprehensive plan f o r meeting the needs of t h e f u t u r e *  I n t r o d u c t i o n of S e r v i c e s t h a t can be Performed by "Volunteers The main s e r v i c e a l l o t e d t o volunteers i s t h a t of f r i e n d l y visiting.  There are married couples and o l d e r c i t i z e n s who  are  house-bound and are unable t o attend day centres o r clubs and p a r t i c i p a t e i n these a c t i v i t i e s , and are thus deprived of normal social l i f e .  For these, the p r o v i s i o n of food, c l o t h i n g , s h e l t e r  65 and medical care i s n o t enough. F r i e n d l y v i s i t i n g t o t h e s i c k and t h e poor i s not new. The a c t i v i t i e s o f many churches long included this service.  and f r a t e r n a l o r g a n i z a t i o n s have  But t h e p a r t n e r s h i p between p r i v a t e  and p u b l i c s o c i a l work agencies i n d e v e l o p i n g and u s i n g t h i s S e r v i c e * the s k i l l e d p l a n n i n g o f ways i n which t h e f r i e n d l y v i s i t o r can supplement {but never r e p l a c e ) t h e p r o f e s s i o n a l s e r v i c e s o f the a g e i n g ,  and t h e c o n c e n t r a t i o n on t h e needs o f t h e  o l d e r persons t o be met by t h i s programme«-these a r e r e l a t i v e l y new and e x c i t i n g developments. I n every case, t h e v o l u n t e e r s h o u l d undergo a c a r e f u l o r i e n t a t i o n b e f o r e S t a r t i n g work.  She should know* n o t o n l y  h e r own r o l e , but a l s o h e r r e l a t i o n s h i p t o t h e agency, t o the c l i e n t , a n d t o t h e community. the agency programmes.  She should be f a m i l i a r w i t h a l l  She should a t t e n d i n d i v i d u a l and group  conferences, and r e g u l a r p e r i o d i c conferences w i t h the s u p e r v i s o r off v o l u n t e e r s , a n d w i t h t h e caseworker. I n a d d i t i o n t o f r i e n d l y v i s i t i n g , v o l u n t e e r s may be a s s i g n e d other t a s k s l i k e motor s e r v i c e t o c l i n i c s a n d churches, c o l l e c t i o n and r e n o v a t i o n off c l o t h i n g , s e r v i n g a n d r a i s i n g off funds f o r s p e c i a l  purposes.  ©are s h o u l d be taken, however, not t o a l l o t them cases who p r e s e n t severe emotional o r p e r s o n a l i t y problems. P r o v i s i o n o f a F u l l - t i m e S t a f f C o n s u l t a n t on S e r v i c e s t o the Ageing As s o c i a l work has been r e - a s s e s s i n g i t s r e l a t i o n s h i p  66  t o a g e i n g d u r i n g t h e l a s t decade, t h e r e has been i n t h e U n i t e d S t a t e s an i n t e r e s t i n g a d d i t i o n t o s t a f f s e r v i c e s , b o t h i n p u b l i c and p r i v a t e a g e n c i e s .  This i s the supplementing of t r a d i t i o n a l  s t a f f p o s i t i o n s w i t h one o r more f u l l - t i m e c o n s u l t a n t s on s e r v i c e s f o r ageing.  H i s h e l p may be sought by c o r p o r a t i o n s and u n i o n s  concerned w i t h personnel  programmes f o r a g e i n g w o r k e r s ; by  f r a t e r n a l and c i v i c groups l o o k i n g f o r s p e c i a l p r o j e c t s ; by r e l i g i o u s denominations o p e r a t i n g homes, h o s p i t a l s , o r o t h e r s o c i a l s e r v i c e s ? by p r o f e s s i o n s , such as e d u c a t i o n , n u r s i n g , o r a r c h i t e c t u r e , t h a t want t o adapt b e t t e r t o the needs o f t h e a g e i n g . To t h e c o n s u l t a n t a l s o come q u e s t i o n s f r o m p e o p l e i n government, a g r i c u l t u r e , s o c i o l o g y , a d v e r t i s i n g , r a d i o , t e l e v i s i o n and t h e press.  I n some a g e n c i e s , t h e t r o u b l e d o l d e r p e r s o n comes t o t h e  C o n s u l t a n t ' s o f f i c e w i t h q u e s t i o n s not c u s t o m a r i l y h a n d l e d by o t h e r s t a f f w o r k e r s , and w i t h problems no a g e n c i e s e x i s t t o meet.  