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Boarding home care for the aged : a study of the social welfare aspects of licensed homes in Vancouver Leydier, Bernice Rae 1948

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BOARDING HOME CARE FOR THE AGED A Study o f the S o c i a l W e l f a r e A s p e c t s o f L i c e n s e d Homes i n Vancouver by B e r n i c e Hae L e y d i e r A Thesis . Submitted i n P a r t i a l F u l f i l m e n t o f the Requirements f o r the Degree o f Master o f S o c i a l Work i n the Department o f S o c i a l Work THE UNIVERSITY OF BRITISH COLUMBIA 1948 TABLE. OF CONTENTS PART I - SETTING OF TTTE p g n^T.M page Chapter I The Growing Problem of the Aged Present day p o p u l a t i o n t r e n d s . P r e s s u r e s on the aged; from s o c i e t y , from the f a m i l y . Some of the 'needs o f o l d people I Chapter I I Concern w i t h the. Aged i n Vancouver The Committee on the Care of the Aged, 1945. A v a i l a b l e accommodation f o r o l d p e o p l e , S p e c i a l hous ing needs o f the o l d . Study of the hous ing o f a s e l e c t e d group, 1947. Where pens ioners l i v e C1948). 17 Chapter I I I The L i c e n s i n g and S u p e r v i s i o n o f B o a r d -i n g Homes Terms of the L i c e n s i n g A c t . R e g u l a t i o n s o f the A c t . The process o f l i c e n s i n g a home. Reasons f o r r e f u s i n g a p p l i c a t i o n s f o r l i c e n s e . R o l e o f i n s p e c t o r as an educator . 34 PART I I — THE BOARDING HOMES Chapter IV Scope of the Study The nature of the b o a r d i n g home. How many aged need b o a r d i n g home care i n Vancouver? P o p u l a -t i o n s of the homes v i s i t e d . Method of c o l l e c t i n g " m a t e r i a l . The f a c t s sought f o r the study 45 Chapter- V G e n e r a l f a c i l i t i e s o f B o a r d i n g Homes C l a s s i f i c a t i o n a c c o r d i n g t o p e r s o n s " o r groups Sponsor ing t h e homes. Methods o f p a y i n g by r e s -i d e n t s . P r o p e r t y s e t t l e m e n t s . L o c a t i o n s of the b o a r d i n g homes. D e s c r i p t i o n s o f f o u r r e p r e s e n t a -t i v e homes 56 Chapter V I Bedroom and Bathroom F a c i l i t i e s B a s i c needs met i n a l l homes. L i g h t i n g i n b e d -rooms. F u r n i s h i n g s i n bedrooms. P r i v a c y f o r t h e occupants o f wards. B a t h i n g f a c i l i t i e s . T o i l e t , f a c i l i t i e s . G e n e r a l O b s e r v a t i o n s 70 Chapter V I I The S e r v i n g o f Meals The m u l t i p l e importance o f f o o d . Types o f f o o d s e r v e d . Between-meal snacks . Methods o f s e r v i n g meals . G e n e r a l Observat ions 80 page Chapter V T I I Use o f L e i s u r e Time i n Boarding Homes The problem o f u n l i m i t e d l e i s u r e . Common fiooms i n the b o a r d i n g homes. R e c r e a t i o n i n d o o r s : r e a d -i n g , r a d i o j h o b b i e s , o t h e r s . R e c r e a t i o n o u t -d o o r s . A c t i v i t i e s brought i n t o the homes. The problem o f the a p a t h e t i c o l d p e o p l e . Summary. . . 91 Chapter I X R e l a t i o n s h i p s w i t h i n b o a r d i n g homes O l d p e o p l e a re people grovm o l d . Genes is o f some p e r s o n a l i t y problems. A t t i t u d e s o f o p e r a t o r s to o l d age . A t t i t u d e s o f o p e r a t o r s -to t h e i r r e s i -d e n t s . A new inmate . S p e c i f i c problems i n a d j u s t -ments. R u l e s , r e g u l a t i o n s and p a r t i c i p a t i o n . The problem of the f a m i l y . G e n e r a l o b s e r v a t i o n s . . . 112 PART I I I - SOME IMPLICATIOES Chapter X Adventures i n P l a n n i n g L o c a l e f f o r t s i n p l a n n i n g . Danish apartment houses f o r the aged. V i l l a g e s f o r the aged. V i s i t i n g housekeeper s e r v i c e s . F o s t e r homes • f o r the aged. The need f o r a d i v e r s i t y o f r e -s o u r c e s . ' 134: Chapter XI C o n c l u s i o n s F i n a n c i a l p r o v i s i o n i s not enough. P h y s i c a l com-f o r t s a re i m p o r t a n t . The p e r s o n a l element.. P l a n s f o r the immediate f u t u r e 144 APPENDICES A - B i b l i o g r a p h y - S p e c i f i c Re ferences . B - B i b l i o g r a p h y - G e n e r a l Re ferences . i I wish t o acknowledge my indebtedness to the f o l l o w i n g f o r t h e i r h e l p d u r i n g the p r e p a r a t i o n o f t h i s s t u d y : West U n i t o f C i t y S o c i a l S e r v i c e De-partment ; the O l d Age Pensions B o a r d , e s p e c i a l l y Miss. Edwards; H o s p i t a l s and I n s t i t u t i o n s , p a r t i c u -l a r l y M r s . Page., whose, v a l u a b l e a s s i s t a n c e has been r e f e r r e d t o i n the study j the. Committee on. the Care o f the. A g e d , .which made i t s r e c o r d s a v a i l a b l e , and. which showed so much i n t e r e s t i n t h i s work; the R o t a r y C l u b , whose f i n a n c i a l he lp made the study p o s -s i b l e ; and D r . L . C . M a r s h , who gave i n v a l u a b l e g u i -dance and advice throughout the p r e p a r a t i o n of t h i s r e p o r t . S p e c i a l thanks are due to a l l the matrons and opera tors of board ing homes who w i l l i n g l y and k i n d l y gave of t h e i r time, and experience whenever i t was asked o f them. F i n a l l y , I am g r a t e f u l t o the. many o l d people who d i s c u s s e d t h e i r problems and d e -s i r e s w i t h me and gave me encouragement. ABSTRACT T h i s study attempts to explore some of the s o c i a l a spec t s of board ing homes f o r the aged i n order to l e a r n what problems are met i n o p e r a t i n g such homes and what a d -justments can be made t o so lve them. S i x t e e n b o a r d i n g homes i n Vancouver were v i s i t e d and the opera tors were i n t e r v i e w e d . These i n t e r v i e w s were t h e b a s i s o f the chapters on the b o a r d i n g homes themselves . I n a d d i t i o n other types o f i n s t i t u t i o n s were c o n s i d e r e d , w i t h one or two b e i n g v i s i t e d and i n v e s t i g a t e d . The. study made by the. Committee on. the Care o f t h e Aged was used f o r background as were two other s t u d i e s made.by the w r i t e r i n order t o determine where o l d people i n one. area, o f the c i t y were l i v i n g . Supplementary m a t e r i a l was o f course drawn from, r e f e r e n c e r e a d i n g . The study i n c l u d e s chapters on g e n e r a l f a c i l i t i e s o f f e r e d i n . b o a r d i n g homes, on bedroom and bathroom f a c i l i -t i e s a_nd on the s e r v i n g o f meals . The use o f l e i s u r e t ime was c o n s i d e r e d t o be v i t a l l y i m p o r t a n t . Perhaps .the most s i g n i f i c a n t f a c t o r i n s u c c e s s f u l o p e r a t i o n o f a: b o a r d i n g home i s the p e r s o n a l r e l a t i o n s h i p s i n v o l v e d . A very d e l i b e r a t e e f f o r t was made to keep c o n c l u -s i o n s and recommendations, a t a p r a c t i c a l l e v e l . I t was r e -c o g n i z e d t h a t p r i v a t e rooms and a comprehensive, w e l l - p l a n -ned r e c r e a t i o n program are d e s i r a b l e , but no such sweeping changes from the present accommodations were even suggested. The l i c e n s i n g system has had a major r o l e i n r a i s i n g s t a n d -a r d s and improving p r a c t i s e s , and w i l l cont inue t o do so i n the f u t u r e . One inescapable c o n c l u s i o n i s t h a t there i s a. s e r i o u s shortage o f board ing homes, f o r o l d p e o p l e , as w e l l as; of a l l other types o f accommodation geared f o r t h e i r needs . No attempt has been made i n the present survey to a s s e s s the extent o f t h i s shortage nor t o propose how or by whom the shortage c o u l d be r e c t i f i e d . I t i s hoped o n l y t h a t t h i s study might be. h e l p f u l to persons who are d e a l i n g d i r e c t l y w i t h b o a r d i n g homes f o r the aged. / PART I SETTING OF THE. PROBLEM Chapter I THE GROWING FROBT.F.MS OF THE AGED The t r a d i t i o n a l p i c t u r e o f the aged person s i t t i n g i n the chimney c o r n e r , the pampered and venerated p a t r i a r c h or m a t r i a r c h , t o whom c h i l d r e n and g r a n d c h i l d r e n look f o r k i n d l y g u i d a n c e , may never have been a t r u e p i c t u r e save f o r a f o r t u n a t e few. There i s perhaps s t i l l a p o p u l a r c o n -c e p t i o n - o r m i s c o n c e p t i o n - t h a t o l d age i s the time when the work o f a l i f e t i m e i s g r a t e f u l l y l a i d a s i d e f o r a c o n -t e n t e d l e i s u r e which i s t o l a s t f o r the r e s t o f one ' s l i f e . Browning ' s t o o - o f t e n - q u o t e d f i r s t l i n e s o f Rabbi Ben E z r a r i n g f a l s e l y i n the ears o f anyone who has v i s i t e d o l d p e o -p l e i n t h e i r d e s o l a t e rooms or watched the o l d men d u l l y w a i t i n g f o r the day t o pass on benches i n V i c t o r y Square o r on the ateps o f the P u b l i c L i b r a r y * P o p u l a t i o n t r e n d s The focus of t h i s s tudy i s on the s o c i a l aspec ts i n v o l v e d i n p r o v i d i n g b o a r d i n g home care f o r aged p e r s o n s , b u t t h i s f o c u s would be a l t o g e t h e r t o o narrow i f the g e n e r a l s i t u a t i o n which faces the aged today were not f i r s t c o n s i d e r -e d . I t i s o n l y too t r u e t h a t , w h i l e the numbers o f o l d peo-p l e i n the p o p u l a t i o n are i n c r e a s i n g every y e a r , there i s l e s s p l a c e f o r them t h a n ever b e f o r e i n a s o c i a l and i n d u s -t r i a l system which p l a c e s a premium on y o u t h . On the o ther hand w i t h s h o r t e r hours and y e a r s o f l a b o u r , b e t t e r l i v i n g c o n d i t i o n s than i n former t i m e s , and m e d i c a l and s c i e n t i f i c advances p r o l o n g i n g l i f e , we can look forward t o many more -1-y e a r s o f l i v i n g t h a n ever b e f o r e . I t i s s t r i k i n g t o c o n s i d e r the i n c r e a s e i n average l i f e expentancy over the c e n t u r i e s , and p a r t i c u l a r l y over the l a s t c e n t u r y which has seen the g r e a t e s t i n c r e a s e . I n the days o f the s Roman Empire one c o u l d hope t o l i v e on ly t o t w e n t y - t h r e e y e a r s , w h i l e i n a n c i e n t Greece the average age a t death was twenty-n ine years f i v e months. By 1800 i n M a s s a c h u s e t t s , people were d y i n g a t the average age o f t h i r t r t y - f i v e y e a r s ; by 1850, a t f o r t y y e a r s ; and by 1890, a t f o r t y -three y e a r s . I n 1935 i n the U n i t e d S t a t e s a man c o u l d ex -p e c t t o l i v e u n t i l he was f i f t y - n i n e y e a r s f o u r months, and a woman u n t i l she was s i x t y - t w o y e a r s n ine months, and the most r e c e n t f i g u r e g i v e n f o r average l i f e expectancy i n B r i t i s h Columbia (based on 1947 s t a t i s t i c s ) was a l i t t l e over s i x t y - t h r e e y e a r s . Every year t h e n , a s l i g h t l y h i g h e r p r o p o r t i o n o f the p o p u l a t i o n i s r e a c h i n g o l d age, l i v i n g p a s t t h e i r p r o d u c t i v e y e a r s i n t o the t ime when, unable t o work , they must depend upon savings or investments f o r t h e i r l i v e l i h o o d - i f they are f o r t u n a t e - o r e l s e are dependent upon t h e i r c h i l d r e n , p r i v a t e c h a r i t y , or p u b l i c f u n d s . Some of the l e s s o p t i m i s t i c o f the s o c i o l o g i s t s , i n s t u d y i n g p o p u l a t i o n t r e n d s , have g l o o m i l y p r e d i c t e d t h a t i f i the present t r e n d c o n t i n u e s i n another q u a r t e r c e n t u r y o r so one h a l f o f the p o p u l a t i o n w i l l be w o r k i n g t o support the o ther h a l f , u n l e s s employment p r a c t i c e s r e g a r d i n g the o l d e r workers are d r a s t i c a l l y changed* The problem o f f i n a n c i a l support f o r the aged would appear t o be f a r e a s i e r o f s o l u t i o n than such p r e s s i n g p r o b -- 2 -lems as where and w i t h whom, i n t h i s e r a o f apartments and bungalows i n urban &&eas, the o l d people w i l l l i v e , and how, where and by whom c h r o n i c care w i l l be s u p p l i e d f o r the i n -f i r m b i d p e o p l e . A r e c e n t es t imate p l a c e d the number o f p e r -sons over 65 y e a r s i n the U n i t e d S t a t e s a t 5 .4 per cent o f the t o t a l p o p u l a t i o n , and s t a t e d t h a t almost c e r t a i n l y by 1980 t h i s would have i n c r e a s e d tp 14.3 per cent o f the t o t a l p o p u l a t i o n aged s i x t y - f i v e or o v e r . I n round numbers t h i s means t h a t p r o b a b l y c l o s e t o n i n e m i l l i o n people i n the U n i t e d S t a t e s w i l l have reached what i s a lmost u n i v e r s a l l y regarded as b e i n g o l d age. I t seems v a l i d t o assume t h a t the p o p u l a -t i o n t r e n d s i n the next t h i r t y y e a r s i n Canada w i l l f o l l o w c l o s e l y those i n . the U n i t e d S t a t e s , s ince the c o n d i t i o n s i n these two c o u n t r i e s are as s i m i l a r as they a r e . The a n n u a l r e p o r t on o l d age pensions f o r 1347 showed t h a t o f the t o t a l p o p u l a t i o n o f Canada 4 . 5 p e r c e n t , or approarimately f i v e h u n -d r e d thousand p e r s o n s , are over seventy y e a r s o f age; 7 p e r c e n t , or a p p r o x i m a t e l y e i g h t hundred and f i f t y thousand p e r -sons , are over s i x t y - f i v e y e a r s ; and 11 per c e n t , o r about one m i l l i o n , three hundred and t e n thousand p e r s o n s , are over s i x t y y e a r s of age . I t cannot be d e n i e d , t h e r e f o r e , t h a t such a l a r g e group of the p o p u l a t i o n should be c o n s i d e r e d and planned f o r , so t h a t t h e i r s p e c i a l needs may be served ade-q u a t e l y and s e n s i b l y . Pressures on the- Aged The aged are sub jec ted t o p r e s s u r e s t h a t have p e r -haps always f a c e d the o l d , b u t which c e r t a i n l y have been a c u t e l y r e i n f o r c e d i n the l a s t c e n t u r y . F a r more people t h a n a t the t ime of C o n f e d e r a t i o n , and a g r e a t m a j o r i t y o f the c i t y d w e l l e r s , now earn a l i v i n g i n the form of a wage-p a i d j o b , and the l i v i n g s tops when w o r k . s t o p s ; whereas i n former d a y s , when the f a m i l y income came from work on the l a n d or i n the home, w i t h f a i l i n g p h y s i c a l powers the income d e c l i n e d but d i d not s t o p . As the o l d e r g e n e r a t i o n became unable t o c a r r y on , the next g e n e r a t i o n took over c o n t r o l o f the f a m i l y i n d u s t r y and c o n t i n u e d t o support the o l d p e r s o n , who was now e n j o y i n g the l e i s u r e he had earned by h i s l i f e -t ime o f t o i l . I n t o d a y ' s h i g h l y u r b a n i z e d s o c i e t y , w i t h s m a l l e r f a m i l y u n i t s l i v i n g i n s m a l l e r homes, and f a m i l i e s w i d e l y separated because o f the ease o f t r a n s p o r t a t i o n and the m o b i l i t y o f l a b o u r , i t i s fcather the e x c e p t i o n t h a n the r u l e t h a t the o l d person has a secure home t o r e t i r e t o when h i s income ends w i t h the end of h i s work ing d a y s . S o c i a l Pressures Aa the numbers o f o l d people have been i n c r e a s i n g , t h e i r g e n e r a l p o s i t i o n i n l a t e r l i f e has been becoming l e s s and l e s s s e c u r e . An ever -growing p r o p o r t i o n o f the w o r k i n g p o p u l a t i o n has been f i n d i n g employment i n h i g h l y o r g a n i z e d i n d u s t r i e s , away from the r u r a l areas where the arrangements and perhaps pace o f l i f e w i l l be b e t t e r geared t o t h e i r a b i l i -t i e s when they r e a c h o l d age. Mechanized i n d u s t r y wears out workers a t a g r e a t e r speed t o d a y , and d i s c a r d s them when they are no longer a b l e t o keep u p . There i s a sudden stoppage o f work as e a r l y as f o r t y y e a r s i n some c a s e s , and too o f t e n the person ae l e t out because o f age i s f o r c e d t o o b t a i n a l e s s a t t r a c t i v e job a t lower wages, i f , i n d e e d , he i s ab le - 4 -t o o b t a i n work a t a l l . The mere t a s k o f meeting day t o day needs w i l l t a k e a l l h i s energ ies and he i s unable t o make adequate p r o v i s i o n f o r l a t e r y e a r s . Some i n d u s t r i e s are b e -g i n n i n g t o take the v iew t h a t the wear ing out o f l a b o u r i s as much a charge on i n d u s t r y as i s the d e p r e c i a t i o n o f p l a n t and machinery, and as a r e s u l t are r e t r a i n i n g o l d e r workers f o r a change of work b e t t e r adapted t o t h e i r lowered p h y s i c a l s t r e n g t h and c o o r d i n a t i o n . The " l a i s s e z - f a i r e " a t t i t u d e i s s t i l l t o be met w i t h i n some u n e n l i g h t e n e d q u a r t e r s . T h i s a t t i t u d e h o l d s t h a t the i n d i v i d u a l who f i n d s h i m s e l f d e s t i -t u t e i n h i s o l d age i s a t f a u l t ; those who work h a r d and are not w a s t e f u l can m a i n t a i n t h e i r independence, and they l o s e t h e i r independence on ly through p e r s o n a l inadequac ies or through s h i f t l e s s n e s s and w a s t e f u l n e s s . The r e c o g n i t i o n t h a t the c a p a c i t y to save depends upon one ' s income d u r i n g w o r k i n g l i f e , and t h a t the incomes o f many are inadequate f o r proper p r o v i s i o n f o r h e a l t h , o l d age and o ther normal economic r i s k s , i s more i n keeping w i t h the f a c t s and w i t h the c u r r e n