Rehabilitation for Self-care The  t r e n d i n p u b l i c w e l f a r e towards r e h a b i l i t a t i o n f o r  s e l f - c a r e i s quite obvious.  But t h e g r e a t advances i n p h y s i c a l  m e d i c i n e and p s y c h o t h e r a p y s i n c e t h e l a s t war have almost e x c l u s i v e l y been used f o r younger p e o p l e judged t o be employable. P u r p o s e f u l r e h a b i l i t a t i o n f o r t h e o l d e r c i t i z e n , w h i c h w i l l keep him o u t o f n u r s i n g home o r h o s p i t a l has been a l m o s t o m i t t e d .  It  i s unwise t o pour m i l l i o n s o f d o l l a r s i n t o i n s t i t u t i o n a l c o n s t r u c t i o n and c u s t o d i a l n u r s i n g , when a l a r g e p r o p o r t i o n o f t h e e l d e r p a t i e n t s can be r e s t o r e d t o t h e p o i n t where t h e y can l o o k a f t e r t h e i r own p e r s o n a l needs.  67  Implications  for  Prevention  The i m p a c t  o f ageing  on t h e American C o n t i n e n t implementation of the  is  community,  community. actually  f o r aged  Therefore,  its  to  concern to those  over. point  It  dependency  Job w e l l ,  problems of  o l d e r age  groups would  1.  Programmes o f h e a l t h  ageing  the  of  the  those  age  cannot  aged;  scale  i.e.,  to that  limit 65  and  variable  originate.,  prevent  dependency  in  be:  as w e l l  as  broader  education  ageing;  social  centres,  including crafts  and c i v i c  and  participation;  3*  A d u l t e d u c a t i o n and v o c a t i o n a l  4.  Church-centred  re-training.  programmes.  S u c h programmes must be f o s t e r e d of  parts  public welfare  would help t o  education,  A l l kinds of a c t i v i t y  parts  to  be l i m i t e d t o  officially  t o g o down t h e  the  necessary*  assistance.  who a r e a l r e a d y  that  becomes  come f r o m a l l  structure that  programmes must be r e l a t e d  dependents  do t h e  The programmes  2.  and so p e r v a s i v e ,  programmes must n o t  i s necessary  at which the  for  prevent  receiving financial  Secondly,  s o o i a l and economic  so g r e a t ,  ways t o  To a c c o m p l i s h t h i s , total  on t h e  community l i v i n g ,  and n a t u r a l l y  as the  and they  T.W.G.A.,  until  are accepted  they  are  and used as  T*M.G.*A. ©r t h e R e d C r o s s  t h u s t h e a g e n c y w i l l have  to  integral widely  Society*  d e v e l o p more i n g e n u i t y  and  and i m a g i n a t i o n  i n d e v i s i n g a d d i t i o n a l C o - o p e r a t i v e arrangements  w i t h l o c a l groups i n terms o f p l a n n i n g and p r o v i d i n g for  senior  services  citizens.  Conclusion The  l a t e r y e a r s , l i k e any o t h e r phase o f t h e l i f e  Span,  p r e s e n t t h e i r s p e c i a l o p p o r t u n i t i e s and t h e i r s p e c i a l problems of adaptation,  b o t h f o r t h e i n d i v i d u a l and f o r t h a t  o f i n d i v i d u a l s we c a l l S o c i e t y .  An attempt was  some o f t h e s e problems i n the p r e c e d i n g how  collection  made t o a n a l y z e  c h a p t e r s , and t o i n d i c a t e  p u b l i c w e l f a r e can h e l p t h e o l d e r i n d i v i d u a l i n a d j u s t m e n t .  B u t , i n t h e end, t h e q u e s t i o n of a g e i n g i n e v i t a b l y r e v e r t s t o i t s p h i l o s o p h i c base: his  The  v a l u e s and meaning t h a t man  seeks f o r i n  life. the b a s i c w o r t h o f each i n d i v i d u a l l i f e and  is  the c e n t r a l v a l u e o f p u b l i c w e l f a r e *  personality  The m a r s h a l l i n g  of  c o l l e c t i v e s t r e n g t h t o s u p p o r t the i n d i v i d u a l , e s p e c i a l l y i n h i s t i m e s o f v u l n e r a b i l i t y , i s i t s p a r t i c u l a r assignment.  This i s  done, not t o pamper weakness at t h e expense o f s t r e n g t h ,  but,  r a t h e r , t o p e r m i t each man  realize  his  own  t o f u l f i l h i s own  d e s t i n y and  s t a t u r e t h r o u g h a p o o l i n g o f the s t r e n g t h o f a l l . This i s a process which begins at b i r t h , supports the  and y o u t h t h r o u g h h i s p e r i o d o f growth t o s e l f - r e l i a n c e , h e l p s a d u l t c a r r y t h e burdens o f m a t u r i t y , and  child the  s u s t a i n s t h e s o e i a l and  economic r e l a t i o n s h i p s o f t h o s e i n t h e i r l a t e r y e a r s .  The i n d i v i d u a l  69 and h i s needs are, a t a l l times, the c e n t r a l f o c u s .  I t i s only  as  these needs change t h a t the s e r v i c e s t o meet them must l i k e w i s e change*  The  developing  s o c i a l philosophy  remains constant.  human p e r s o n a l i t y knows no age  However, the p o p u l a t i o n challenge  o f the o l d e r ag©  s p i r i t , of imagination, has  limits.  i s growing o l d e r , f a s t .  awaits men  the  and women of  The  whole  pioneering  o f v i s i o n and o f understanding.  The  writer  t r i e d t o suggest seme g u i d e p o s t s f o r h e l p i n g o l d e r c i t i z e n s t o  happier*  r i c h e r , and mor© u s e f u l l i v e s by more comprehensive case-  work c o u n s e l l i n g , group a c t i v i t i e s , occupation, and  The v a l u e of  g e n e r a l i n t e r e s t i n l i v i n g ; above a l l ,  s c a l e , and  ffosterifcg  by going down the  programmes o f p r e v e n t i o n  the problems o r i g i n a t e .  a secure s h e l t e r  These w i l l p r o v i d e  at th©  age  p o i n t where  o p p o r t u n i t i e s f o r the  o l d e r a d u l t t o f i n d companionship, t o f e e l needed, t o enlarge e x p e r i e n c e s and knowledge, t o meet h i s r e s p o n s i b i l i t i e s as citizen,  and t o f e e l s e c u r e and  happy.  his  a  I t would promote s e l f -  esteem and acceptance so necessary t o people o f a l l ages, f o r the American s o c i e t y to-day puts a premium ©n the f e e l i n g o f s t a t u s , frowns when there i s no c o n t r i b u t i o n . h i m s e l f , a l l to©  The  o f t e n , i n the p a r a d o x i c a l  and  senior c i t i z e n finds s i t u a t i o n off t r y i n g t o  remain a c o n t r i b u t i n g member o f a s o c i e t y t h a t i s t a k i n g away h i s opportunity  t o do  so.  I t i s not o n l y the o l d e r s i n g l e person t h a t has m a r r i e d couples are no l e s s exposed* from s o c i a l r e l a t i o n s h i p s and  problems}  They, t o o , can b© cut o f f  o u t s i d e i n t e r e s t s , and are u s u a l l y  70 f a c e d w i t h an e v e r - i n c r e a s i n g number o f unmet needs. come e i t h e r suddenly or unexpectedly.  Age does n o t  I t comes t o both r i c h  and  poor a l i k e ; f o r s e n i o r c i t i z e n s a r e i n d i v i d u a l s , w i t h i n d i v i d u a l p e r s o n a l i t i e s , d e s i r e s , problems,  and needs.  These needs are  e s s e n t i a l l y the same as those o f a l l people, but Complicated t h e i r waning a b i l i t i e s .  Some of t h e i r problems r e l a t e t o m a t e r i a l  needs, but o t h e r s t o l e s s t a n g i b l e , but e q u a l l y r e a l and e m o t i o n a l needs.  by  important  T h i s i s a time o f t h e u p s u r g i n g of a l l u n s o l v e d  problems o f t h e past, f e a r s and a n x i e t i e s , c o n f l i c t s and  frustra-  t i o n s , r e l a t i o n s h i p s w i t h people, present d i f f i c u l t i e s m a g n i f i e d by l a c k o f r e l e a s e through p h y s i c a l a c t i v i t y , and y e t w i t h l e s s a b i l i t y t o h e l p themselves. I t i s sometimes f o r g o t t e n t h a t the w e l f a r e of t h e aged i s important f o r the w e l f a r e o f c h i l d r e n .  