t a c -ceptance o f n B e v e r i d g e " - t y p e p l a n n i n g . The a d o p t i o n o f o l d age pensions i n most o f the more modern c o u n t r i e s t e s t i f i e s t o the f a c t . t h a t the o b l i g a -; t i o n o f the S ta te t o p r o v i d e a t l e a s t minimum maintenance t o I t s c i t i z e n s i s s l o w l y b e i n g r e c o g n i z e d , a l t h o u g h i t has taken more than f o r t y y e a r s f o r the o b l i g a t i o n t o be brought up t o date i n some c o u n t r i e s . Canada only came i n t o l i n e i n 1927, and t h a t o n l y p a r t i a l l y s i n c e there I s s t i l l a stigma a t t a c h e d t o h a v i n g t o accept such maintenance, expressed through pens ions b e i n g based on need as determined by a - 5 -means t e s t , o l d age i n s u r a n c e , toward which the r e c i p i e n t has c o n t r i b u t e d through p a y r o l l or o ther d e d u c t i o n s , comes t o the person when he reaches the r e q u i r e d age , and c a r r i e s w i t h i t no i m p l i c a t i o n o f h i s inadequacy t o be s e l f - m a i n t a i n -i n g . The va lue Canadian s o c i e t y p l a c e s on independence, p a r -t i c u l a r l y f i n a n c i a l independence, means t h a t f o r many the a c t o f a p p l y i n g f o r p e n s i o n i s an admiss ion o f p e r s o n a l f a i l u r e . Y e t the s o c i a l s t r u c t u r e and g e n e r a l income l e v e l i s such t h a t f o r a g r e a t number o f people such independence i s impos-s i b l e . Even where a man has been ab le t o work u n t i l a f a i r l y advanced age, i f he has r a i s e d a f a m i l y he w i l l have had l i t -t l e o p p o r t u n i t y t o accumulate s a v i n g s . The same i n d u s t r i a l i -z a t i o n which tends t o d e p r i v e him of h i s l i v e l i h o o d a t any time a f t e r he has reached middle age , has developed a p r o -g r e s s i v e l y h i g h e r s tandard of l i v i n g so t h a t wages never r e a l -l y s t r e t c h f a r enough. I n a d d i t i o n the worker i s dependent upon the s h i f t i n g economic f o r t u n e s o f the whole c o u n t r y t o a f a r g r e a t e r ex tent than he was even f i f t y y e a r s ago. P e r -s o n a l d i s a s t e r s such as i l l n e s s or d e a t h , can wipe out a l i f e t i m e s ' s s a v i n g s ; so can a n a t i o n a l d i s a s t e r such as severe or pro longed d e p r e s s i o n . The f a c t t h a t 35 .4 per cent o f a l l persons 70 or over i n Canada i n 1947 were i n r e c e i p t o f o l d age pens ions u n d e r l i n e s the i m p o s s i b i l i t y o f most persons i n . " a v e r a g e " c i rcumstances b e i n g ab le t o p r o v i d e f i n a n c i a l l y f o r th&t* o l d age . Fami ly P r e s s u r e s on the Aged A t the same time as the economic p o s i t i o n o f the 6-i n d i v i d u a l has been becoming such t h a t f i n a n c i a l l y i n d e p e n -dent o l d age i s d i f f i c u l t i f not i m p o s s i b l e o f achievement, . the way o f l i f e has been changing r a p i d l y , and, to a l a r g e ex tent e x c l u d i n g the o l d p e r s o n . As. the f a m i l y has changed from a " p r o d u c i n g r u r a l u n i t " w i t h a. p l a c e i n the f a m i l y 1 b u s i n e s s f o r every member, to a "consuming urban u n i t " there have been r a p i d and r a d i c a l changes i n . manners, d r e s s , and s o c i a l codes , as. w e l l as i n the more obvious matter o f hous-i n g . The s m a l l e r f a m i l i e s o f today are l i v i n g i n s m a l l houses or i n . s u i t e s where there i s q u i t e l i t e r a l l y no room f o r one or more o l d p e r s o n s . I f they are. crowded i n t o the home the d i f f e r e n c e s mentioned above, i n . manners, d e e s s , e t c . l e a d t o d i s s e n s i o n , even t o c h r o n i c h o s t i l i t y . There i s no l i m i t t o the p o s s i b l e reasons f o r c o n t e n t i o n between members o f the "present g e n e r a t i o n " and t h e i r parents where there i s overcrowding o f s m a l l q u a r t e r s , l a c k of p r i v a c y and constant t e n s i o n . Tak ing an o l d person i n t o the home today may w e l l mean d i s r u p t i o n i n t h a t home, y e t the f a c i l i t i e s to which the o l d person can t u r n i n the community are few and i n a d e -quate , and may leave no a l t e r n a t i v e to making room f o r h i m . Age b r i n g s w i t h i t many i l l s , too o f t e n i n c l u d i n g hardening o f the a t t i t u d e s , and the o l d person who does f i n d there i s a p l a c e f o r him i n one o f the homes .of h i s c h i l d r e n may be unable to accept the changing f a s h i n n s o f l i v i n g , and become a focus o f compla int and c r i t i c i s m . Youngsters are 1. T h i s te rminology i s used by E . R . Graves i n . h"is S o c i a l Prv^TPTTifi o f_the f a m i l y . ( L i p p i n c o t t , C h i c a g o , 1927) p.207 g i v e n a degree o f freedom today t h a t the grandmother or g r a n d f a t h e r might w e l l , i f they c l i n g t o the s tandards o f t h e i r own d a y , f e e l i s dangerous and f o o l h a r d y i n the e x -treme, and w i l l on ly l e a d t o the c h i l d r e n h a v i n g no t r a i n -i n g i n steady work-a-day h a b i t s * Women do not show the mod-e s t y o f an e a r l i e r day^, they c o m p l a i n , or they may f e e l t h a t men f a i l t o t r e a t them w i t h the r e s p e c t they d i d i n " " the ir d a y " . Many manners and customs t h a t are d i f f e r e n t , i n f a c t , can d i s t u r b anColder person who had l o s t h i s e l a s t i c i t y , and so l e a d t o c o m p l a i n t s and arguments. £ven where the o l d person I s accepted i n the home as a r e s p e c t e d guest there can be a g r e a t d e a l o f unhappiness , u n l e s s he or she i s g i v e n the o p p o r t u n i t y o f p a r t i c i p a t i n g i n the f a m i l y l i f e . The p r o t e s t touched on b r i e f l y above can o f t e n be due i n l a r g e measure t o a f e e l i n g o f u s e l e s s n e s s , o f not b e l o n g i n g , which i s b e i n g met by an a t t i t u d e t h a t says i n e f f e c t , " W e l l , I d o n ' t b e l o n g because t h i s i s such a w i c k e d , i n c o n s i d e r a t e age ( o r whatever o ther a d j e c t i v e s f i t the p a t t e r n o f the c o m p l a i n t s ) - my own day was a much f i n e r and b e t t e r one" . There i s no l o n g e r any r e a l n i c h e f o r h i m , or h e r . T h i s i s i n e f f e c t t r u e even o f the o l d person who i s b e i n g coddled and p r o t e c t e d by h i s c h i l d r e n , and kept from any a c t i v e share i n the b u s i n e s s o f l i v i n g . No one wants t o be s h e l v e d , even i n a k i n d and l o v i n g f a s h i o n , because he i s no l o n g e r young. I f the o l d person who s t i l l has a f a m i l y t o l i v e w i t h can be l o n e l y , d i s c o n t e n t e d and unhappy, how much more - 8 -u n f o r t u n a t e i s the o l d person who i s a l l a lone f o r one reason o r another- He may be unwanted by h i s c h i l d r e n and a c t u a l l y shoved out o f the f a m i l y group - even when n o m i n a l l y and p h y -s i c a l l y s t i l l a member of a household* He may never have had a f a m i l y . , or he may s u r v i v e the f a m i l y he once h a d . An o l d man or woman w i t h perhaps an inadequate income, and no p l a c e of h i s own anywhere, i n a w o r l d t h a t i s moving a t a f a s t pace and i s f u l l o f b e w i l d e r i n g gadgets and 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 to a d a p t , i s i n a p o s i t i o n o f the g r e a t e s t i n s e c u r i t y * - He heeds a maximum o f unders tanding from the people he meets and l i v e s w i t h , b u t too 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 and misunders tanding and impat ience i n a w o r l d t h a t has ceased t o need him or even t o want h i m . The Needs o f the Aged The needs o f o l d people are r e a l l y j u s t the needs o f a l l p e o p l e , w i t h some m o d i f i c a t i o n s t o a l l o w f o r t h e i r l essened s t r e n g t h and speed and sureness o f movement, and p o s s i b l y t h e i r decreased a b i l i t y t o a d j u s t and a d a p t . They need to f e e l wanted and u s e f u l , t o b e l o n g ; t h i s i s t r u e what-ever the r e a l i s t i c , p h y s i c a l s i t u a t i o n may happen t o b e . L i k e a l l o ther humans o f whatever age they heed a f f e c t i o n and r e -c o g n i t i o n . G i v e n e m o t i o n a l s e c u r i t y , they can do a p r e t t y f a i r j o b , on the whole , o f a d j u s t i n g themselves t o a l l k i n d s o f cramped and i n c o n v e n i e n t l i v i n g arrangements . On a more p r a c t i c a l l e v e l , the o l d person needs a t l e a s t a minimum of p h y s i c a l comfor t . and s e c u r i t y . He needs - 9 -the f i n a n c i a l s e c u r i t y and independence t h a t the p e n s i o n g i v e s h i m i f he has not accumulated means p r i v a t e l y . He w i l l f e e l b e t t e r about the p e n s i o n and more secure as a p e r -son , p r o b a b l y , i n the f u t u r e go lden age when h i e p e n s i o n w i l l come t o him a u t o m a t i c a l l y as a r i g h t w i t h no terms o f e l i g i -b i l i t y o ther t h a n t h a t o f age . Independence i s v e r y i m p o r -t a n t , and he should have the o p p o r t u n i t y to choose f o r h i m -s e l f where and how he w i l l l i v e , w i t h i n the r e a l i s t i c l i m i -t a t i o n s the environment imposes; t h i s must be f u r t h e r q u a l i -f i e d o f c o u r s e , wherever p e r s o n a l l i m i t a t i o n s due t o i l l n e s s and f a i l i n g f a c u l t i e s , because o f age , make i t necessary t o change an o l d p e r s o n ' s way o f l i f e a g a i n s t h i s own w i s h e s . But w h i l e he i s ab le t o do so the o l d person should p a r t i c i -pate i n p l a n s b e i n g made f o r h i m . The above are g e n e r a l i z e d needs. O l d people a l s o need l i v i n g accommodation planned t o t h e i r s p e c i f i c needs . There should be a l l k i n d s and degrees o f accommodation f o r them, from t h a t which i s s u i t a b l e f o r the spry and i n d e p e n -dent p e r s o n , through accommodation o f f e r i n g v a r y i n g degrees o f p r o t e c t i o n , t o t h a t des igned f o r the h e l p l e s s p e r s o n . I n p l a n n i n g f o r hous ing needs f o r the f u t u r e o l d people must not be f o r g o t t e n , s ince they r e p r e s e n t a r e l a t i v e l y l a r g e p r o p o r t i o n of the p o p u l a t i o n . I t should be remembered too i n p l a n n i n g t h a t no one type o f accommodati6n o f f e r s the s a t i s f a c t o r y answer t o a l l o l d p e o p l e ' s needs any more t h a n a l i m i t e d s t a n d a r d i z a t i o n o f hous ing would meet a l l the needs o f the g e n e r a l p o p u l a t i o n . They need a c h o i c e o f c o t -10-tages w i t h or w i t h o u t gardens , s u i t e s f o r s i n g l e and m a r r i e d p e r s o n s , b o a r d i n g or l i g h t - h o u s e k e e p i n g arrangements , a v a r i -ety o f homes and n u r s i n g homes. There have even been e x p e r -iments i n some c o u n t r i e s w i t h whole v i l l a g e s o f o l d p e o p l e , as w e l l as w i t h f o s t e r homes f o r o l d p e o p l e , and housekeeper s e r v i c e s w i t h i n t h e i r own homes. T h e i r needs are as v a r i o u s , and need a s v a r i e d answers , as those o f Bay other p o p u l a t i o n g r o u p , and reach a c c o r d i n g l y i n t o as many a r e a s o f l i f e . The o l d t h e r e f o r e , have the same needs f o r f o o d , s h e l t e r , comfor t s and emot iona l s a t i s f a c t i o n s t h a t o t h e r a d u l t s have , w i t h c e r t a i n handicaps such as are due t o f a i l -i n g s t r e n g t h and l a c k o f employment t o c o m p l i c a t e the b u s i -ness o f meeting t h e i r needs . Canada has a lmost one and a h a l f m i l l i o n persons s i x t y y e a r s and over t o whom the p r o b -lems t h a t come w i t h o l d age are v e r y r e a l . Many o f these aged persons are i n Vancouver and t h e r e f o r e the t a s k o f p l a n -n i n g f o r the aged i s a l o c a l as w e l l as a n a t i o n a l r e s p o n s i -b i l i t y . Vancouver i s growing r a p i d l y year by y e a r , and would i n the normal course o f events have a l a r g e number o f persons who can be c o n s i d e r e d t o be aged. I t has been a matter o f p o p u l a r knowledge t h a t many Canadians on r e a c h i n g r e t i r e m e n t age come t o the P a c i f i c Coast t o spend t h e i r r e -maining y e a r s , thereby s w e l l i n g the numbers o f aged persons out o f p r o p o r t i o n to the remainder o f the p o p u l a t i o n . W h i l e the imaginery p i c t u r e o f Vancouver and other B r i t i s h Columbia towns and c i t i e s b e i n g composed of f i f t y or more per cent o f -11-aged people i s somewhat exaggerated, n e v e r t h e l e s s the 1947 f i g u r e s r e l e a s e d by the O l d Age Pens ion Board g i v e support to the "common knowledge" t h a t people do r e t i r e to the c o a s t . As has been recorded e a r l i e r , 4 . 5 per cent o f Canada's t o t a l p o p u l a t i o n are seventy y e a r s of age or 61der . B r i t i s h Columbia has 5 . 1 per cent o f i t s p o p u l a t i o n seventy years or o v e r . More s i g n i f i c a n t l y s t i l l , 35 .4 per cent o f t h i s age group are on p e n s i o n i n B r i t i s h Columbia , w h i l e 40 per cent are on p e n s i o n i n a l l o f Canada. T h i s apparent d i s -crepancy i s probably e x p l a i n e d by the f a c t t h a t many persons upon r e t i r i n g seek the more moderate c l i m a t e found on the West c o a s t , and those w i t h independent means are more ab le t o make such a move than are those who must l o o k to the government f o r s u p p o r t . Vancouver has a more p r e s s i n g need to p l a n i n -t e l l i g e n t l y f o r o l d people than o ther c i t i e s s i n c e , as the f o l l o w i n g t a b l e demonstrates , Vancouver has a h i g h e r p r o -p o r t i o n o f o l d people i n i t s p o p u l a t i o n than have o ther Can-d i a n c i t i e s , p r o b a b l y w i t h the e x c e p t i o n o f V i c t o r i a , B r i t -i s h C o l u m b i a . 12 Table 1 PERCENTAGE OF POPULATION IN MAJOR AGE GROUPS 1940 C i t v 10-14.VTS.' 1 5 - 1 9 v r s . 2 0 - 4 4 v r s . ' 45 & over 1 Vancouver t 1 7 t 8 r 40 1 i 35 • M o n t r e a l • 25 • 9 42 1 24 1 Toronto • 19 1 8 t 41 ' 32 1 Winnipeg ' 18 1 9 43 r 30 1 Farm* I t o n 1 22 * 9 40 * 29 1 S e a t t l e r 16 • 7 t i 41 1 36 ' Rochester * 19 1 9 1 40 » 33 • L o u i s v i l l e 1 21 r 8 42 1 33 r A t l a n t a 1 21 1 9 47 1 23 1 Houston ' 21 1 8 50 1 21 1 Source : Economic background and popyifl^-fow growth , Vancouver Town P l a n n i n g Commission, O c t o -b e r , 1945, p . 2 5 . T h i s need f o r p l a n n i n g w i l l i n c r e a s e as t ime goes on i f p o p u l a t i o n t r e n d s f o l l o w the p a t t e r n s p r e d i c t e d by s o c i o l o g i s t s . C e r t a i n l y the make-up o f the p o p u l a t i o n o f the c i t y , i n age groups as w e l l as other such groups as e t h -n i c and o c c u p a t i o n g r o u p s , must be taken i n t o account i f h o u s i n g and o ther f a c i l i t i e s are t o be adequate i n k i n d as w e l l as i n numbers t o meet the meeds o f the c i t y ' s i n h a b i -t a n t s . •13-I t I s i m p o s s i b l e to be even a p p r o x i m a t e l y a c -c u r a t e i n e s t i m a t i n g the numbers o f the aged l i v i n g i n V a n -c o u v e r . C e r t a i n f i g u r e s do g i v e a rough e s t i m a t e . I n 1941, the y e a r o f the l a s t census , a p p r o x i m a t e l y 1 per cent o f Vancouver ' s p o p u l a t i o n had reached the age o f e i g h t y y e a r s or over - n e a r l y three thousand persons a t the p r e s e n t t ime i f t h i s percentage i s v a l i d . The r e c e n t f i g u r e s i s s u e d by the O l d Age P e n s i o n Board i n t h e i r annual r e p o r t show t h a t f i v e per cent o f Vancouver ' s c i t i z e n s are a t l e a s t seventy , and p r o b a b l y mose than double t h a t number are s i x t y and o v e r . That the matter o f p l a n n i n g f o r the aged i n C a n -ada i s one which i s becoming l a r g e r and w i l l cont inue t o do so i s g r a p h i c a l l y shown by the t a b l e below i n which the t o -t a l p o p u l a t i o n i n c r e a s e s f o r Canada are e s t i m a t e d , as w e l l as|"or the i n d i v i d u a l p r o v i n c e . Even a c a s u a l examinat ion o f these f i g u r e s shows t h a t the a c t u a l and f o r e c a s t i n c r e a s -es i n the numbers o f persons from s i x t y - f i v e y e a r s o f age o n , i s much h i g h e r p r o p o r t i o n a t e l y t h a n i s the i n c r e a s e i n the numbers o f the t o t a l p o p u l a t i o n . More c a r e f u l p e r u s a l o f the t a b l e w i l l f u r t h e r show t h a t B r i t i s h Columbia has a h i g h e r p r o p o r t i o n of aged persons t o the g e n e r a l p o p u l a -t i o n t h a n most other p r o v i n c e s , and t h a t h e r aged p o p u l a t i o n i s , and can be expected t o i n the f u t u r e , i n c r e a s i n g more r a p i d l y , i n p r o p o r t i o n , than i s t r u e f o r o ther p r o v i n c e s . - 14 -Table 11 FORECAST OF TOTAL POPULATION, NUMBER OF PERSONS AGED 65-69 , AND NUMBER OF PERSONS AGED 70 AND OVER, BY PROVINCES ( i n thousands) P r o v i n c e 1941 Census 1948 ( e s t . ) F o r e c a s t T o t a l 1 65-69 ' 70 p l u s T o t a l 1 65-69 1 70 p l u s 1 B . C . 818 ' 30 1 38 943 t i 40 ' 55 1 Man. 730 ' 19 1 27 362 i t i 25 ' 34 » Sask . 896 1 20 1 26 '• 891 i i 30 1 34 1 A l t a . 