The treatment of the e l d e r  and h i s u l t i m a t e p l a c e i n the f a m i l y bear s i g n i f i c a n t l y upon t h e w e l f a r e and  s o c i a l o r i e n t a t i o n o f subsequent  generations.  The  moral and e t h i c a l standards r e s t w i t h the e l d e r s of a c u l t u r e . The c h i l d i s g u i d e d i n t o s o c i a l l y a p p r o p r i a t e ways of t h i n k i n g and behaving through the example of h i s parents and through a p p e a l t o h i s l o g i c ; but the e f f e c t i v e n e s s o f t h i s e d u c a t i o n a l system depends t o a l a r g e e x t e n t upon t h e awe  i n which t h e c h i l d h o l d s h i s  e l d e r s and the i n s p i r a t i o n a l g o a l s they p e r s o n i f y , t h a t t h e maintenance o f t h e grandparent  " i t seems c l e a r  i d e a l as t h e f o u n t o f  wisdom, t h e o r a c l e o f p e r f e c t i o n and the source of l o v e , tempered w i t h unwavering adherence t o p r i n c i p l e i s important i n the C r e a t i o n o f an i d e a l c o n s c i e n c e i n the c h i l d * . . .  A s t r o n g p o s s i b i l i t y of  71  r e a l s o c i a l danger and o f p o t e n t i a l damage t o c h i l d r e n I s c o n t a i n e d i n any c u l t u r a l system i n which the e l d e r s a r e d e v a l ued. ^ n  The  debasement o f the e l d e r as t h e symbol o f a u t h o r i t y  has a tendency t o d i m i n i s h t h e i m p o r t a n c e o f a l l a u t h o r i t y .  It  c r e a t e s i n t h e younger p e r s o n an e x a l t e d b e l i e f i n h i s  own  c a p a c i t y t o d e s t r o y t r a d i t i o n , f l o u t mores, and r e j e c t  qualities  Of d i s c i p l i n e t h a t have been h i s t o r i c a l l y e s t a b l i s h e d and have s t o o d t h e t e s t o f a p p l i c a t i o n t h r o u g h o u t t h e ages.  The  youngster  can develop out o f t h e s e e x p e r i e n c e s t h e p o i n t o f v i e w t h a t he i s a l a w unto h i m s e l f , and t h a t h i s w i s h e s are s u p e r i o r t o the demands o f s o c i e t y .  This a t t i t u d e is l i k e l y to l e a d t o a c t s  o f d e l i n q u e n c y and crime p e r p e t r a t e d a g a i n s t s o c i e t y . The y o u n g s t e r s watch the s u b t l e , and sometimes o v e r t , r e j e c t i o n meted out t o t h e g r a n d p a r e n t s  by t h e i r p a r e n t s ,  t h i s c r e a t e s i n them a c e r t a i n s e t o f a t t i t u d e s .  As t h e  and child  i n c o r p o r a t e s i n h i m s e l f t h e image o f h i s p a r e n t as p a r t o f h i s i n t e r n a l s o c i a l o r g a n ! a a t i o n , he a b s o r b s among o t h e r t h i n g s t h i s v e r y p a t t e r n off sadism against the e l d e r .  Thus i s guaranteed  the f a c t that the v i c i o u s c y c l e of e l d e r r e j e c t i o n w i l l unbroken t h r o u g h g e n e r a t i o n a f t e r g e n e r a t i o n .  The tendency off a  c u l t u r e t o r e j e c t i t s e l d e r s , t o n e g l e c t and d i s c a r d t h e r e p r e s e n t a t i v e s o f a u t h o r i t y may  remain  symbolic  w e l l be a m a t t e r o f g r e a t  signif-  icance i n s t i m u l a t i n g tendencies of excessive r e b e l l i o n , insupera b l e u r g e s t o d e s t r o y t r a d i t i o n , and u n b r i d l e d l o n g i n g s f o r  H i n d e n , M a u r i c e , "The O l d e r Person i n t h e F a m i l y " , S o c i a l Casework, V o l . XXXVII No. 2, F e b r u a r y 1956. ~  72  boundless ©mancipation i n the young*  ©a© of the answers to  the problem of youthful misbehaviour i s to be found i n a study of the senior members of society. Ia the foregoing page® a f a i r l y large assortment of s o c i o l o g i c a l and psychological elements that bear upoa the welfare of senior c i t l s e a s aad t h e i r f a m i l i e s has been considered.  I t has been demonstrated that many of the causes  leading t o the development of s e n i l i t y originate l a human attitudes and psychological i n c l i n a t i o n s ,  this strongly suggests  that the factors ©oatributiag to th© psychological i n f i r m i t i e s of ageiag are withia man's potential to maaage and maaipulat©* I t may further be stated that much of what i s seen as s e n i l i t y to-day i s preventable  i n th© future, with appropriate mental aad  s o c i a l hygiene. Primarily, as has been pointed out, the needs of older persons are th© same as those o f any other group |a the community. To some degree they must b© met with i n s p e c i a l ways,  l a their  solution, the facts about ageiag and t h e i r s p e c i a l needs must be taken i n t o account* just a s i n Child welfare programmes* the t  needs of c h i l d r e a are considered.  The problems of ageiag ar© not  greater than those of other age groups.  Therefore, programmes  f o r s@aior c i t i z e n s must get t h e i r due share i a the t o t a l commuaity programmes. there i s a growing r e a l i z a t i o n that the l a t e r years are not an end, but, rather, oa© of the many phases of l i f e  bleadiag  73 i n t o each o t h e r .  With the co-operation o f i n d i v i d u a l s , of  g r o u p s , b o t h p u b l i c and p r i v a t e , and o f t h e community as a whole, t h e o l d e r a d u l t c a n r e g a i n and m a i n t a i n h i s r i g h t f u l p l a c e i n s o c i e t y as a u s e f u l and happy c i t i z e n .  Appendix A  I n f o r m a t i o n O b t a i n e d from Case-Records  1.  Name and address  2.  Date and p l a c e o f b i r t h  3«  Date o f marriage  4*  Number o f c h i l d r e n  5.  Former o c c u p a t i o n  6.  Religion  7.  P h y s i c a l and Mental c o n d i t i o n  8.  Housing arrangements and r e n t p a i d  9.  A s s e t s : Bank accounts, immoveable property, insurance p o l i c i e s .  Appendix B  Guide Questions Used i n Interviews  1.  How do you f e e l as regards physical health? i f any)  2.  How many children do you have?  3.  How often do your children v i s i t you? (where applicable)  4.  How many friends do you have? How often do you see them?  5.  Is the house space adequate? Are there many s t a i r s to climb? Is the rent f a i r ? Is your home conveniently located f o r marketing purposes?  6*  How much free time do you have?  7.  What do you do i n your free time?  8.  What are your hobbies or favourite pastimes?  9.  How much time do you spend each day i n reading? kind of book, magazine etc. do you read?  10.  Do you go to the movies? not?  11.  Do you l i s t e n t o the radio?  (problems  Are thoy close friends?  I f so, how often? For how long?  What  I f not, why Which  programmes do you l i k e the best? 12.  Do you belong to any club or association?  13. 14.  Do you go to church? Does your pastor v i s i t you? Are you s a t i s f i e d with your present position? Does i t make you f e e l secure?  15.  I f your income has been lowered, what things have you had to do because of this? (e.g. moved to a l e s s expensive home5 eat l e s s expensive foods; buy l e s s expensive clothes).  Appendix C  BIBLIOGRAPHY a. Books 1.  Gavah, Burgess| Havinghurst and Goldhamer, Personal Adjustment i n Old Age (Science Research Association Inc.,. Chicago) 1949  2. Donahue, Wilms. Education f o r Later Maturity (New York, ... . Whiteside.) 1551 " ' !  3. . Donahue k T i b b i t s . Planning.the Older tears (University of Michigan Press) 1950 '" 4.  Garrett, Annette, Interviewing, i t s P r i n c i p l e s and Methods (New York, Family Services Association of America) 1942  5.  G i l b e r t , iJeanne, Understanding Old Age (The Ronald Press Co., New York)  6.  