796 ' 19 1 23 ' 857 i t 27 1 32 ' O n t . 3 ,788 1 116 1 185 •4,051 i t i 137 1 216 ' Que. '3 ,332 • 7 1 i 105 •3,680 i i 83 1 124 1 P . E . I . N . S . 1 95 • 578 1 3. 1 i 1 ? r i 1 ? i 6 30 ' 95 • 636 t i i t t 4 18 1 6 i • 33 1 N . B . 457 ' 12 ' 20 ' 491 i 13 • 22 f Canada '11 ,490 ' 307 ' 460 "12,406 ! -1 t 377 1 556 1 Source ; P r o p o s a l s o f the Government o f Canada« Dominion-P r o v i n c i a l Conference on R e c o n s t r u c t i o n , A u g u s t , 1945. p 4 1 . Wi th these f a c t s i n m i n d , i t can be p o i n t e d out t h a t Vancouver e m p h a t i c a l l y needs i n t e l l i g e n t and f o r e s i g h t e d p l a n n i n g i n the f u t u r e . E x h a u s t i v e l o c a l p o p u l a t i o n surveys s h o u l d i n d i c a t e how many h o s p i t a l beds are needed f o r the c h r o n i c a l l y i l l o l d p e r s o n , how many b o a r d i n g homes are nec -e s s a r y t o adequate ly serve those who are s e m i - a c t i v e , and how -15 many homes o f v a r i o u s k i n d s are needed f o r the a c t i v e o l d p e o p l e * Modern knowledge o f p e r s o n a l and e m o t i o n a l needs as w e l l as o f a r c h i t e c t u r a l methods should be used t o g u i d e b u i l d e r s o f the f u t u r e . The o l d people have not had any r e a l l y i n t e l l i g e n t concern shown f o r t h e i r needs as a group o f the g e n e r a l p o p u l a t i o n * - 1 6 -Chapter I I CONCERN WITH THE AGED IN VANCOUVER As a background f o r the more s p e c i f i c d i s c u s s i o n o f the sub jec t o f t h i s s t u d y , i t w i l l be h e l p f u l t o rev iew some of the r e c e n t s t u d i e s on t h i s problem made w i t h i n the l a s t t h r e e y e a r s i n Vancouver- These w i l l serve t o make more g r a p h i c the s i t u a t i o n f a c i n g the aged i n Vancouver-Study o f the Committee on the Care o f the Aged The Committee on the Care o f the Aged f u n c t i o n s as a sub-committee of the F a m i l y D i v i s i o n o f the Wel fare C o u n c i l o f G r e a t e r Vancouver- I t i s composed o f i n t e r e s t e d persons from the v a r i o u s s o c i a l agencies i n the c i t y , f rom churches and other community b o d i e s such as the N a t i o n a l Em-ployment S e r v i c e . They began meeting i n 1943, and have grown to be an a c t i v e and e f f e c t i v e g r o u p . I n December, 1945 they submit ted a r e p o r t on a survey made by the Committee on the Care of the Aged i n Vancouver . The f i e l d was r e v i e w -ed by the members of t h i s committee, w i t h p a r t i c u l a r r e f e r r ence t o the l e g i s l a t i o n a p p l i c a b l e t o the aged, i t s e f f e c t i v e -n e s s , and the community f a c i l i t i e s then a v a i l a b l e t o Vancou^ v e r ' s s e n i o r c i t i z e n s . The study was made f o r the purpose o f c l a r i f y i n g the s i t u a t i o n o f the aged t o enable the Com-m i t t e e t o p l a n more i n t e l l i g e n t l y ; i t was t h e r e f o r e broad i n i t s coverage , but not v e r y e x h a u s t i v e . The Committee developed the survey under s i x g e n e r a l h e a d i n g s . These were;maintenance f o r the aged, care - 1 7 -and accommodation, h o u s i n g , m e d i c a l c a r e , o ther h e a l t h r e -q u i r e m e n t s , and r e c r e a t i o n a l f a c i l i t i e s . Under "Maintenance" , the Old Age Pensions A c t , the S o c i a l A s s i s t a n c e A c t , the War V e t e r a n s 1 Al lowance A c t , the P a r e n t s ' Maintenance A c t and the Residence and R e s p o n s i -b i l i t y A c t are reviewed b r i e f l y , w i t h a s h o r t summary of the method o f a d m i n i s t r a t i o n o f each A c t . The e l i g i b i l i t y r u l e s are o u t l i n e d i n each c a s e , and the amounts p a i d t o the r e -c i p i e n t s g i v e n . Supplementary s e r v i c e s p r o v i d e d i n each case" are named. A t the t ime the r e p o r t was made there had been s e v e r a l amendments t o some of the A c t s , p a r t i c u l a r l y t o the O l d Age Pens ions A c t , and a l s o s i g n i f i c a n t changes i n p o l i c y , a l l made w i t h the o b j e c t i v e o f a more generous i n t e r p r e t a t i o n of the p r o v i s i o n s of the a c t s . S ince t h a t t ime the terms of e l i g i b i l i t y f o r the O l d Age P e n s i o n have been l i b e r a l i z e d , p a r t i c u l a r l y w i t h r e g a r d to the r e s p o n s i b i l i t y o f c h i l d r e n f o r maintenance o f t h e i r p a r e n t s , and two i n c r e a s e s o f $5.00 each have been added t o the p e n s i o n . I n the second s e c t i o n d e a l i n g w i t h care and a c c -ommodation, the Qommittee d i v i d e s the types o f care needed i n -t o f o u r c a t e g o r i e s , i n order t o s i m p l i f y a c o m p l i c a t e d p r o b -l e m . They d e s c r i b e these groups as f o l l o w s -Am A c t i v e - These are the people capable o f d o i n g t h e i r own housekeeping, and otherwise l o o k i n g a f t e r them-s e l v e s i n reasonably convenient q u a r t e r s . B . S e m i - a c t i v e - People who are up and about , but unable t o per form household t a s k s such as keeping a room c l e a n and p r e p a r i n g meals . These persons r e q u i r e p r o t e c -t i o n and a c e r t a i n amount o f p e r s o n a l c a r e * C I n a c t i v e - These are i n c a p a c i t a t e d people u s u a l l y r e q u i r i n g n u r s i n g c a r e . D . S e n i l e - T h i s group r e q u i r e s c u s t o d i a l c a r e . I t i s worth w h i l e t o note b r i e f l y the accommoda-t i o n s a v a i l a b l e f o r these other g r o u p s . The s i t u a t i o n f a c i n g those who are a c t i v e , and whose g r e a t e s t need i s f o r what the Committee teemed " reasonab ly convenient q u a r t e r s " , i s v e r y s e r i o u s and w i l l be d i s c u s s e d i n some d e t a i l l a t e r * The s e m i - a c t i v e aged, the p r i n c i p a l concern o f the p r e s e n t s t u d y , are p r o t e c t e d by the W e l f a r e . I n s t i t u t i o n s L i c e n s i n g A c t which p r o v i d e s t h a t any person who uses h i s or her home f o r the care o f two or more: aged persons who are i n r e c e i p t of some form of s o c i a l a s s i s t a n c e , must secure a l i c e n s e under t h i s A c t , whether the s e r v i c e i s charged f o r or n o t . Large i n s t i t u t i o n s o f f e r i n g s i m i l a r care are a l s o s u b j e c t t o t h i s s u p e r v i s i o n . T h i s i n c l u d e s the Vancouver O l d P e o p l e ' s Home, now known as T a y l o r Manor, which can a c -commodate up t o f i t y men and seven women, ( d e s c r i b e d l a t e r ) . I t i s f i n a n c e d by the C i t y o f Vancouver , and admiss ions t o i t are made by the C i t y S o c i a l S e r v i c e Department. There i s a l s o a P r o v i n c i a l Home s i t u a t e d a t Kamloops which w i l l a c -commodate one hundred o l d men, who o b t a i n a d m i s s i o n through the Deputy P r o v i n c i a l S e c r e t a r y a t V i c t o r i a . W i t h i n Vancouver there are a l s o a t p r e s e n t more than t w e n t y - f i v e b o a r d i n g homes which come under the Wel fare I n s t i t u t i o n s L i c e n s i n g A c t and which have accommodation f o r something under f i v e hundred p e r s o n s . S ince these form the main s u b j e c t matter o f t h i s s t u d y , no more w i l l be s a i d of them h e r e , except t h a t they c a t e r p a r t i c u l a r l y t o o l d people 19-i n need of a somewhat p r o t e c t i v e environment and t h i s k i n d of accommodation i s not n e a r l y adequate enough, i n p o i n t o f numbers, to meet the need. For the most p a r t the p r o p r i e t o r s do not keep w a i t i n g l i s t s f o r they would soon become so l o n g as t o be q u i t e r i d i c u l o u s . Some of the people i n group C , i n a c t i v e persons who are i n c a p a c i t a t e d , r e q u i r i n g n u r s i n g c a r e , are accommo-dated i n the three u n i t s o f the P r o v i n c i a l I n f i r m a r y . They were e s t a b l i s h e d a f t e r 1937 t o p r o v i d e eare f o r approximate-l y f i v e hundred and twenty people who, b e i n g c h r o n i c a l l y i l l w i t h some b o d i l y d isease or i n f i r m i t y , do not r e q u i r e care or t reatment i n acute g e n e r a l h o s p i t a l o r are not l i k e l y t o b e n e f i t from i t . Both men and women are a d m i t t e d to the Marpole I n f i r m a r y , and most are bed c a s e s . A l l c o , near Haney, B . C , i s made up of a number of c a b i n s w i t h a c e n t r a l admins? i s t r a t i o n o f f i c e , and has room f o r e i g h t y men. Persons must be ambulatory t o be accepted h e r e . The t h i r d u n i t , Mount S t . Mary a t V i c t o r i a , B . C , admits b e d - r i d d e n men and women. F u r t h e r needs o f the b e d - r i d d e n are p a r t i a l l y met by p r i v a t e n u r s i n g homes, which are s u p e r v i s e d under the H o s p i t a l s A c t , which o f f e r care t o two or more bed p a t i e n t s . The matron must be a graduate nurse and must l i v e on the p r e -m i s e s . Each p a t i e n t must have a t l e a s t e i g h t hundred c u b i c f e e t o f a i r space. S ince these are p r i v a t e l y operated i n -s t i t u t i o n s the c o s t o f care i s se t by the owner, which p l a c e s i t beyond the means o f • persons on p e n s i o n s . The average charge has been approx imate ly $75.00 per month. There i s accommodation i n them f o r about f i v e hundred people i n - 2 0 -Vancouver , and much the same s i t u a t i o n o b t a i n s r e g a r d i n g the keeping of w a i t i n g l i s t s , as w i t h b o a r d i n g homes f o r s e m i -a c t i v e p e r s o n s . F i n a l l y , f o r the aged w i t h s p e c i a l d i s a b i l i t i e s r e q u i r i n g i n s t i t u t i o n a l care there i s the P r o v i n c i a l Home f o r the Aged a t P o r t C o q u i t l a m , which was b u i l t i n 1936. Regu-l a t i o n s s t a t e t h a t p a t i e n t s must be 70 y e a r s or over and " s u f -f e r i n g from p h y s i c a l a b n o r m a l i t i e s , s e n i l e dementia or o ther d i s a b l i n g c o n d i t i o n s as t o need i n s t i t u t i o n a l c a r e . " A p p l i -c a t i o n s f o r a d m i s s i o n must be s i g n e d by the p e r s o n or h i s agent and be accompanied by a c e r t i f i c a t e from h i s p h y s i c i a n , and i s then s u b j e c t t o the a p p r o v a l o f the Super in tendent o f the Home. P r o s p e c t i v e p a t i e n t s are sent t o Essondale P r o v i n -c i a l H o s p i t a l f o r e x a m i n a t i o n , and are then d i s c h a r g e d and sent on t o the Home f o r the A g e d . U s u a l l y they are s u f f e r -i n g from some degree o f s e n i l i t y * The charge a t the P r o v i n c i a l Home i s low enough t o be met comple te ly by p e n s i o n e r s , who are a l l o w e d $5.00 from t h e i r monthly cheques f o r p e r s o n a l s p e n d i n g . The home has been f u l l t o c a p a c i t y s i n c e i t was opened and there i s always a w a i t i n g l i s t . The w r i t e r has seen a number o f r e s i d e n t s i n p r i v a t e b o a r d i n g homes who have become s e n i l e s i n c e moving i n t o them, and who have had t o w a i t p e r i o d s up t o a y e a r be fore there was a bed f o r them i n t h i s one Home des igned t o meet t h e i r needs. Whi le i t I s an i n s t i t u t i o n , and n e c e s s a r i l y conducted as s u c h , c l o s e c o n t a c t w i t h f a m i l y i s encouraged and there are d a i l y v i s i t i n g hours from two t o f o u r p . m . As much i n d i v i d u a l a t t e n t i o n as i s p o s s i b l e i s -21 g i v e n the p a t i e n t s by the s t a f f , which i s s e l e c t e d as c a r e -f u l l y f o r t h e i r i n t e r e s t i n people as f o r t h e i r a b i l i t y t o do the work. A l l i n a l l , the s i t u a t i o n f a c i n g o l d people i n need o f p r o t e c t e d environments i s not too good. Whi le the q u a l i t y o f accommodation o f f e r e d i s o f a reasonably h i g h s t a n d a r d , and i n some cases e x c e l l e n t , there i s . not n e a r l y enough of i t . F a m i l i e s must go on c a r i n g f o r o l d people who need s p e c i a l care i n t h e i r own homes, f o r l a c k o f p r o p e r a c -commodation e lsewhere , and i n many cases t h i s i n v o l v e s a g r e a t d e a l o f inconvenience and s a c r i f i c e f o r c h i l d r e n and g r a n d c h i l d r e n . S o c i a l agencies. , p a r t i c u l a r l y the C i t y S o c i a l S e r v i c e Department, are keenly aware o f the numbers o f o l d people e k i n g out a drab e x i s t e n c e i n u n d e s i r a b l e s u r -r o u n d i n g s . Where c o n d i t i o n s d e t e r i o r a t e to the. p o i n t t h a t t h e o l d person l i v i n g a lone can no longer look a f t e r h i m -s e l f he must sometimes, be p l a c e d i n one or the o ther o f the a v a i l a b l e homes, w h i l e f a m i l i e s a re f o r c e d t o go on s t r u g g -l i n g w i t h s i t u a t i o n s they are s c a r c e l y equipped t o d e a l w i t h , because t h e r e a t l e a s t the person i s r e c e i v i n g ade-quate c a r e . There i s a t e r r i b l e d e a r t h o f apartments and l i g h t - h o u s e k e e p i n g rooms w i t h conveniences geared t o t h e needs o f e l d e r l y people and w:i th the p r o t e c t i o n of s u p e r v i -s i o n by i n t e r e s t e d p e o p l e . The A c t i v e Aged The f i r s t group l i s t e d by the Committee on the Care o f the Aged, the a c t i v e o l d people s t i l l a b l e t o l ook a f t e r themselves , came i n f o r s p e c i a l study by the Committee. -22-They face the hous ing shortage which i s so acute i n Vancouver , as i t i s e l sewhere , j u s t as do o ther groups i n the g e n e r a l p o p u l a t i o n , but w i t h a d d i t i o n a l h a n d i c a p s . One o f these i s t h a t f o r the most p a r t , whether on p e n s i o n or independent , the o l d people have v e r y l i m i t e d incomes and must t h e r e f o r e seek rooms a t a v e r y low r e n t a l . A g g r a v a t i n g t h i s i s the f a c t t h a t o l d people on the whole need, and l ook f o r , spe-c i a l i z e d types o f hous ing - they need t o be on the ground f l o o r or a t l e a s t not above the second f l o o r ; they need warm rooms; and i t i s d e s i r a b l e t h a t they be on the same f l o o r as a bathroom. O l d p e o p l e , moreover, are p a s t the peak o f t h e i r e n e r g i e s , and house h u n t i n g i n these days c a l l s f o r a lmost u n l i m i t e d energy and s t a m i n a . F i n a l l y , they face a p r e j u -d i c e on the p a r t o f 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 , t h a t i s perhaps on ly e q u a l l e d by the r e l u c t a n c e t o t a k e c h i l -d r e n . O l d people are l o o k e d upon as b e i n g u n d e s i r a b l e t e n -ante because of t h e i r need for_ e x t r a heat and o f t e n e x t r a s e r v i c e s i n keeping rooms c leaned and so o n . Other t e n a n t s o b j e c t t o them o f t e n because they are apt t o be " f u s s y " n e i g h -b o u r s who d i s l i k e n o i s e and a c t i v i t y . L a n d l o r d s are o f t e n annoyed because the o l d person i s p u t t e r i n g about the house a l l d a y . F i n a l l y , and t h i s i s a v e r y sound r e a s o n , t h e r e i s the danger t h a t the e l d e r l y tenant w i l l l a t e r become i n c a p a -c i t a t e d because o f advancing age and h e l p l e s s n e s s , and b e -come a s e r i o u s problem to the l a n d l o r d * I n order t o o b t a i n some i d e a as t o where o l d people - 2 3 -were l i v i n g , and where they would l i k e to l i v e , answers t o a q u e s t i o n n a i r e were o b t a i n e d from n i n e t y - f o u r o l d people p i c k e d a t random. They were i n t e r v i e w e d by v o l u n t e e r s . Spe-c i a l a t t e n t i o n was p a i d t o the k i n d o f h o u s i n g a t p r e s e n t occupied by each p e r s o n , and each was asked what h i s f i r s t p r e f e r e n c e would be i f there were enough hous ing a v a i l a b l e t o make some c h o i c e p o s s i b l e . S e v e n t y - e i g h t o f the people i n t e r v i e w e d were women, and only s i x t e e n were men. Seventy were w i t h o u t m a r i t a l p a r t n e r , and t w e n t y - f o u r were l i v i n g w i t h spouse . F o l l o w i n g i s the l i s t o f p l a c e s where the n i n e t y - f o u r were l i v i n g : A c t u a l Accommodation 1 No . o f persons Own home 1 12 Rented house ' 1 4 S u i t e 1 15 Housekeeping room 1 41 Boarding house • 11 L i v i n g w i t h r e l a t i v e s • 1 9 L i v i n g w i t h f r i e n d s 2 T o t a l 94 I n answer t o the q u e s t i o n about where they would l i k e t o l i v e , the f o l l o w i n g answers were g i v e n : P r e f e r r e d Accommodation N o . o f persons Housekeeping room 1 35 Cot tage • 30 Own house ' 9 C o - o p e r a t i v e house 1 5 W i t h r e l a t i v e s •' 2 S u i t e 1 Mo. r e p o r t ' 1 2 T o t a l 94 - 2 4 -A d e s i r e f o r p r i v a c y was the one t h i n g most s t r e s s e d by the o l d people i n t e r v i e w e d i n t h i s s u r v e y . T h e i r hopes were modest 5 but they each wanted above a l l a room o f t h e i r own. A warm comfortable xroom a t a low r e n t a l appears t o be the dream o f a l l dependent o l d p e o p l e , and i f a k i n d -l y l a n d l a d y c o u l d be thrown i n " i t would be near the I d e a l ? (p.13) The a c t u a l s i t u a t i o n i s t h a t most o l d people l i v i n g a lone l a c k most o f the conveniences they would ask f o r , and do need, and i n a d d i t i o n i n most cases the aged l o d g e r i s o n l y t o l e r a t e d . The Housing R e g i s t r y r e p o r t e d a t t h a t t ime t h a t there were as many as t w e n t y - f i v e a p p l i c a t i o n s per week f o r a s s i s t a n c e i n f i n d i n g rooms from persons who were judged to be seventy or o v e r . The l a r g e r p o r t i o n o f these a p p l i -c a n t s were women, who were more d i f f i c u l t t o p l a c e than were men of the same ages . Almost a l l r eques t s were f o r house-keeping rooms. From t h i s r e p o r t i t i s obvious t h a t t h e r e i s r e a l need f o r some p r o v i s i o n i n hous ing p l a n s t o meet the s p e c i a l requirements o f the aged. A sample survey o f f i f -teen hundred b i d age pens ioners served by Centre U n i t o f C i t y S o c i a l S e r v i c e Department a t t h a t t ime showed t h a t 72.6- per cent l i v e d i n s i n g l e rooms - a p p r o x i m a t e l y one thousand and n i n e t y p e r s o n s . These p a i d an average o f $10.00 p e r month r e n t (about o n e - t h i r d o f t h e i r t o t a l income) , some p a y i n g as h i g h as $15.00 or $18.00 a month. Study of the^Housing o f & S e l e c t e d Group A d i f f e r e n t k i n d of study was made i n F e b r u a r y , 1947, by the present w r i t e r , o f one hundred s e l e c t e d c a s e s . - 2 5 -I n t e r e s t was p a r t i c u l a r l y centred on the k i n d of hous ing o l d people complete ly dependent upon t h e i r pensions, were ab le t o o b t a i n . For t h i s reason only those, pens ioners l i v i n g en-t i r e l y alone and h a v i n g no supplementary incomes and h a v i n g no r e l a t i o n s whatever l i v i n g withinthe G r e a t e r Vancouver area were s e l e c t e d . The data were c o l l e c t e d from the r e c o r d s on f i l e i n the West U n i t o f f i c e of the C i t y S o c i a l S e r v i c e D e -1. partment . The f i r s t r e s u l t o f t h i s examinat ion o f records was the h i g h r a t i o o f o l d people l i v i n g e n t i r e l y a l o n e . I t i s shocking t o c o n s i d e r t h a t over t e n per cent o f the p e n -s i o n e r s l i v i n g i n . onfcof • the more favoured u n i t s are. w i t h o u t f a m i l y i n the c i t y and e n t i r e l y dependent upon t h e i r p e n -s i o n s . Moreover , t h i s figufce i s probably c o n s e r v a t i v e s ince wherever the r e c o r d was not c l e a r a s t o the p e n s i o n e r s ' s t a -t u s i n these r e s p e c t s , the r e c o r d was not u s e d . Based on. the o p i n i o n o f the C i t y v i s i t o r , t h i s sample hundred showed t h a t the hous ing occupied by e leven per cent was- o f e x c e l l e n t q u a l i t y , o f f e r i n g comfort and convenience t o the occupants . F i f t e e n p e r ' c e n t were l i v i n g i n what v i s i t o r s c o n s i d e r e d t o be good h o u s i n g . F o r t y - t w o per cent were i n hous ing o f o n l y f a i r q u a l i t y ; and t h i r t y -two per cent were i n hous ing c h a r a c t e r i z e d as p o o r . N e a r -l y t h r e e - q u a r t e r s , t h e r e f o r e , were i n hous ing t h a t f e l l be -low reasonably good s t a n d a r d s . I t must be p o i n t e d out t h a t 1. Almost n ine hundred and f i f t y r e c o r d s were examined t o c o l l e c t the r e q u i r e d hundred- they were taken a l p h a b e t -i c a l l y b e g i n n i n g w i t h "A" and working through t o some-where i n the , f G ! s " , so t h a t the sample can be assumed to be f a i r l y r e p r e s e n t a t i v e of West U n i t cases a t l e a s t . -26-a c i t y w o r k e r ' s d i a g n o s i s o f e x c e l l e n t , good, f a i r o r p o o r , i s not based on the l u x u r i o u s n e s s or beauty o f a room, b u t on the convenience and comfort and p e r h a p s , c h e e r f u l n e s s . They are q u i t e used t o e v a l u a t i n g threadbare but b r i g h t and comfortable surroundings as e x c e l l e n t : the d e s c r i p t i o n i n o ther words , may be i n t e r p r e t e d i n terms o f g e n e r a l " l i v a b i l i t y " o f the accommodation. D e t a i l e d account o f the houses i n which these peo-p l e l i v e d was a v a i l a b l e i n f o r t y - n i n e c a s e s . Three o f the worst had been condemned by c i t y o f f i c i a l s and were s c h e d -u l e d t o be d e m o l i s h e d . Other persons l i v e d i n o l d run-down rooming houses , some w i t h i m p r o v i s e d f a c i l i t i e s f o r l i g h t -housekeeping , some i n f a i r l y w e l l equipped rooms. Some few were i n houses of good s t a n d a r d . Four l i v e d i n t i n y c o t -t a g e s , two owning t h e s e , the o ther two r e n t e d * Of the t h i r t y - f o u r cases where the f l o o r they were l i v i n g on was r e p o r t e d , t e n were i n basement s u i t e s , another t e n on the second f l o o r , s i x were on the f i r s t f l o o r and e i g h t on the t h i r d f l o o r or i n a t t i c rooms. The r e l a t i o n s between the o l d people and the l a n d -l o r d s or o ther tenants were r e p o r t e d on i n over h a l f o f the c a s e s , a p p a r e n t l y wherever the degree o f these r e l a t i o n s seemed impor tant enough t o n o t e . A p p r o x i m a t e l y o n e - t h i r d o f the f i f t y - o d d r e p o r t e d had extremely f r i e n d l y c o n t a c t s w i t h o thers i n the house, l i t t l e k indnesses were exchanged and a g r e a t d e a l o f v i s i t i n g went o n . The remain ing two-t h i r d s were on v e r y bad terms w i t h o t h e r s i n the house and c o m p l a i n t s were p l e n t i f u l . -27-The hundred persons were spot ted on a map of the d i s t r i c t , and, as might be expec ted , were found to be l i v i n g i n the main i n the poorer hous ing areas below Broadway be -tween G r a n v i l l e and M a i n S t . , and between G r a n v i l l e and B u r r a r d S t . The few who were s c a t t e r e d through the b e t t e r d i s t r i c t s , when rechecked , were a l l found t o be p a y i n g h i g h -e r r e n t s ; i t f o l l o w s t h a t , s i n c e these were a l l persons w i t h no r e s o u r c e s a s i d e from the p e n s i o n , they were s a c r i f i c i n g d i e t f o r the advantages o f b e t t e r rooms i n more d e s i r a b l e d i s t r i c t s . The r e n t s p a i d are v e r y h i g h i n p r o p o r t i o n t o the income - alammingly h i g h i n a few c a s e s . The average r e n t o f the hundred persons was $9.30 per month. However, the e i g h t y - t w o p a y i n g s t r a i g h t cash f o r r e n t ( o m i t t i n g the home owners, and the f i v e , a l l men, who worked f o r t h e i r r e n t ) p a i d an average r e n t o f $10.77 per month. T h i s v a r i e d from the $2.00 p a i d by one o l d l a d y f o r a tumble-down shack, t o the $20.00 per month p a i d by two p e r s o n s . T h i r t y - s e v e n p a i d over $10 .00 , w h i l e n i n e t e e n p a i d $10.00, p e r month. More t h a n one r e c o r d showed t h a t p e n s i o n e r s had t o l d t h e i r v i s i -t o r s t h a t i n order t o save on f o o d they s tayed i n bed u n t i l noon , thus a v o i d i n g b r e a & f a s t , and there were numerous com-ments t o the e f f e c t t h a t a l l but one meal each day c o n s i s t e d o f bread and t e a . T h i s seems i n e v i t a b l e when one c o n s i d e r s t h a t s i x t y - t w o of t h i s sample group were p a y i n g w e l l over the o n e - f i f t h o f the income which i s g e n e r a l l y regarded as the maximum which should be used f o r r e n t . •28 The ages o f these p e o p l e , i t may be n o t e d , ranged f rom seventy t o n i n e t y - t w o y e a r s , w i t h an average o f s e v e n t y -s i x y e a r s nine months. A g r e a t many of them, (as w i l l be c l e a r l y shown by the f o l l o w i n g i n f o r m a t i o n ) had h e a l t h p r o b -lems t o add t o the d i f f i c u l t i e s o f d a i l y l i v i n g , and i t i s t o be remembered t h a t everyone o f them was l i v i n g a lone and had no r e l a t i v e s , even d i s t a n t r e l a t i v e s , i n Vancouver . W h i l e t h i r t y o f the o l d people were r e p o r t e d t o be i n good h e a l t h , and f o u r i n e x c e l l e n t h e a l t h . t e n (which i s t e n per cent ) were b l i n d ; two of these a l s o had d i a b e t e s , and one o f the b l i n d d i a b e t i c s was deaf i n a d d i t i o n . (The number o f b l i n d i n t h i s sample may be abnormal ly h i g h and i s perhaps w e l l over the average r a t i o o f p e n s i o n e r - p o p u l a t i o n ) S i x showed d e f i n i t e s i g n s o f s e n i l i t y , r e p o r t e d as b e i n g eccen-t r i c , q u e r e l o u s , s u f f e r i n g from l o s s o f memory, or b e i n g v e r y confused m e n t a l l y . Only f o u r r e p o r t e d h e a r t c o n d i t i o n s , one had had a s t r o k e ; three had h i g h b l o o d p r e s s u r e , which a f t e r a l l i s an a l l i e d c o n d i t i o n . Two s u f f e r e d from a r t h i r -t i s , two more from s w o l l e n f e e t and a n k l e s . One each had the f o l l o w i n g - eczema, c a n c e r , n e u r i t i s , c r i p p l e d l e g . I n a d d i -t i o n , e i g h t were s a i d t o be e i t h e r f r a i l or f e e b l e . N a t u r a l l y t h i s i s a l i m i t e d survey but one i s f o r c e d t o conclude t h a t i n view of the extreme d i f f i c u l t i e s o l d people meet when t r y i n g t o l i v e a lone under the p r e s e n t h o u s i n g c o n d i t i o n s , those who have found t h e i r way i n t o the t w e n t y - e i g h t or t h i r t y b o a r d i n g homes and r e s t homes i n the c i t y are f o r t u n a t e i n d e e d . They no l o n g e r are s t r u g g l i n g - 2 9 -on a l o n e , ( indeed u n f o r t u n a t e l y , many have g i v e n up d o i n g a n y t h i n g b u t w a i t f o r death) b u t they are assured o f three meals a day i n warm houses , and care f o r t h e i r needs whether they are w e l l or i l l . The same w r i t e r made a second l e s s d e t a i l e d s u r -vey i n May 1948, t o f i n d where pens ioners i n the same area are l i v i n g . I n t h i s i n s t a n c e the f i r s t thousand f i l e s o f O l d Age Pens ioners were examine* c o n s e c u t i v e l y , and a count made, under n ine c a t e g o r i e s , o f where the p e n s i o n e r s are making t h e i r homes. No a t t e n t i o n was g i v e n t o the q u a l i t y o f the accommodation or the amount o f comfort the p e n s i o n e r s e n j o y e d . The f o l l o w i n g page shows the t a b u l a t e d r e s u l t s o f t h i s c o u n t . I t must be remembered i n c o n s i d e r i n g the r e s u l t s shown i n t h i s t a b l e , t h a t , as i n the p r e v i o u s s u r v e y , the area under survey c o n s i s t s mainihy o f r e s i d e n t i a l s e c t i o n s . A s i m i l a r count a t the o ther U n i t O f f i c e s o f the C i t y S o c i a l S e r v i c e Department would show v e r y d i f f e r e n t r e s u l t s . Two hundred and e i g h t e e n o f the one thousand f i l e s examined a c t u a l l y represented two people each , s i n c e i n each case they were opened f o r a man and h i s w i f e . One hundred and twenty-two couples were b o t h i n r e c e i p t o f p e n -s i o n . Seventy-two m a r r i e d men were pensioned w h i l e t h e i r wives were n o t , and f o u r t e e n women were pensioned w h i l e t h e i r husbands were mot. Of these the m a j o r i t y are l i v i n g i n t h e i r own homes or i n r e n t e d houses or s u i t e s , w h i l e the r e m a i n i n g c o u p l e s ( f i f t y - f o u r ) l i v e i n the homes o f r e l a t i v e s . Almost e x a c t l y o n e - h a l f o f the f i l e s examined r e -- 3 9 -HOUSING AND FAMILY SITUATION OF AGED PERSONS (Sample o f 1000 S o c i a l A s s i s t a n c e cases . Vancouver } mid - 1948) Type o f Accommodation M a r r i e d Couples 1 S i n g l e Men 1 S i n g l e Women ' T o t a l 1 " •both on'husband on 1 n e n s i on 1 p e n s i o n •wife on 1 ' p e n s i o n ' a lone 1 r e l . ( a ) 1 a l o n e 1 r e l . ( a ) L i v i n g w i t h . r e l a t i v e s • 34 • 17 3 1 91 1 ' 356 501 (b)» I n own home ' 42 ' 30 1 9 1 3 1 5 1 4 ' 23 116 f Im r e n t e d house ' 16 1 8 1 .1 1 1 • 3 • 2 1 12 » 43 • Xn r e n t e d s u i t e • 23 1 14 • _ * 4 1 5 x 8 1 28 1 82 1 B o a r d i n g i n p r i v a t e house 1 1 • 1 1 1 3 r 4 1 10 1 6 73 r 25 t Room, l i g h t housekeeping 1 6 • 3 \ - \ 28 1 14 ' 31 ' 78 » 160 1 S i n g l e room, e a t i n g out I 5 1 ! 1 3 r 8 1 Xn b o a r d i n g home ! \ . \ 5 « 3 ' 8 1 23 1 39 1 Xn i n s t i t u t i o n « 1 _ t 1 1 8 1 3 1 14 1 26 1 T o t a l (c) 1 122 72 I i • 14 1 50 1 133 • 66 1 543 1000 1 S o u r c e : S p e c i a l t a b u l a t i o n f rom r e c o r d s o f C i t y S o c i a l S e r v i c e Department, West U n i t (Van-couver) . J u d g i n g f rom t h i s sample, couples c o n s t i t u t e about 40 p e r cent o f a l l c a s e s . (a) W i t h r e l a t i v e s i n Vancouver, (b) Of t h e s e , 65 were l i v i n g w i t h unmarried sons o r d a u g h t e r s , (c) The thousand cases comprised 1208 p e r s o n s , o f whom 1122 were p e n s i o n e r s : 213 (11 per cent) were unable t o c a r e f o r themselves , because o f f a i l i n g h e a l t h , h a n d i -c a p s , e t c . ( i n c l u d i n g 17 comple te ly b e d r i d d e n , 54 b l i n d ) . presented pensioners l i v i n g i n the homes of r e l a t i v e s . I t i s i n t e r e s t i n g that, of these, s i x t y - f i v e are making t h e i r homes with unmarried sons or daughters. One f i l e noted that two unmarried daughters cared f o r t h e i r aged mother, who had had both legs amputated, and who was also b l i n d . Eighteen of the o l d people l i v i n g with r e l a t i v e s were b l i n d . One i s i n c l i n e d , of course, to think of the o l d people who are able to l i v e with r e l a t i v e s as being fortunate indeed, since they are sheltered and cared f o r i n the bosoms of t h e i r f a m i l i e s . How many are i n fact, happy with t h e i r families could only be learned by a c a r e f u l and continuing study of a number of such si t u a t i o n s , done by a s k i l l e d person. Sixteen per cent of the f i l e s , examined showed old people l i v i n g i n light-housekeeping rooms. Over a t h i r d of these had no r e l a t i v e s l i v i n g i n Vancouver. Only t h i r t y - n i n e pensioners were found to be l i v i n g i n boarding homes f o r aged persons, less than four per cent of the pensioners wfeose f i l e s were seen. When t h i s point was mentioned to a worker from C i t y S o c i a l Service Department, i t was learned that a l l those pensioners whose pensions are supplemented to bring them up to the boarding-home rates, are given s o c i a l assistance f i l e s ; accordingly these are not included i n the survey under discussion. That the. thousand f i l e s represented eight hundred and ninety-four women, and only three hundred and twenty-four men only confirms popular knowledge that women outl i v e men. These figures, i n t e r e s t i n g as they are, must be applied only to a limited area of Vancouver. Another area, might - 3 2 -reasonably be expected t o show a preponderance o f men, w i t h the o v e r a l l f i g u r e f o r the c i t y i t s e l f l y i n g somewhere b e -tween the two. These surveys are a l l t h o u g h t - p r o v o k i n g , and p o i n t up the need f o r community p l a n n i n g f o r b i d p e o p l e , b u t they do not i n any r e a l sense measure the amounts and k i n d s o f accommodation needed. I t may be taken f o r g r a n t e d t h a t a g r e a t many more o f a v a r i e t y o f k i n d s o f h o u s i n g are necesr s a r y b e f o r e o l d people w i l l have- adequate cho iee o f homes s u i t e d t o t h e i r d e s i r e s and t h e i r s p e c i a l needs . Some a p -p r o x i m a t e l y accurate es t imate o f the need f o r boarding-home care might be a r r i v e d a t through r e l a t i v e l y l o n g - t e r m study o f a p p l i c a t i o n s made to a l l such homes i n the c i t y . I t i s j u s t i f i a b l e to say a t l e a s t t h a t n o t as ; many b o a r d i n g homes a s are needed are a v a i l a b l e . -33 Chapter 1X1 THE LICENSING AND SUPERVISION ""OP" BOARDING HOMES B r i t i s h Columbia i s the o n l y Canadian p r o v i n c e t h a t has c o d i f i e d i t s p r o v i s i o n s f o r l i c e n s i n g and s u p e r v i s -i o n o f Wel fare I n s t i t u t i o n s i n t o a s i n g l e p i e c e o f l e g i s l a -t i o n . A survey o f the l e g i s l a t i o n i n t h i s r e s p e c t i n the o t h e r p r o v i n c e s r e v e a l s t h a t p r o v i s i o n f o r l i c e n s i n g and i n s p e c t i o n i s v e r y s p o t t y , and machinery f o r enforcement i s i n a d e q u a t e . C h i l d r e n ' s homes are more o f t e n covered t h a n any other type o f home, w i t h such l e g i s l a t i o n as there i 6 i n c o r p o r a t e d i n t o a C h i l d Welfare A c t or P r o t e c t i o n o f C h i l -d r e n A c t * or some other comparable a c t . Where an i n s t i t u t i o n i s operated by the government i t i s covered by an a c t o f i t s own which guarantees s tandards f o r t h a t , p a r t i c u l a r home, w i t h -out g i v i n g any p r o t e c t i o n t o inmates i n other p r i v a t e l y o p e r -a t e d homes* A l b e r t a has passed an e n a b l i n g a c t making i t p o s -s i b l e f o r any m u n i c i p a l i t y or u n i o n o f two or more m u n i c i p a l -i t i e s t o se t up an i n s p e c t i o n and l i c e n s i n g b o d y . T h i s i s not compulsory upon the m u n i c i p a l i t i e s , and performance t h e r e -f o r e depends upon the s o c i a l t h i n k i n g and p r o b a b l y f i n a n c e s a v a i l a b l e i n the i n d i v i d u a l m u n i c i p a l i t i e s ; i t can mean t h