Kaplan, <Jerome, A S o c i a l Program f o r Older People (University o f Minnesota Press) 1953—  7*  Lawton, George, Aging Successfully (Golumbia University press) 1946  8.  Lawton* George, New Goals f o r Old Age (Golumbia University Press) 1943 ' " "' • ' " " "  9.  Maslow and Mittleman, p r i n c i p l e s of Abnormal psychology (Harper Brothers, New York) 1951  10.  MacEachern, William, Fourteen Days as an Old Age Pensioner (reprinted from the Toronto Daily Star) March 1956 ./ . , . "/" — *  11.  Towle, Charlotte, Common Human Needs (Federal Security Agency) 1945  12.  Wickenden, Elizabeth, The Needs of Older People and Public Welfare Services "to Meet Them (American Public Welfare Association) 1953 '"  13.  Woods, .James, Helping Older people Enjoy L i f e (Harper Brothers) 1953  14.  Young and McLenahan, The S o c i a l Workers Dictionary (Social Work Technique, Los Angeles,.'California) WW 1  b. Pamphlets» Reports, and  Articles  1.  Aging (Family H e a l t h S e r i e s , Community S e r v i c e S o c i e t y , Department of E d u c a t i o n a l Nursing, New Tork) 1948  2.  F a c t Book on Aging ( F e d e r a l S e c u r i t y Agency, Government O f f i c e ) 1952  3.  Grant, <J©an, R e c r e a t i o n a l I n t e r e s t s and A c t i v i t i e s f o r S e n i o r C i t i z e n s i n Vancouver ( U n i v e r s i t y o f B r i t i s h Columbia) l 9 $ 4 — -  4.  Govan, E l i z a b e t h , "The Needs o f the Aged" (Canadian Welfare C o u n c i l ) 1951  5.  G r e e n l e l g h , Lawrence, "Soma P s y c h o l o g i c a l A s p e c t s o f Ageing" ( S o c i a l Casework V o l . XXXVI No. 3, March  U.S.  1955)  6*  H e a l t h and Welfare S e r v i c e s f o r the Aged i n t h e P r o v i n c e of B* 0. ( S o c i a l Welfare Branch, Department o f H e a l t h and Welfare, V i c t o r i a , B.0*) May 1950  7.  Housing f o r pur O l d e r C I t i g e n s (Vancouver A s s o c l a t l o h ) March 1949  8.  i n t e r n a t i o n a l Survey o f Programs o f S o c i a l Development 1 ! (United N a t i o n s 1  Housing  ri9ir  9. *- L i n d e n , Maurice, "The O l d e r Person i n the F a m i l y " ( S o c i a l Casework* V o l * 3UCXVII, No. 2, February 105©) 10.  L i v i n g through the O l d e r Years. Proceedings o f the C h a r l e s A F i s h e P Memorial I n s i i t U t C o n Aging* E d i t e d by T i b b i t s ( U n i v e r s i t y o f Michigan P r e s s ) 1951  11.  Making the f e a r s Count (New York S t a t e *Joint l e g i s l a t i v e Coaxaittee on P r o b l e m s o f the Aging) 1955  12.  O l d People - Report o f a Survey Committee on Problems o f the Ageing and the Care o f O l d People, under chairmans h i p o f B. Seebohm Rowntre© ( N u f f i e l d Foundation, O x f o r d U n i v e r s i t y P r e s s , London) 1947  13*  " P e r s o n a l i z o d Care f o r the Aged C l i e n t " , Papers by P e t e r s , Rapp, Ryder and Wagner - R e p r i n t e d from The F a m i l y l o u r n a l o f S o c i a l Casework 1946  14*  Powell, Amy S., " S p e c i a l S k i l l s " (^Qurnal o f S o c i a l Casework) February 1949 --------------  15.  Proceedings o f th©^Gov©ftior's Conference on_the Problems o f the Aging (Sacramento* C a l i f o r n i a ) October 1951  16.  "Symposiums Casework and the Aging Population", Reynolds, Powell and 2elditch, Journal of Social Casework, February 1949 • • • .* • ,. 17. Social and Biological Challenge of our Aging Population. Proceedings of the Eastern States Health Education Conference, March-April 1949 (Golumbia University Press) 1950.  C.  Theses  1.  Deildal, R.M., Foster Home, Care for the Dependent Aged,  2,  Guest, Dennis T . , Taylor Manor, 1952  3*  Kuhn* G. J , * Public Assistance * The Recipients* Experiences.,,'' 1949'• '" ' •• "y : • ..  4. Leydier, Bernlce, Boarding Home Care for the Aged. 1940 ( A l l those l i s t e d are Master of Social Work theses of the University of B r i t i s h Golumbia)  

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