a t w h i l e homes i n one area of the p r o v i n c e are r e q u i r e d t o meet s p e c i f i c s t a n d a r d s , s i m i l a r homes i n o ther areas are c o m p l e t e l y w i t h o u t s u p e r v i s i o n . None of the remain ing p r o -v i n c e s have gone even t h i s f a r i n r e c o g n i z i n g the need f o r •34-the s e t t i n g o f l e g a l s tandards o f care i n . b o a r d i n g homes, and proper enforcement o f them. The Wel fare I n s t i t u t i o n s L i c e n s i n g A c t B r i t i s h C o l u m b i a ' s A c t R e s p e c t i n g P r i v a t e Wel fare  I n s t i t u t i o n s was assented t o on December 1 0 t h , 1937. W e l -f a r e i n s t i t u t i o n " i s d e f i n e d so as t o i n c l u d e any k i n d of b u i l d i n g used as a board ing home f o r two or more c h i l d r e n , two or more pregnant women, two or more aged or i n f i r m p e r -sons , or f i f t e e n or more a b l e - b o d i e d unemployed. I n each case the phrase " w i t h or w i t h o u t charge" i s used i n the d e f i n i t i o n . P a r t (c) of the d e f i n i t i o n which r e l a t e s d i -r e c t l y t o the homes w i t h which t h i s study i s concerned, i s worthy of r e p r o d u c t i o n i n f u l l . "Wel fare i n s t i t u t i o n " means a b u i l d i n g or p a r t o f a b u i l d i n g , or a t e n t , or any other s t r u c -t u r e , conducted: or operated by any person and which i s used , i n whole or i n p a r t : ( c ) As a r e f u g e , s h e l t e r , poor house, i n f i r m a r y , nurs ing-home, boarding-home, or o ther i n s t i -t u t i o n t o serve d e s t i t u t e , d e f e c t i v e , d e l i n -q u e n t , or o ther u n d e r - p r i v i l e g e d p e r s o n s , where in f o o d and l o d g i n g are f u r n i s h e d , w i t h or w i t h o u t charge , f o r f i v e or more p e r s o n s , who, on account of age, i n f i r m i t y , p h y s i c a l o r mental d e f e c t , or o ther d i s a b i l i t y , a re unemployable and who are d e s t i t u t e or are i n r e c e i p t of o ld-age p e n s i o n , poor r e l i e f , o r some other form of p u b l i c a s s i s t a n c e g r a n t e d o n l y to persons who are d e s t i t u t e ? e x c e p t i n g any home mainta ined by a p e r s o n t o whom such inmates are r e l a t e d by b l o o d or m a r r i a g e . " T h i s s e c t i o n cas amended i n March 1943, by s t r i k -i n g out " f i v e " and s u b s t i t u t i n g " t w o " , so t h a t the s m a l l e r b o a r d i n g homes were brought under the A c t . The P r o v i n c i a l S e c r e t a r y i s charged w i t h the - 3 5 -a d m i n i s t r a t i o n o f t h i s A c t , which p r o v i d e s t h a t f o r the p u r -pose o f a d m i n i s t e r i n g and c a r r y i n g out the p r o v i s i o n s , a "Wel fare I n s t i t u t i o n s Board" o f not more than f i v e persons i s t o be a p p o i n t e d * One member o f the b o a r d , the S u p e r i n -tendent o f C h i l d Welfare i s named, and a second i s t o be a member of the P r o v i n c i a l Board o f H e a l t h . The three r e -main ing members are a l l members o f the C i v i l S e r v i c e o f B r i -t i s h C o l u m b i a . A l l members o f the. board serve w i t h o u t r e -m u n e r a t i o n , except f o r such expenses as are i n c u r r e d by them i n c a r r y i n g out t h e i r o f f i c i a l d u t i e s . S u p e r v i s i o n and i n s p e c t i o n under the A c t are c a r -r i e d out by a s t a f f o f f o u r , o f whom three are i n s p e c t o r s . . They are charged w i t h making an i n v e s t i g a t i o n o f , and a r e -p o r t t o the Board upon, every a p p l i c a t i o n f o r a l i c e n s e t o operate a w e l f a r e i n s t i t u t i o n , and a l s o w i t h annual i n s p e c -t i o n o f every w e l f a r e I n s t i t u t i o n i n the P r o v i n c e . Opera-t i o n o f a welfare^ i n s t i t u t i o n w i t h o u t l i c e n s e i s p r o h i b i t e d , s u b j e c t t o p e n a l t y of from $25.00 t o $300.00. Sub jec t t o these p r o v i s i o n s , the Board may i s s u e a l i c e n s e ' to any person t o conduct and operate a w e l f a r e i n -s t i t u t i o n i f i t i s s a t i s f i e d t h a t : (a) The a p p l i c a n t i s a f i t and proper person t o operate a w e l f a r e i n s t i t u t i o n . (b) The premises t o be used are i n a c l e a n and s a n i t a r y c o n d i t i o n and i n good r e p a i r and are reasonably secure a g a i n s t the hazard o f f i r e . ( c ) The a p p l i c a n t i s l i k e l y t o conduct and oper -ate a w e l f a r e i n s t i t u t i o n i n a manner t h a t w i l l not be d e t r i m e n t a l t o the w e l f a r e o f the inmates or t o the g e n e r a l p u b l i c i n t e r e s t . -36-The Board has the power t o c a n c e l the l i c e n s e I f the l i c e n s e e or any o f h i s employees v i o l a t e s any p r o v i s i o n s o f the A c t or the r e g u l a t i o n s , and can r e f u s e t o r e i s s u e a l i c e n s e u n t i l i t I s s a t i s f i e d t h a t he and h i s employees a r e l i k e l y t o abide by the s a i d p r o v i s i o n s , ^ v e r y l i c e n s e d w e l -f a r e i n s t i t u t i o n i s open a t a l l t imes t o v i s i t a t i o n and i n -s p e c t i o n by any member o f the Board or any a u t h o r i z e d r e p r e -s e n t a t i v e o f the B o a r d , and these r e p r e s e n t a t i v e s may a l s o examine a l l books and r e c o r d s , and enquire i n t o a l l mat te rs 1 . c o n c e r n i n g the i n s t i t u t i o n , i t s employees, and i t s inmates* Among the t h i n g s which the A c t f o r b i d s p r o p r i e t o r s o f i n s t i t u t i o n s t o do I s to b r i n g or encourage i n any way t o be b r o u g h t , persons from other p r o v i n c e s to en ter i n s t i t u -t i o n s h e r e , They cannot s o l i c i t funds from the p u b l i c w i t h -. out f i r s t i n f o r m i n g the Board i n w r i t i n g . The A c t does not a p p l y t o p r i v a t e i n s t i t u t i o n s which are covered by the H o s p i t a l A c t , n o r t o h o t e l s 60 l i c e n s e d by any m u n i c i p a l i -t y , nor t o homes operated by any d u l y i n c o r p o r a t e d S h i l d r e n ' s a i d s o c i e t y , nor t o any d e t e n t i o n home* W i t h r e g a r d t o the B o a r d ' s power t o make r e g u l a -t i o n s , the A c t s t a t e s t h a t : "The l i e u t e n a n t - G o v e r n o r i n C o u n c i l may make such r e g u l a t i o n s as he c o n s i d e r s necessary o r a d v i s a b l e f o r the purpose o f c a r r y i n g i n -t o e f f e c t the p r o v i s i o n s o f t h i s A c t a c c o r d -i n g t o t h e i r t ime i n t e n t and s u p p l y i n g any d e f i c i e n c y t h e r e i n . " 1 . The i n s p e c t o r s a l s o . h a v e f u l l r i g h t s , under the A c t , t o en ter and i n v e s t i g a t e any b u i l d i n g where i t i s suspected t h a t such b u i l d i n g i s b e i n g used as a w e l f a r e i n s t i t u t i o n . - 37 -Such power to make r e g u l a t i o n s i s extended t o cover the f o l -l o w i n g , w i t h o u t however, l i m i t i n g the g e n e r a l i t y of the c l a u s e s quoted above. (a) P r e s c r i b i n g the manner i n which l i c e n s e s s h a l l be a p p l i e d f o r , and the form and content o f such a p -p l i c a t i o n s . (b) P r e s c r i b i n g the fees, to be p a i d f o r such l i c e n s e s . ( c ) P r e s c r i b i n g the c o n d i t i o n s w i t h which any a p p l i c a n t f e r n a l i c e n s e must comply i n order to become e l i g i -b l e f o r a l i c e n s e . (d) P r e s c r i b i n g the conduct , management, appointments , and g e n e r a l s tandards of o p e r a t i o n t e be r e q u i r e d o f l i c e n s e d w e l f a r e i n s t i t u t i o n s . (e) P r e s c r i b i n g the keeping of r e c o r d s and the submis-s i o n of r e p o r t s t o the B o a r d . ( f ) G e n e r a l l y f o r the b e t t e r c a r r y i n g out of the p r o -v i s i o n s of t h i s A c t . The Board i s r e q u i r e d t o r e p o r t a n n u a l l y t o the P r o v i n c i a l S e c r e t a r y on the a d m i n i s t r a t i o n of the A c t , g i v -i n g such i n f o r m a t i o n as he s h a l l r e q u i r e . E v a l u a t i o n of the A c t C l e a r l y t h i s A c t c a r e f u l l y d e f i n e s the j u r i s d i c -t i o n of the powers of the l i c e n s i n g Board and i t s o f f i c e r s so t h a t they are a b l e to a c t e f f e c t i v e l y and so t h a t every type o f Wel fare I n s t i t u t i o n not covered by o ther s p e c i f i c a c t s i s covered h e r e . Having done t h i s , i t l eaves the w r i t i n g o f r e g u l a t i o n s which such i n s t i t u t i o n s must f o l l o w up t o the government department , so t h a t s tandards may be s e t , and r a i s e d , w i t h o u t the n e c e s s i t y o f g o i n g through the slow process o f b r i n g i n g each d e s i r a b l e change t o the l e g i s l a t u r e f o r i t s a p p r o v a l . The q u a l i t y o f a d m i n i s t r a --38-t i o n under such an A c t depends, o f c o u r s e , on the q u a l i t y o f the p e r s o n n e l who are a d m i n i s t e r i n g i t , and c o u l d c o n -c e i v a b l y r e s u l t i n a l l k i n d s of l a x i t y and abuses . The A c t i t s e l f p r o v i d e s a safeguard a g a i n s t t h i s by r e q u i r i n g t h a t the Super intendent o f N e g l e c t e d C h i l d r e n (now the S u p e r i n -tendent of C h i l d Wel fare ) and a s e n i o r o f f i c i a l o f the D e -partment of H e a l t h s i t on the B o a r d , a l o n g w i t h three o t h -e r s who are employed i n the C i v i l S e r v i c e . Such r e s p o n s i -b l e p e o p l e , i t can be assumed, w i l l see t o i t t h a t the r e g -u l a t i o n s under which l i c e n s i n g and s u p e r v i s i o n take p l a c e are sound and r e a s o n a b l e , and t h a t the p e r s o n n e l e x p l o y e d t o c a r r y out the a c t u a l work are competent, i n t e r e s t e d p e r -sons who w i l l t u r n i n a h i g h l e v e l o f per formance . Such an A c t guards men, women, and c h i l d r e n of * a l l ages , who must l i v e i n p r i v a t e w e l f a r e i n s t i t u t i o n s , a g a i n s t e x p l o i t a t i o n by the p r o p r i e t o r s , and guarantees a c e r t a i n minimum of p h y s i c a l care and c o m f o r t . I t enables the i n d i v i d u a l s who a d m i n i s t e r i t to enforce a good s t a n -d a r d now and work towards enforcement o f a h i g h e r s tandard i n the f u t u r e , w i t h o u t l i m i t i n g t h e i r power i n any way to p u t i n t o p r a c t i c e new and more p r o g r e s s i v e r e g u l a t i o n s . T h i s type o f A c t perhaps needs a h i g h e r q u a l i t y o f p e r s o n -n e l i n order t o be w e l l a d m i n i s t e r e d t h a n does an a c t o u t -l i n i n g a l l r e g u l a t i o n s s p e c i f i c a l l y , b u t g i v e n good p e r -s o n n e l , i t f r e e s them t o do a b e t t e r j o b . R e g u l a t i o n s Under the A c t The r e g u l a t i o n s Bet up under the Wel fare I n s t i -t u t i o n s L i c e n s i n g A c t c l e a r l y p l a c e more importance on -39 s t a n d a r d s and t h e i r i n s p e c t i o n than upon l i c e n s e f e e s . The f e e t o be p a i d f o r a l i c e n s e i s on ly $1 .00 , and there i s no fee f o r renewal o f l i c e n s e s . The a p p l i c a n t i s r e q u i r e d t o make a p p l i c a t i o n f o r a l i c e n s e t o the Board i n a p r e s c r i b e d f o r m , and every l i c e n s e e undertakes t o s e t up a book-keep-i n g system t h a t i s s a t i s f a c t o r y t o the C h i e f I n s p e c t o r . The r e g u l a t i o n s s t a t e t h a t "no a p p l i c a n t s h a l l be g r a n t e d a l i c e n s e who i s i n r e c e i p t o f p u b l i c r e l i e f " , and e l sewhere , t h a t "any l i c e n s e e i n r e c e i p t o f p u b l i c r e l i e f ( e x c l u d i n g h o s p i t a l or m e d i c a l r e l i e f ) s h a l l have h i s l i -cense r e s c i n d e d " . T h i s i s des igned as a p r o t e c t i o n a g a i n s t e x p l o i t a t i o n o f o l d people and other dependent g r o u p s , s i n c e i t i s the f e e l i n g o f the l i c e n s i n g a d m i n i s t r a t o r s t h a t the making of money should not be the p r i m a r y motive o f anyone who conducts a w e l f a r e i n s t i t u t i o n . E x c e p t i o n has been made t o t h i s c l a u s e i n one i n s t a n c e where the I n s p e c t o r and the Board f e l t the woman concerned was o f e x c e p t i o n a l l y f i n e c h a r a c t e r . The r e g u l a t i o n s f u r t h e r r e q u i r e t h a t each l i c e n -see must keep a w r i t t e n r e c o r d i n a book or c a r d index i n a form s a t i s f a c t o r y t o the C h i e f I n s p e c t o r and the r e c o r d should c o n t a i n the f o l l o w i n g i n f o r m a t i o n : the date o f a d -m i s s i o n , f u l l name, b i r t h date and b i r t h p l a c e , m a r i t a l s t a -t u s , the address from which he or she came, as w e l l as such other i n f o r m a t i o n as the source and amount o f m a i n -tenance and the f u l l name and address o f next o f k i n . A r e e o r d must a l s o be kept o f - d e p a r t u r e s , g i v i n g date o f -40-d i s c h a r g e , and the reason f o r l e a v i n g . The remaining r e g u l a t i o n s p e r t a i n to the l e n g t h o f time w i t h i n which a l i c e n s e e must r e p o r t a change o f h i s own or a manager's address t o the B o a r d , the date upon which the C h i e f I n s p e c t o r must make h i s annual r e p o r t , and one or two other r e g u l a t i o n s not r e l e v a n t to a w e l f a r e i n -s t i t u t i o n g i v i n g care t o the aged. The Process o f I s s u i n g a. L i c e n s e A sample r e p o r t on the l i c e n s i n g o f a home f o r oid people was prepared f o r p r e s e n t a t i o n a t the 1947 Conference o f the Canadian A s s o c i a t i o n o f S o c i a l Work by the A s s i s t a n t I n s p e c t o r , showing the s t e p s through which an a p p l i c a n t must go be fore b e i n g granted a l i c e n s e by the l i c e n s i n g B o a r d . C a r e f u l i n s p e c t i o n o f the proposed premises were made i n order t o a s c e r t a i n t h a t they were s u i t a b l e f o r accommodation f o r aged p e r s o n s . The a p p l i c a n t i n t h i s p a r t i c u l a r i n s t a n c e was a widow w i t h some means, and a p -peared t o be a p l e a s a n t , capable person of good r e p u t a t i o n . She r e d e c o r a t e d the. house , b e a r i n g i n mind the a d v i c e o f the i n s p e c t o r . A f t e r a p p r o v a l of the home i n w r i t i n g had been forwarded t o the i n s p e c t o r by the z o n i n g a u t h o r i t i e s , the f i r e warden, the b u i l d i n g i n s p e c t o r , the i n s p e c t o r v i s i t e d the home. J u d g i n g from the accommodation, i n c l u -d i n g the r e q u i r e d f i v e hundred c u b i c f e e t o f space per p e r -s o n , the c o o k i n g and d i n i n g f a c i l i t i e s , a n d the bathroom f a c i l i t i e s , the i n s p e c t o r ' s a d v i c e to the Board was t h a t the home c o u l d accommodate twelve aged p e r s o n s . On the -41 b a s i s o f the good accommodation and the f a v o u r a b l e i m p r e s -s i o n o f the a p p l i c a n t as a p e r s o n , a l i c e n s e was i s s u e d t o her f o r t h i s p u r p o s e . Reasons f o r r e f u s a l to L i c e n s e The Annual Reports o f the Welfare I n s t i t u t i o n s , l i c e n s i n g Board i n d i c a t e t h a t approx imate ly two a p p l i c a -t i o n s f o r l i c e n s i n g are r e c e i v e d f o r every l i c e n s e i s s u e d . A c t u a l l y n e a r l y f o u r i n v e s t i g a t i o n s o f new a p p l i c a t i o n s are made f o r each hewl icense i s s u e d s i n c e most o f the l i c e n s e s are r e n e w a l s . Most l i c e n s e s are r e f u s e d because the a p p l i c a n t does not appear t o those concerned t o be a f i t and proper person to operate an i n s t i t u t i o n . Some are r e f u s e d because o f u n s u i t a b l e accommodation f o r the purpose f o r which the l i c e n s e i s asked , and j u s t a few are r e f u s e d because the f i n a n c i a l s i t u a t i o n i s such t h a t there would be danger o f e x p l o i t a t i o n o f inmates , or o f the venture f a i l i n g because o f f i n a n c i a l i n s e c u r i t y . I n most cases the Inspec tor ' i s ab le t o g i v e the a p p l i c a n t a reasonable e x p l a n a t i o n f o r r e f u s a l on the grounds t h a t the accommodation i s u n s u i t a b l e , but where t h i s i s m a n i -f e s t l y i m p o s s i b l e , and the reason f o r r e f u s a l i s - b a s e d on p e r s o n a l i t y , the s i t u a t i o n must be handled w i t h u n d e r s t a n d -i n g and sympathy. I n such i n s t a n c e s a g r e a t d e a l of t ime i s o f t e n devoted t o h e l p i n g the a p p l i c a n t accept the f a c t t h a t he or she i s not s u i t e d to t h i s type o f work and should i n s t e a d t u r n t o some other f i e l d of endeavour. John J . G r i f f i n i n an a r t i c l e e n t i t l e d " S h e l -- 4 2 -1 t e r e d Care f o r the A g e d , " has o u t l i n e d the f a c t o r s t h a t h i s l o n g exper ience (as S u p e r v i s o r o f the Bureau of Old Age A s s i s t a n c e a t S o m e r v i l l e , Massachuset ts ) has shown are most i m p o r t a n t i n the l i c e n s i n g and s u p e r v i s i o n o f b o a r d i n g homes f o r the aged. The l e g i s l a t i o n c o n t r o l l i n g i t should be d e f i n i t e i n g i v i n g the power o f i n s p e c t i n g and e n f o r c i n g r e g u l a t i o n s , but should leave the s e t t i n g o f s tandards t o the a d m i n i s t r a t o r s . As a l r e a d y i n d i c a t e d , the B r i t i s h C o l -umbia l e g i s l a t i o n measures up w e l l i n t h i s r e g a r d . P h y s i -c a l s tandards should be h i g h , and c e r t a i n r e g u l a t i o n s as t o amount o f a i r space per p e r s o n , the numbers o f persons t o a bathroom, the p r o v i s i o n o f h a n d r a i l s on a l l s t a i r s , and many more, should be i n s i s t e d on as minimum s tandards i n a l l homes. The most important f a c t o r he f e l t to b e , however, t h a t the opera tor o f the home be a f i t and proper p e r s o n , and t h a t the l e g i s l a t i o n should i n c l u d e a c l a u s e e n a b l i n g the a d m i n i s t r a t o r s o f the A c t t o r e f u s e l i c e n s e t o a person who otherwise meets a l l requirements i f t h a t person does not seem t o possess the type of p e r s o n a l i t y t h a t would make f o r contented inmates i n the b o a r d i n g home. I t i s e v i d e n t t h a t t h i s o p i n i o n i s shared by the a d m i n i s -t r a t o r s charged w i t h c a r r y i n g out the terms of the Wel fare I n s t i t u t i o n s L i c e n s i n g A c t . I . G r i f f i n , John J . , " S h e l t e r e d Care o f the A g e d . " .Survey Midmonthly , Survey A s s o c i a t i o n , I n c . , E a s t S t r o u d s b u r g , P a . , December 1945, p.323 -43 A number o f the o l d p e o p l e 1 s b o a r d i n g homed now i n o p e r a t i o n do not meet the d e s i r e d s tandards s e t up by the l i c e n s i n g Board* These were homes t h a t were a l r e a d y i n e x i s t e n c e a t the t ime the A c t was p a s s e d . They have presented a s p e c i a l problem, s ince they p r o v i d e b a d l y need-ed accommodation, and, t o the o p e r a t o r s , they r e p r e s e n t a b i g investment i n t i m e , work and money. Therefore the I n -s p e c t o r s have worked w i t h these homes, endeavouring t o r a i s e s tandards s l o w l y where changes seemed necessary and p o s s i b l e . T h i s has i n v o l v e d a l o n g - t e r m e d u c a t i o n a l j ob f o r the i n s p e c t o r s , and a v e r y d i f f i c u l t one. !Hiat i t has been done w e l l i s i n d i c a t e d by the a p p r e c i a t i v e way i n w h i c h a l l the p r o p r i e t o r s o f homes, i n I n t e r v i e w s , spoke of the l i c e n s i n g p e r s o n n e l . The e d u c a t i o n a l work done by the i n s p e c t o r s i s not c o n f i n e d t o those o p e r a t o r s who are r u n n i n g homes e s -t a b l i s h e d b e f o r e the advent o f l i c e n s i n g and i n s p e c t i o n . Much i s done, and a g r e a t d e a l more needs t o be done, t o h e l p the opera tors o f homes t o a p p r e c i a t e the needs and c a p a b i l i t i e s o f the aged, and to h e l p them t o meet the f o r -mer and to h e l p develop the l a t t e r t o the f u l l . The v o l -ume of work a t present f a c i n g the s t a f f i s too g r e a t t o a l l o w f o r the i n t e n s i v e work w i t h i n d i v i d u a l s t h a t would probab ly be necessary t o h e l p o p e r a t o r s o f such homes g i v e the f i n e s t p o s s i b l e s e r v i c e t o the aged i n m a t e s . - 4 4 -PART I I THE BOARDING HOMES Chapter I V . SCOPE OF THE. STUDY Ehe Boarding Homes w i t h which t h i s s tudy i s c o n -c e r n e d , are those which o f f e r "room and b o a r d " t o o l d peo-p l e i n a r e l a t i v e l y p r o t e c t e d environment; t h i s s i m p l y means t h a t t h e i r meals are prepared f o r them and t h e i r q u a r t e r s cared f o r by o t h e r s , and there i s a matron or some r e s p o n s i b l e person i n the p o s i t i o n o f s u p e r v i s i n g them. Such b o a r d i n g homes are des igned o n l y f o r o l d p e o -p l e who are s t i l l ab le t o be up and about and t o look a f t e r t h e i r own p e r s o n a l needs, b u t who are no l o n g e r so a c t i v e o r so s t r o n g t h a t they can care f o r a l l t h e i r own p h y s i c a l needs i n an unprotec ted s e t t i n g . I t was f e l t by t h i s w r i -t e r a t the outse t t h a t o l d p e r s o n s ' needs would i n a l l p r o b a b i l i t y f a l l i n t o two broad g e n e r a l c a t e g o r i e s , the p h y s i c a l and the s o c i a l . The p h y s i c a l needs o f the aged are no d i f f e r e n t from the b a s i c needs o f a l l p e o p l e , f o r f o o d , s h e l t e r and c l o t h i n g . However, i t seems h i g h l y p r o -b a b l e t h a t , due t o the p h y s i c a l l i m i t a t i o n s and even d i s -a b i l i t i e s imposed on the i n d i v i d u a l by advancing age , some m o d i f i c a t i o n s i n the environment would be needed t o a f f o r d the h i g h e s t degree o f comfort t o the aged - m o d i f i c a t i o n s p o s s i b l y i n b u i l d i n g s t r u c t u r e , f u r n i t u r e , and f o o d , f o r i n s t a n c e • The term " s o c i a l needs" i s vague enough t o cover any phase o f a p e r s o n ' s l i f e , a n d , i n d e e d , the w r i t e r found - 4 5 -i t i m p o s s i b l e t o make a c l e a r d i v i s i o n between a p e r s o n ' s need f o r a good d i e t , , f o r example, and h i s need f o r p l e a s -ant surroundings a t h i s m e a l . The p h y s i c a l adjustments are o f g r e a t importance , and should not be m i n i m i z e d , but o f much g r e a t e r importance i s the atmosphere o f the home. The o l d p e r s o n , l i k e people o f a l l ages , needs warmth and acceptance , a f e e l i n g o f independence and a sense o f h i s own worth as an i n d i v i d u a l . He needs s e c u r i t y and s t a t u s j u s t as he d i d i n h i s youth and middle y e a r s * The f a c t t h a t he i s now l i v i n g i n a b o a r d i n g home i m p l i e s t h a t he has l o s t h i s c l o s e s t f a m i l y t i e s i n one way or a n o t h e r , and he i s no l o n g e r a t work a t a j o b , and has g i v e n u p , f o r whatever r e a s o n s , the t a s k o f c a r i n g f o r most o f h i s p e r s o n a l needs* The b o a r d i n g home has become t o a g r e a t -e r or l e s s e r degree (depending on the i n d i v i d u a l and h i s own c i rcumstances ) h i s home, and must o f f e r , i n p a r t o r I n whole , t o take the p l a c e f o r m e r l y occupied by f r i e n d s , f a m i l y , work, and other a c t i v i t i e s . I t was r e a l i z e d t h a t much more i n t e n s i v e s tudy would be necessary i f a v a l i d e v a l u a t i o n were t o be made o f how the b o a r d i n g homes which were surveyed are meet ing the s o c i a l and p e r s o n a l needs o f t h e i r r e s i d e n t s . How-e v e r , the content of the c o n v e r s a t i o n s o f the matrons w i t h the w r i t e r , and t h e i r observable behaviour when t a l k -i n g o f the o l d p e o p l e , c o u l d be expected t o g i v e some i n -d i c a t i o n o f t h e i r a t t i t u d e s towards the aged. The s tudy i s not in tended t o be a c r i t i c a l r e p o r t geared t o expos ing -46 f a u l t s and l a c k s i n e x i s t i n g homes. I t was c e r t a i n l y a l e a r n i n g process f o r the w r i t e r , who hoped t o l e a r n , f rom the p o s i t i v e elements found i n a number o f b o a r d i n g homes, what i s bo th d e s i r a b l e and p o s s i b l e i n any such home; n e g -a t i v e and unfavourable impress ions are used i n the study f o r what may be l e a r n e d from them t h a t might b e n e f i t gues ts i n o l d p e o p l e ' s homes. I t was f e l t t h a t a t t i t u d e s and r e -l a t i o n s h i p s w i t h i n the home can be c r i t i c a l f a c t o r s i n c r e a t i n g a happy or an unhappy environment f o r o l d p e o p l e , and the study a c c o r d i n g l y p a i d p a r t i c u l a r a t t e n t i o n t o the awareness o f the matrons t o these f a c t o r s . How many Aged need Boarding Home cage? Vancouver has about t h i r t y o l d p e o p l e ' s homes which o f f e r p r o t e c t e d care t o ambulatory o l d p e o p l e . These homes have beds f o r a p p r o x i m a t e l y f i v e hundred p e r s o n s , two-t h i r d s o f them men and the remain ing t h i r d f o r women. I n view, o f the f a c t t h a t a s u b s t a n t i a l p r o p o r t i o n o f o l d age p e n s i o n e r s i n the c i t y are e n t i r e l y w i t h o u t r e l a t i v e s l i v i n g w i t h i n G r e a t e r Vancouver , (as i n d i c a t e d i n the p r e c e d i n g chap-t e r ) i t i s obvious t h a t a number v a s t l y g r e a t e r than f i v e hundred c o u l d use b o a r d i n g home care w i t h advantage i f i t were a v a i l a b l e . There were no means by which even a r e a -sonably accurate es t imate c o u l d be obta ined o f the numbers o f aged persons who c o u l d p r o f i t by a b e a r d i n g home p l a c e -ment- and would accept such placement . Operators and matrons o f the homes i n e x i s t e n c e have found i t Imposs ib le t o keep w a i t i n g l i s t s because the l i s t s became so f a n t a s t i c a l l y - 4 7 -l o n g . One opera tor s a i d t h a t almost every day a p p l i c a n t s or t h e i r f r i e n d s came t o h i s home h o p i n g t o f i n d a vacancy . A rough and a d m i t t e d l y v e r y i n a c c u r a t e es t imate o f the number o f o l d people - aged s i x t y - f i v e y e a r s and over - who are l i v i n g a lone i n s i n g l e rooms might be reached by u s i n g the f i g u r e s a r r i v e d a t by the 1945 Survey o f the Committee on the Care o f the Aged . Of the Vancouver p o p u -l a t i o n , p r o b a b l y between t w e n t y - f o u r and t w e n t y - f i v e t h o u -sands are s i x t y - f i v e or o v e r . (Seven p e r c e n t o f the B r i t -i s h Columbia p o p u l a t i o n i s o f t h i s age group) The survey r e c o r d e d t h a t 72.6 p e r cent of a sample o f f i f t e e n hundred o l d age p e n s i o n e r s served by the Centre U n i t o f C i t y S o c i a l S e r v i c e Department were l i v i n g i n l i g h t - h o u s e k e e p i n g rooms. I f t h i s sample i s r e p r e s e n t a t i v e , then between seventeen and e i g h t e e n thousand persons o f s i x t y - f i v e and o v e r , are p r o b a b l y l i v i n g alone i n housekeeping rooms i n the c i t y . There i s no way of e s t i m a t i n g even v e r y r o u g h l y the num-b e r s o f persons o f t h a t age group who are l i v i n g w i t h fam-i l y or f r i e n d s , and f o r whom the b o a r d i n g home placement would be d e s i r a b l e . S o c i a l workers are v e r y much aware o f the s h o r t - / age o f such f a c i l i t i e s , as are a g r e a t many l a y people through t h e i r c o n t a c t s w i t h o l d people who are r e l a t i v e s or a c q u a i n t a n c e s . T h i s s tudy i s concerned not w i t h the problem of the extreme shortage o f b o a r d i n g homes, but w i t h the w e l f a r e aspec ts o f such homes, and s p e c i a l a t t e n t i o n w i l l be g i v e n i n the c h a p t e r s f o l l o w i n g t o such mat te rs as -48 p r o v i s i o n f o r p r i v a c y o f persons who must share rooms, and f a c i l i t i e s f o r r e c r e a t i o n w i t h i n b o a r d i n g homes. I t i s not out o f p l a c e however t o remark here t h a t a v a r i e t y o f k i n d s o f hous ing are needed now and f o r the f u t u r e f o r the aged members of the p o p u l a t i o n . C o t t a g e s , apartments f o r couples and s i n g l e p e r s o n s , c o o p e r a t i v e houses and b o a r d i n g homes a l l should have t h e i r p l a c e - and t h e i r pro-v i s i o n would not l i g h t e n g r e a t l y , the e x i s t i n g shortage of b o a r d i n g homes f o r the "second c a t e g o r y " o f the aged. P o p u l a t i o n o f the Homes V i s i t e d I t i s a v e r y s i g n i f i c a n t f a c t t h a t o n l y about o n e - t h i r d o f the f i v e hundred beds a v a i l a b l e i n Vancouver are f o r women, i n s p i t e o f the f a c t t h a t there are a t l e a s t as many women i n the o l d e r age range as there are men. I t was g e n e r a l l y agreed by the matrons, when they were q u e s -t i o n e d on t h i s preponderance o f accommodation o f f e r e d f o r men, t h a t the women l e f t a lone i n t h e i r o l d age are b e t t e r a b l e to l o o k a f t e r t h e i r own needs than are men, most o f whom have never l e a r n e d t o keep house and cook. P o s s i b l y , t o o , they thought , o l d e r women more o f t e n f i n d a p l a c e f o r themselves i n the homes o f c h i l d r e n than do o l d e r men who are not so l i k e l y t o be ab le t o h e l p w i t h the housekeeping and the care o f the c h i l d r e n . Some matrons expressed a p r e f e r e n c e f o r men guests who, they s a i d , are not as c r i -t i c a l o f s e r v i c e s i n a home, and are much l e s s l i k e l y t o q u a r r e l among themselves . A t l e a s t one matron f e l t t h a t aged women "poke and p r y " and f u s s c o n t i n u a l l y and are a l --49 ways " u n d e r f o o t ^ . However o ther matrons p r e f e r r e d women guests because they make l e s s work, are more s e l f - r e l i a n t , and on the whole much more p l e a s a n t and easy t o ge t a l o n g w i t h , t h a n are men. I t would appear t h e r e f o r e t h a t there i s more accommodation o f f e r e d f o r men than women because more of the i n d i v i d u a l matrons and o p e r a t o r s happen t o p r e -f e r h a v i n g male g u e s t s , r a t h e r than t h a t there i s a c t u a l l y g r e a t e r need f o r such accommodation f o r men. I t i s t o be f u r t h e r observed t h a t homes f o r o l d men o n l y are apt t o be r a t h e r p l a i n e r and l e s s p r e t e n t i o u s than are homes f o r o l d women, and p o s s i b l y the persons opening- such homes have f e l t t h a t women would not accept u n c r i t i c a l l y r a t h e r u n a t -t r a c t i v e s u r r o u n d i n g s , even though f a c i l i t i e s might be ex-c e l l e n t . A h i g h p r o p o r t i o n , p r o b a b l y w e l l over h a l f , o f the persons i n the b o a r d i n g homes are i n r e c e i p t o f s o c i a l a l l o w a n c e , o l d age p e n s i o n or o ther a s s i s t a n c e , and the C i t y S o c i a l S e r v i c e Department or t h e i r f a m i l i e s make up the d i f f e r e n c e between the board r a t e and t h e i r p e n s i o n r a t e . The remainder are supported by t h e i r own investments o r by t h e i r f a m i l i e s , or i n a v e r y few i n s t a n c e s , by f r i e n d s . The p o p u l a t i o n s o f the b o a r d i n g homes seem t o be drawn from a l l economic l e v e l s and from every v a r i e t y o f f a m i l y s i t u a t i o n . No two homes r e p o r t e d a n y t h i n g l i k e the same p r o p o r t i o n o f m a r r i e d , widowed and s i n g l e p e r s o n s , or persons w i t h , as a g a i n s t persons w i t h o u t , f a m i l y members s t i l l i n c o n t a c t w i t h them. Whereas, f o r i n s t a n c e , one home -50 w i t h twenty men l i v i n g i n i t r e p o r t e d t h a t w i t h oneeex-c e p t i o n a l l the inmates were; e i t h e r s i n g l e or had l o s t the m a r i t a l p a r t n e r and had no r e l a t i v e s i n t e r e s t e d i n . them, a second home s h e l t e r i n g t w e n t y - f i v e men r e p o r t e d t h a t n e a r l y a l l have some f a m i l y or r e l a t i v e s , l i v i n g i n o r near Vancouver w i t h whom contac t i s m a i n t a i n e d . I n t h e former home most o f the men were e x - l o g g e r s or l a -b o u r e r s , the m a j o r i t y on p e n s i o n ; i n the l a t t e r home over ha l f , a r e now i n . r e c e i p t o f p e n s i o n , but some i n -mates, had been profess ional fcnen or w h i t e - c o l l a r workers and a number have, p r i v a t e means. Standards, i n the two homes are. q u i t e s i m i l a r , but the board r a t e charged i n the second home i s c o n s i d e r a b l y lower than t h a t charged i n the f i r s t . S i m i l a r l y , one matron o f a home s e r v i n g f i f -teen women s a i d most of her guests are w i t h o u t l i v i n g r e -l a t i v e s , w h i l e a few have c h i l d r e n or others who h e l p t o support and who v i s i t them from t ime t o t i m e . A second matron of a home of s i m i l a r s i z e r e p o r t e d t h a t most o f h e r aged gues t s have, f a m i l i e s who have pushed the l a d i e s out o f t h e i r homes and l i v e s , and who grudge every penny and every moment of time or e f f o r t the o l d people c o s t them. These homes a g a i n have comparable s t a n d a r d s , w h i l e the second charges the h i g h e r board r a t e . Regarding, the make-up of the p o p u l a t i o n o f the b o a r d i n g homes, t h e n , i t i s on ly safe to say t h a t they come from a l l income l e v e l s and a l l k i n d s o f f a m i l y s i t u --51-a t i o n s . A good many of course are a lone i n the w o r l d , e i -t h e r because they have never m a r r i e d , or because f o r one reason or another spouses and other r e l a t i v e s are gone. Others have f a m i l i e s who cannot keep them a t home because o f p r a c t i c a l c o n s i d e r a t i o n s , or because of unhappy r e l a -t i o n s h i p s . T h i s much i s c e r t a i n , however, wherever the o l d people have come f r o m , and however much or l i t t l e they may now have i n money or i n r e l a t i o n s h i p s , they need t o f i n d s e c u r i t y , acceptance and u n d e r s t a n d i n g , and a chance t o l i v e t o the ex tent o f t h e i r c a p a c i t i e s , i n the b o a r d i n g home which has now become t h e i r home. Method of C o l l e c t i n g M a t e r i a l I n the course o f t h i s s t u d y , f i e l d t r i p s were made t o s i x t e e n o l d p e o p l e ' s homes. I n a l l b u t one home the w r i t e r was shown over the e n t i r e e s t a b l i s h m e n t , i n -c l u d i n g basements and a t t i c s , i f there were a n y o a t t i c s . These t o u r s o f i n s p e c t i o n were i n t e r e s t i n g and v a l u a b l e , b u t the most impor tant i n f o r m a t i o n was ga ined from i n t e r -v iews w i t h the matrons or owners o f the homes, w i t h some a d d i t i o n a l m a t e r i a l ob ta ined from i n t e r v i e w s w i t h inmates o f the homes. Appointments were made i n advance by t e l e -phone i n f i f t e e n i n s t a n c e s , w i t h some e x p l a n a t i o n b e i n g g i v e n of the study t h a t was b e i n g u n d e r t a k e n . ( 1 ) TT) ; " : Three homes so contac ted were not v i s i t e d because the ma-t r o n s were u n w i l l i n g to see the v i s i t o r ; one s a i d she c o u l d n o t p o s s i b l y spare the t i m e , the second c o u l d not be p e r -suaded she c o u l d g i v e any i n f o r m a t i o n the v i s i t o r c o u l d n ' t get by c a l l i n g the I n s p e c t o r and making i n q u i r i e s , and the t h i r d s a i d b l u n t l y t h a t she" wanted no one messing about i n h e r b o a r d i n g home\ 5 2 Each of the matrons expressed some degree o f i n -t e r e s t i n the s t u d y , some becoming q u i t e e n t h u s i a s t i c and eager not on ly t o g i v e the w r i t e r any h e l p they c o u l d , but a l s o t o ge t from her any sugges t ions ehe might, have , based on what she had seen i n o ther homes v i s i t e d . They a l l seemed t o grasp a t once t h a t the w r i t e r was there t o l e a r n f rom them, and not t o f e r r e t out mat ters f o r c r i t i c i s m or even f o r s p e c i a l p e a i s e . Four o f them - o n e - q u a r t e r o f the group - went out of t h e i r way t o ensure the w r i t e r an o p -p o r t u n i t y f o r f a i r l y l e n g t h y t a l k s w i t h a t . l e a s t a few o f the inmates . Two made the v i s i t an o c c a s i o n f o r t e a i n the l i v i n g r o o m w i t h a l l the g u e s t s , b e f o r e g i v i n g a p e r s o n -a l i n t e r v i e w . A t Soroptomist House a l l the l a d i e s had been t o l d o f the purpose o f the v i s i t and more than an hour was spent w i t h them, over a v e r y a t t r a c t i v e l u n c h , i n d i s c u s -s i n g v a r i o u s a s p e c t s o f b o a r d i n g homes f o r o l d p e o p l e . A number o f i n t e r e s t i n g and c o n s t r u c t i v e suggest ions were o f -f e r e d by the l a d i e s , who had o b v i o u s l y been t a l k i n g the mat ter over d u r i n g the p r e c e d i n g f o u r or f i v e d a y s . Of the remain ing homes i n the c i t y which have n o t been v i s i t e d , three were r u l e d out because, c a t e r i n g as they do t o s p e c i a l groups such as b l i n d persons or t u -b e r c u l a r p a t i e n t s , they present problems needing v e r y s p e -c i a l ad jus tments , and c o u l d not be c o n s i d e r e d t o be long t o the g e n e r a l group of homes o f f e r i n g b o a r d i n g care t o ambulatory o l d p e r s o n s . Two more were not v i s i t e d because o f the i l l n e s s o f the matrons, a l t h o u g h i n b o t h cases the -53 w r i t e r was i n v i t e d t o c a l l when the matron had r e c o v e r e d . Another was not v i s i t e d because, i n s p i t e o f a c a r e f u l check of the c o r r e c t address , and three separate at tempts to l o c a t e i t , the w r i t e r has t o date been unable t o f i n d i t * The remain ing three were not v i s i t e d because o f a com-b i n a t i o n o f d i s t a n c e , inc lement weather , and an a t t a c k o f i n f l u e n z a s u f f e r e d by the w r i t e r . The F a c t s Sought f o r the Study Before the f i e l d t r i p s t o the homes were made, a rough q u e s t i o n n a i r e was drawn up c o v e r i n g the i n f o r m a -t i o n the w r i t e r hoped t o o b t a i n on each t r i p , f o r h e r own guidance i n c a r r y i n g out the i n t e r v i e w s . M r s . Page, A s s i s -t a n t I n s p e c t o r o f the Wel fare I n s t i t u t i o n s 1 L i c e n s i n g O f -f i c e , gave extremely v a l u a b l e h e l p i n t h i s p r e l i m i n a r y work, a s w e l l as a t i n t e r v a l s throughout the y e a r whenever such h e l p was needed* E x p e r i m e n t a l v i s i t s were made t o the I c e l a n d i c O l d F o l k s 1 Home, w i t h the c o o p e r a t i o n o f the matron , M r s . Thompson, t o t e s t out the t e n t a t i v e q u e s t i o n o u t l i n e . These v i s i t s showed c l e a r l y t h a t i t would be necessary t o c o l l e c t a good deal more m a t e r i a l r e g a r d i n g the p h y s i c a l p l a n t t h a n had been a t f i r s t a n t i c i p a t e d i n v iew o f the h i g h s tandards r e q u i r e d by the l i c e n s i n g a c t and the e x c e l l e n t s u p e r v i s i o n g i v e n the homes. The f i n a l o u t l i n e o f q u e s t i o n s t o be used as a g u i d e i n the i n t e r v i e w s i n c l u d e d the f o l l o w i n g r a t h e r broad headings (1) The p h y s i c a l s e t - u p . - 5 4 -( 2 . ) The r o u t i n e and house r u l e s . (3) The inmates ; t h e i r ages , sex , c h a r a c t e r i s t i c s and background. ( (4.) R e c r e a t i o n and a c t i v i t i e s pursued by the inmates . (5) P e r s o n a l ad justments ; t o the r o u t i n e of the home, t o the other inmates , to the matron. (6) P a r t i c i p a t i o n of the o l d people, i n the conduct of the home. In . most i n s t a n c e s i t was unnecessary for the w r i t e r t o pose the q u e s t i o n s s ince the matrons demonstra-t e d t h e i r w i l l i n g n e s s t o h e l p by d i s c u s s i n g t h e i r own boarding, homes and the problems they meet i n them, and t h e i r Ideas, as to what f e a t u r e s they f e e l are most i m p o r -t a n t i n such homes, w i t h l i t t l e need f o r prompting or d i -r e c t i n g . The i n f o r m a t i o n so gathered covered a l l phases o f l i f e i n b o a r d i n g homes, and showed some d i f f e r e n c e s . ; . i n p o i n t s o f view on s p e c i f i c mat ters among p r o p r i e t o r s o f homes as to what o l d people want and need. However, s e v -e r a l p r i n c i p l e s emerged upon which t h e r e was g e n e r a l agreement amongst p r o p r i e t o r s , and a number o f i n t e r e s t i n g means o f m o d i f y i n g the environment to a d j u s t to the needs o f the aged were observed w h i c h were of g r e a t i n t e r e s t . - 5 5 -Chapter V GENERAL FACILITIES OF BOARDING HOMES The s i x t e e n homes v i s i t e d group n a t u r a l l y under f o u r c l a s s i f i c a t i o n s a c c o r d i n g t o the persons or groups op-e r a t i n g them. Two, the I c e l a n d i c O l d P e o p l e ' s Home and the J e w i s h O l d P e o p l e ' s Home, were opened by the r e s p e c t i v e n a t i o n a l groups which they are in tended s e r v e , and are sup-p o r t e d i n p a r t by the c o n t r i b u t i o n s from the g r o u p , and p a r t l y by payments made by the o l d p e o p l e , w i t h some a d d i -t i o n a l h e l p from the p r o v i n c i a l government. Three more are n o n - p r o f i t u n d e r t a k i n g s , two b e i n g s u b s i d i z e d by s e r v i c e c l u b s , and the t h i r d by the o p e r a t o r . T a y l o r Manor, s i t u -a t e d on Boundary Road, i s operated by the C i t y o f Vancouver , w i t h admiss ions a l l b e i n g made through the C i t y S o c i a l S e r -v i c e Department. F i n a l l y , the f o u r t h and by f a r the l a r g -e s t group o f homes, t e n i n a l l , are r u n by p r i v a t e i n d i v i -d u a l s on a b u s i n e s s b a s i s . The m a j o r i t y o f the homes accept persons on p e n -s i o n or s o c i a l a s s i s t a n c e , u s u a l l y under agreements w i t h the C i t y S o c i a l S e r v i c e Department. I n such cases the p e n s i o n cheque i s p a i d over t o the c i t y , w i t h a t e n per cent r e t u r n made t o the i n d i v i d u a l f o r spending money, and the C i t y pays the home the r a t e Which has been set by the C i t y S o c i a l S e r v i c e Department. A t present (1948) t h i s r a t e i s $55.00 p e r month, h a v i n g been r a i s e d t o t h i s amount d u r i n g the p a s t y e a r s i n r e c o g n i t i o n o f the i n c r e a s e d c o s t s o f food - 5 6 -and o ther o p e r a t i n g expenses. A few accept o n l y p r i v a t e p a t i e n t s , soine o f whom are on p e n s i o n s ; i n these cases the f a m i l y o f the p a t i e n t pays the d i f f e r e n c e between the p e n -s i o n and the board r a t e and s u p p l i e s a l l c l o t h i n g and other p e r s o n a l needs. M r s . F o w l e r ' s home, which i s r u n on a non-p r o f i t b a s i s , i s a lmost unique i n t h a t she charges h e r g u e s t s onjy$27.50 per month, which enables p e n s i o n e r s l i v i n g i n h e r home t o support themselves on t h e i r pens ions w i t h o u t r e f e r e n c e t o the C i t y department. The I c e l a n d i c O l d Peo-p l e ' s Home charges $30.00 per month except where a p e n s i o n e r i s i n r e c e i p t o f a p e n s i o n o f o n l y $30.00 , ( e . g . , i f he a p -p l i e d f o r h i s pens ion i n Manitoba t h i s i s the r a t e he r e -c e i v e s ) i n which case the charge i s $25 .00 . Because the w r i t e r was i n t e r e s t e d i n the mat ter o f p r o p e r t y se t t lements made t o homes by people on e n t e r i n g , she d i s c u s s e d t h i s w i t h most o f the matrons i n t e r v i e w e d . S e v e r a l had had some experience w i t h them a l t h o u g h o n l y one home i n Vancouver was mentioned as making such a se t t l ement o f p r o p e r t y compulsory. A second home has accepted s m a l l s e t t l e m e n t s where the r e s i d e n t has expressed a d e s i r e t o b e -queath h i s es ta te to the home, but t h i s I s r a r e l y done and o n l y a t the request o f the i n d i v i d u a l . Among the matrons who had had exper ience w i t h p r o p e r t y se t t l ements there seemed t o be g e n e r a l agreement on the e f f e c t these arrangements had on the r e s i d e n t s and the r e l a t i o n s h i p s i n the home. Where o l d people had been r e q u i r e d t o make over t h e i r a s s e t s to the p r o p r i e t o r s o f -57 a home, whether these were i n d i v i d u a l o r b o a r d s , the a r -rangements d i d have the advantage t h a t persons w i t h v e r y s m a l l e s t a t e s ensured themselves a comfortable home f o r the remainder of t h e i r l i v e s when they p o s s i b l y c o u l d not have done so outside?/ the home, tfnder such an arrangement a l s o they f e l t a c e r t a i n p r o p r i e t o r y i n t e r e s t i n the home. On the o ther hand there was always a r i s k t h a t someone who had concluded such an arrangement might f e e l t h a t he had done b a d l y , and even t h a t the persons i n charge of the home had been g u i l t y o f d i s h o n e s t y . The a c t o f s i g n i n g away one ' s p r o p e r t y i n t h i s manner, even though i n f a c t they r e -c e i v e a q u i d pro QUO, seemed t o reduce the person t o a d e -pendent p o s i t i o n , perhaps f o r the f i r s t t ime i n h i s l i f e , and c o u l d g i v e r i s e to a l l k i n d s o f resentment . Once the agreement had been made, the o l d person might w i t h some reason f e e l t h a t he was now i r r e v o c a b l y t r a p p e d and must spend the r e s t o f h i s days i n t h i s house , even i f he should l a t e r d e s i r e t o move out o f i t . F i n a l l y , such arrangements can be a cause o f much d i s s e n s i o n i n a home where someone who has s i g n e d over a l a r g e es ta te r e c e i v e s the same t r e a t -ment i n a l l r e s p e c t s as another person who has c o n t r i b u t e d l i t t l e i f a n y t h i n g to the a s s e t s o f the Board r u n n i n g the home. The more e q u i t a b l e k i n d o f arrangement by which i n -mates pay as they g o , whether the source o f t h e i r payment i s p r i v a t e or p u b l i c f u n d s , r e s u l t s i n e a s i e r and l e s s com-p l i c a t e d r e l a t i o n s between p r o p r i e t o r s and inmates , as w e l l as between inmates themselves . -58 The matrons whose o p i n i o n s were asked c o n c e r n -i n g , such arrangements w i t h inmates of b o a r d i n g homes a l l expressed the view t h a t the persons who pay t h e i r board by the month a t a se t r a t e r e t a i n a v a l u a b l e f e e l i n g o f independence, and are more ready t o make every e f f o r t t o a d j u s t t o the home and t o other persons i n i t . They do not f e e l , as do some who have s igned over p r o p e r t y , t h a t they need not bother t o do t h e i r p a r t i n h e l p i n g the home r u n smoothly s ince they cannot be asked t o move. One ma-t r o n w i t h a lmost twenty y e a r s o f exper ience i n b o a r d i n g and n u r s i n g home work s a i d t h a t o l d people are f a r too e a s i l y e x p l o i t e d , and are on ly p r o t e c t e d a g a i n s t e x p l o i t a t i o n i f t h e r e are c l e a r - c u t c o n t r a c t u a l arrangements. She f e l t t h a t w h i l e the a d m i n i s t r a t o r s o f the homes w h i c h accepted deeds o f p r o p e r t y from the o l d people g o i n g i n t o the homes, might be s c r u p u l o u s l y honest and i n p o i n t o f f a c t even g i v -i n g such o l d people "more than t h e i r money's w o r t h , " such t r a n s a c t i o n s c o u l d l e a d t o r e a l abuses i f f u t u r e a d m i n i s t r a -t o r s should happen not to be h o n e s t . She f u r t h e r f e l t t h a t t h e r e should a t no time be agreements by which inmates would w i l l t h e i r p r o p e r t y t o the b o a r d i n g home, f o r much the same if reasons t h a t they should not be r e q u i r e d to s i g n / o v e r on e n t e r i n g the home. Whatever arrangements might be concluded i n these r e s p e c t s should be done o n l y on the i n m a t e ' s own r e q u e s t . Opin ions on t h i s s u b j e c t were sought from s e v e r a l o p e r a t o r s and the consensus o f o p i n i o n was t h a t they f e l t -59 s t r o n g l y such arrangements o n l y c r e a t e problems w i t h the homes. Most have not d i r e c t l y had experience w i t h them, h u t they a l l agreed they p r e f e r r e d a month by month p a y -ment o f board a t an agreed r a t e s i n c e both inmate and o p -e r a t o r then know e x a c t l y where they s tand i n r e l a t i o n to one a n o t h e r . L o c a t i o n s of the Boarding Homes A l l but two of the homes v i s i t e d are w i t h i n a b l o c k or two of shopping c e n t r e s , and over h a l f are a l s o c l o s e t o p a r k s or beaches . Only one i s so f a r from bus or s t r e e t c a r r o u t e s t h a t the o l d people cannot e a s i l y r e a c h them. These facts - are important t o the happiness o f the o l d p e o p l e , a lmost a l l o f whom want t o ge t about a l i t t l e , to v i s i t f r i e n d s or f a m i l y , go to s t o r e s and perhaps movies , and spend q u i e t t imes i n p a r k s or on the beaches . They do not want to be c u t o f f ;from the a c t i v e l i f e o f the c i t y around them, and enjoy b e i n g ab le t o watch t r a f f i c and movement from the windows of t h e i r homes, as w e l l as g o i n g out on w a l k s , shopping t o u r s and v i s i t s . A c e n t r a l l y l o c a t e d b o a r d i n g home o f f e r s them b o t h the q u i e t s e c u r i t y of the home i t s e l f , and the op-p o r t u n i t y t o keep up some i n t e r e s t i n a f f a i r s o u t s i d e the home. T a y l o r Manor i s f a r t h e r from shopping and other f a c i l i t i e s than any other home, and t h i s appears t o have most to do w i t h the f a c t t h a t u n t i l q u i t e r e c e n t -l y i t has not been f u l l t o c a p a c i t y . I n compensation i t 60 has peasant , spac ious grounds , and anyone d e s i r i n g t o share i n gardening or c a r i n g f o r the grounds i s encouraged t o do so and may he g i v e n a plo& of h i s own i f he d e s i r e s . T h e i r own p r i v a t e park g i v e s the o l d people a chance to enjoy b e -i n g out of d o o r s , and a few. out -door games are s u p p l i e d t o g i v e them f u r t h e r i n t e r e s t s . S e v e r a l o ther homes, i n c l u d -i n g M r s . F o w l e r ' s and M r s . B a i l e y ' s , as w e l l as The K i n g ' s Daughters ' Res t Home have q u i t e apacious grounds . M r s . Fow-l e r ' s home seems to have the i d e a l l o c a t i o n f o r the o l d men w h o l l i v e t h e r e j s ince S t a n l e y P a r k , C o a l H a r b o u r , and the c e n t r a l p a r t of the c i t y are a l l w i t h i n w a l k i n g d i s t a n c e , and the r a t h e r heavy t r a f f i c p a s t the home I s always a source of i n t e r e s t t o the men. Other groups o f o l d people p r e f e r q u i e t e r l o c a t i o n s w i t h l i t t l e t r a f f i c p a s s i n g by, :^but a l l save the few who are r e c l u s e s by n a t u r e , w i s h t o l i v e w i t h i n easy reach of s t o r e s and p a r k s and other f a c i l i t i e s . S i z e o f the Homes The m a j o r i t y o f the homes have been conver ted t o the p r e s e n t use from f a m i l y homes. T a y l o r Manor, which can accommodate f i f t y - n i n e p e r s o n s , and The M a y f a i r N u r s i n g Home, w i t h room f o r f o r t y - t w o , are i n s t i t u t i o n s , a l t h o u g h o n l y T a y l o r Manor was o r i g i n a l l y b u i l t as one. Some o f the homes, f o r i n s t a n c e , the I c e l a n d i c and the J e w i s h homes, and some of the p r i v a t e homes, have l u x u r i o u s appointments , w i t h f i n e wood p a n e l l i n g , b e a u t i f u l s t a i r c a s e s and massive f i r e p l a c e s . O t h e r s , such as M r s . B a i l e y ' s and M r s . D e a l ' s , are q u i t e o r d i n a r y f a m i l y homes. M r s . F o w l e r ' s home appears •61-t o be v e r y o l d and r a t h e r r u n down aa a b u i l d i n g , a l t h o u g h i t o f f e r s comfortable q u a r t e r s to the inmates . C h e e r f u l surroundings t h a t g i v e adequate a t t e n t i o n t o p h y s i c a l com-f o r t can be achieved i n houses o f q u i t e u n p r e t e n t i o u s p r o -p o r t i o n s as w e l l as i n the l u x u r i o u s houses . A R e c e n t l y Opened Boarding Home I t w i l l perhaps be more r e w a r d i n g t o d e s c r i b e the f a c i l i t i e s i n three or f o u r homes than t o endeavor t o make g e n e r a l statements r e g a r d i n g f a c i l i t i e s i n a l l the homes v i s i t e d . The f i r s t one t o be d i s c u s s e d was opened d u r i n g the p a s t year by a n a t i o n a l group f o r i t s aged c i t -i z e n s , and was o f course r e q u i r e d t o meet the s tandards now demanded by the l i c e n s i n g body. T h i s home i s l o c a t e d i n the Shaughnessy d i s t r i c t c l o s e t o a s t r e e t - c a r l i n e . I t has a l a r g e lawn i n f r o n t and a two-car garage and roomy garden a t the back . The v e r -andah can be used by q u i t e a number o f persons d u r i n g the summer months. A. s m a l l park i s l o c a t e d one b lock , away and i t i s not more than f o u r b l o c k s t o one of the l a r g e s t o f the c i t y ' s shopping c e n t r e s . The house, w h i l e weatherbea-t e n , l o o k s a t t r a c t i v e from the o u t s i d e , and the l a r g e f r o n t door opens i n t o a b e a u t i f u l h a l l . The h a l l i s p a n e l l e d i n oak and the wide s t a i r c a s e has a r a i l i n g around three s i d e s o f i t on the second f l o o r , so t h a t there appears t o be a ba lcony a t t h a t l e v e l . The c o l o u r e d s k y l i g h t above the s t a i r s adds d i g n i t y t o the l a r g e h a l l . The h a l l opens i n -to a spac ious drawing room which i s v e r y comfor tab ly f u r -- 6 2 -n i s h e d and has a r a d i o and some books f o r the use o f the r e s i d e n t s . The f i r s t f l o o r a l s o has the matron 's q u a r t e r s , a b i g c h e e r f u l k i t c h e n , w e l l equipped, and the d i n i n g room where the o l d people take t h e i r meals . There i s a complete bathroom on t h i s f l o o r . The second f l o o r has f i v e rooms i n which s i x t e e n p e r s o n a are l i v i n g ; one room has two, a marr ied c o u p l e , s h a r -i n g i t , two rooms each have three persons i n them, and two more rooms have f o u r i n them. There a r e t h r e e complete bathrooms, i n c l u d i n g tubs and showers, on t h i s f l o o r . The t h i r d f l o o r has f i v e rooms a l s o , one of which i s occupied by the housekeeping s t a f f . One man has a s i n g l e room, two l i v e i n a second room, w i t h three i n each o f the r e m a i n i n g two rooms. There i s o n l y one b a t h on t h i s f l o o r , w i t h the t o i l e t s e p a r a t e , and the matron agrees there should be a t l e a s t another bathroom p l u s a second t o i l e t f o r the number o f persons on t h i s f l o o r . She agreed a l s o t h a t no home f o r the aged should have more t h a n two s t o r e y s . She t r i e s t o make sure those l i v i n g on the t h i r d f l o o r a r e the h e a l -t h i e s t and s p r y e s t i n . the home, but two f l i g h t s o f s t a i r s a r e h a r d on any aged p e r s o n . The rooms a r e a l l equipped w i t h s i n g l e beds f o r each p e r s o n , beds ide t a b l e s and bed lamps f o r each . U s u a l l y two share a d r e s s e r , but the women have a d r e s s i n g t a b l e o f t h e i r own. The c l o t h e s c l o s e t s a re a l l very roomy and have l i g h t s i n them so t h a t they can be - and are - used as d r e s -s i n g rooms, g i v i n g some p r i v a c y t o people who must share -63-t h e i r room w i t h one or more p e r s o n s . • The basement has one s i n g l e room f o r a man, and two men s h a r i n g a second room. These are much p l a i n e r and s i m p l e r rooms than those u p s t a i r s . There i s a l i b r a r y and s i t t i n g room i n the basement a l s o , not y e t p r o p e r l y f u r -n i s h e d . The l i b r a r y of the sponsor ing n a t i o n a l group has been moved i n t o t h i s room and i s a p o i n t of c o n t a c t f o r the members w i t h the community o u t s i d e the home. There i s a w e l l - e q u i p p e d l a u n d r y and i r o n i n g room where the l a u n d r y f o r the home i s done, and where inmates can do t h e i r p e r s o n a l washing i f they w i s h t o . There i s a complete bathroom and a second t o i l e t and wash b a s i n i n the basement* There i s a rough p a r t i a l l y equipped workshop i n the basement which the men are f r e e t o u s e . F i r e escapes from the second and t h i r d f l o o r s and a f i r e door i n the basement were b u i l t i n order t o meet l i c e n s i n g r e q u i r e m e n t s , and e x i t l i g h t s put above, the doors l e a d i n g to these escapes . The s t a i r s throughout the house, i n c l u d i n g those l e a d i n g down i n t o the basement, are b r o a d , r i s e g e n t l y , , and have new h a n d r a i l s where there were not a l r e a d y b a n n i s t e r s . The generous l i n e n s u p p l i e s and much o f the f u r n i t u r e were a c q u i r e d when the house, which was p r e v i o u s l y used a s a guest house, was purchased . The whole house i s w e l l l i t by l a r g e windows and by generous ly d i s -t r i b u t e d e l e c t r i c l i g h t s . An O l d e r E s t a b l i s h e d Boarding Home The second b o a r d i n g home t o be d e s c r i b e d i s v e r y -64-d i f f e r e n t i n t y p e . I t I s one which accepts both p r i v a t e and c i t y p a t i e n t s , a l l of whom must be ambulatory . The p o p u l a t i o n here i s mixed , s i n c e some come f o r a c o n v e l e s -c e n t p e r i o d f o l l o w i n g o p e r a t i o n s , and leave a g a i n a f t e r a s h o r t t i m e . O t h e r s , p a r t i c u l a r l y the o l d e r p e r s o n s , s tay i n the home f o r s e v e r a l y e a r s . The home i s a l a r g e , a t t r a c t i v e l o o k i n g b u i l d -i n g se t i n q u i t e e x t e n s i v e grounds which a d j o i n a p u b l i c p a r k . The verandah i s used by some f o r s i t t i n g out o f d o o r s , b u t the m a j o r i t y go out to the park or down t o the beach . A new bus route passes v e r y c l o s e by and makes, down town Vancouver a v a i l a b l e to the p a t i e n t s . The home accommodates about f o r t y persons ; the men's rooms are always f i l l e d and there i s a w a i t i n g l i s t f o r them, but there are f r e q u e n t l y v a c a n c i e s i n the Women's wards . The charge a t the time t h i s home was v i s i t e d was $45.00 per month, but an i n c r e a s e t o probab ly $55.00 was a n t i c i p a t e d . The main f l o o r has room f o r over twenty men, m most of whom are i n two rooms which a d j o i n one another and i n the day time are made one by opening the c u r t a i n e d French d o o r s . These rooms are w e l l l i g h t e d by l a r g e windows, but are bare and u n a t t r a c t i v e . Each room c o n t a i n s s i x or seven h o s p i t a l - s t y l e b e d s , s t r a i g h t wooden c h a i r s and beds ide t a -b l e s . There are two f u l l t i l e d bathrooms on t h i s f l o o r . The k i t c h e n i s w e l l - e q u i p p e d , i n c l u d i n g t r a y r a c k s which h o l d the i n d i v i d u a l t r a y s f o r each inmate . C l o s e t space - 6 5 -i s a lmost e n t i r e l y l a c k i n g . The matron expressed g r e a t r e -g r e t t h a t t h e r e i s no common room f o r the p a t i e n t s ' u s e , and f e e l s t h a t t h i s i s one of the most s e r i o u s l a c k s i n the home • The s t a i r s are wide and equipped w i t h both b a n -b i s t e r s and h a n d r a i l s . The rooms u p s t a i r s , occupied by the women p a t i e n t s , are more convenient and a t t r a c t i v e than are those on the main f l o o r . One room c o n t a i n s three b e d s , a n -o ther c o n t a i n s f o u r , and the r e m a i n i n g two have f i v e beds e a c h . These rooms are somewhat crowded, b u t have w i c k e r easy c h a i r s and more c o l o u r f u l d e c o r a t i o n , and t h e r e are more p e r s o n a l b e l o n g i n g s o f the p a t i e n t s i n e v i d e n c e . These rooms do not look a s much l i k e h o s p i t a l wards as do the d o w n s t a i r s rooms. There i s one f u l l bathroom and a separa te t o i l e t on t h i s f l o o r . The c l o s e t space i s more n e a r l y ade-quate . T h i s home has been i n o p e r a t i o n f o r a number o f y e a r s , and f a i l s to meet p r e s e n t l i c e n s i n g requirements i n many r e s p e c t s , but over the p a s t f o u r y e a r s some improve-ments have been made by the o p e r a t o r s . A Boarding Home f o r Men B o a r d i n g Home No. 3 i s s i t u a t e d c l o s e to the j u n c -t i o n of Broadway and G r a n v i l l e and accommodates f o u r t e e n men. L i k e the l a s t home d i s c u s s e d , i t i s operated by a p r i -v a t e f a m i l y on a p r o f i t b a s i s . • I t i s an o l d house, r a t h e r f a d e d - l o o k i n g from the o u t s i d e , b u t i n e x c e l l e n t r e p a i r . The grounds are s u f f i c i e n t l y l a r g e t o a l l o w the men adequate -66-room o u t - o f - d o o r s , and they almost l i v e on the lawn d u r i n g the summer months. The South G r a n v i l l e shopping c e n t r e i s v e r y c l o s e b y , and s e v e r a l s t r e e t car r o u t e s converge near b y . E i g h t of the rooms i n t h i s house are s i n g l e rooms, and three are double rooms. The house has b r i g h t l i n o l e u m , l a i d w a l l t o w a l l throughout , eo t h a t there i s a c l e a n w e l l - k e p t a i r about i t a l l . Each s i n g l e room has a c l o s e t , a s i n g l e b e d , and easy c h a i r and a. d r e s s e r , i n a d d i t i o n t o whatever p e r s o n a l f u r n i t u r e the person may have added. The double rooms have s i m i l a r f u r n i s h i n g s f o r each man, except t h a t one has a t a b l e shared by the two occupants . A l l are w e l l - l i t and cheery i n appearance. There are two f u l l b a t h s , one on each f l o o r , and the manager and h i s f a m i l y occupy a s u i t e on the main f l o o r . The k i t c h e n i s roomy and w e l l f i t t e d , w i t h b l o c k l i n o l e u m on the f l o o r and other a t t r a c t i v e h o m e - l i k e touches . There i s no common s i t t i n g room or d i n i n g i r o o m , but t h i s i s regarded by the manager as an advantage on the grounds t h a t i t e l i m i n a t e s many arguments! The rooms are comfor tab le and o f f e r p r i v a c y t o those who d e s i r e i t , w h i l e o t h e r s are f r e e t o v i s i t i n t h e i r rooms. They can d i n e a l o n e , or seek company by the s imple expedient o f c a r -r y i n g t h e i r d i n n e r t r a y s i n t o a f r i e n d ' s room. The men pay $45.00 per month i f they share a room, $55.00 f o r a s i n g l e room, and $60.00 f o r a s i n g l e room w i t h r u n n i n g w a t e r . A separate s i d e entrance f o r the -67 inmates g i v e s them a g r e a t e r measure o f p r i v a c y than the f r o n t entrance would d o . A Boarding Home f o r Women The f o u r t h i s a house operated as a b o a r d i n g home f o r women o n l y , by one of the s e r v i c e c l u b s . I t a l -so I s c e n t r a l l y l o c a t e d , c l o s e to the South G r a n v i l l e shop-p i n g d i s t r i c t . I t has a v e r y s m a l l y a r d which cannot be used a g r e a t d e a l by the inmates , but there i s q u i t e a roomy verandah where the l a d l e s take t h e i r c h a i r s i n the Bummer. F i f t e e n women and the matron occupy t h i s t h r e e -s t o r y b u i l d i n g . Though o l d , i t i s i n good r e p a i r , w i t h some r a t h e r f i n e p a n e l l i n g i n s i d e . The main f l o o r c o n t a i n s the matron ' s q u a r t e r s and two s i n g l e rooms i n a d d i t i o n t o the d i n i n g room and l i v i n g room, which are shared by a l l the occupants , and the s m a l l i s h , but convenient k i t c h e n . The second and t h i r d f l o o r s accommodate t h i r t e e n women i n one t r i p l e and f i v e double rooms. Only one bathroom serves both f l o o r s . The s e r v i c e c l u b p l a n s t o b u i l d a new home f o r about the same number of women, u s i n g t h e i r exper ience i n t h i s home t o guide them i n g i v i n g the most comfor tab le and s u i t a b l e a c -commodation t o t h e i r c l i e n t s . However, wartime b u i l d i n g r e s t r i c t i o n s made t h i s i m p o s s i b l e , and the p r e s e n t h i g h c o s t s o f c o n s t r u c t i o n are f u r t h e r d e l a y i n g the, new home. The f u r n i t u r e i n the bedrooms i s u t i l i t a r i a n b u t c o m f o r t a b l e , the beds b e i n g o f tube s t e e l , and the d r e s s e r s roomy. Each bed has I t s own bed l i g h t , and a l l - 6 8 -t h e women have brought i n some of t h e i r own f u r n i t u r e and numbers- of p e r s o n a l a r t i c l e s . The atmosphere of the b o a r d -i n g home i s extremely homelike and f r i e n d l y . These examples are s u f f i c i e n t t o g i v e some i d e a o f c o n d i t i o n s . I t i s i m p o s s i b l e t o g e n e r a l i z e on the types and q u a l i t i e s of accommodation o f f e r e d i n b o a r d i n g homes, s i n c e , as has been shown, the accommodation v a r i e s from t h a t o f f e r i n g the bare n e c e s s i t i e s f o r reasonable c o m f o r t , through q u i t e o r d i n a r y accommodation to t h a t w i t h a h i g h degree of l u x u r y . I n r e a l i t y there , are a number o f e l e -ments i n a b o a r d i n g home t h a t are more important t o the contentment of the guests t h a n the l u x u r y o f the a p p o i n t -ments . A home o f f e r i n g only a minimum of p h y s i c a l com-f o r t s can g i v e the gues t s a g r e a t d e a l more i n a c t u a l happiness than a b e a u t i f u l , p r e t e n t i o u s home m i g h t , i f M B needs as an i n d i v i d u a l are o v e r l o o k e d . I t i s v e r y important t h a t a minimum s tandard of accommodation be i n s i s t e d upon; and t h i s appearstfco be reasonably w e l l done i n B r i t i s h C o l u m b i a . S u i t a b l e hous-i n g forms the necessary background f o r the k i n d o f p r o -gram and a d a p t a t i o n s w i t h i n a b o a r d i n g home t h a t can g i v e an o l d person a sense o f b e l o n g i n g i n . a s e t t i n g t h a t i s s u i t a b l e f o r h i m . -69-Chapter V I TrerrannM AHD BATFmnQS FACILITIES Every b o a r d i n g home p r o v i d e s the o l d person w i t h a bed o f h i s own, some storage p l a c e o f h i s own, a c h a i r o f h i s own, and other b a s i c needs. I t i s v e r y u n f o r t u n a t e t h a t each e l d e r l y man or woman cannot have a room of h i s or her own, and t h a t there; are not enough rooms f o r m a r r i e d c o u p l e s t o s h a r e . The m a j o r i t y o f inmates o f b o a r d i n g homes i n the c i t y have t o share, a room w i t h from one t o n i n e or more p e r s o n s , a lmost a l l o f whom are a t the o u t s e t complete s t r a n g e r s . Without e x c e p t i o n matrons and o p e r a t o r s o f homes were o f the o p i n i o n t h a t o l d p e o p l e ' s homes should p r o v i d e s i n g l e rooms f o r the m a j o r i t y , and double rooms o n l y f o r those who wished t o share a room w i t h spouse or f r i e n d . L i g h t i n g i n the Bedrooms S u r p r i s i n g l y , i n v iew of t h i s unanimous o p i n i o n , most homes, do not make some of the r e l a t i v e l y minor a d j u s t -ments i n t h e i r rooms and wards which would g i v e the guests a t l e a s t some p r i v a c y w i t h i n the l i m i t a t i o n s o f a shared room. Most persons do have t h e i r own bedlamps, b e l o n g i n g e i t h e r t o themselves or t o the home i t s e l f , so t h a t they can r e a d or work on t h e i r own beds i n c o m f o r t . These do not shed enough l i g h t t o d i s t u r b o thers i n the room who choose t o s leep e a r l i e r , u n l e s s the i n d i v i d u a l happens t o be u n u s u a l l y easy to d i s t u r b . -70-Being unable t o t u r n o f f t h e i r own l i g h t s when they choose must be f o r some a source o f g r e a t i r r i t a t i o n , and a. r e a l i n f r i n g e m e n t on t h e i r p e r s o n a l freedom. I n on-l y one o f the homes v i s i t e d i n which the o l d people have bedlamps and l i v e no more than f o u r or f i v e t o a room i s there, a s e t l i g h t s - o u t time which a p p l i e s t o a l l the o l d p e o p l e , even those i n s i n g l e rooms. Not even a l l the homes w i t h o n l y overhead l i g h t i n g f i n d i t necessary t o enforce such a r i g i d r u l e . Ye t those s l e e p i n g i n d o r m i t o r i e s or rooms l i g h t e d o n l y by an overhead l i g h t must of n e c e s s i t y be sub jec ted t o a common, " l i g h t s - o u t " t i m e . I f there i s p o s i t i v e l y no a l t e r n a t i v e t o throwing t h e s w i t c h and b l a c k -i n g out the whole room, the time f o r do ing so should be a r r i v e d a t by agreement among the persons s h a r i n g the room, i f p o s s i b l e , r a t h e r than by the matron s e t t i n g an a r b i t r a -r y t i m e . I t would seem obvious a l s o t h a t b e f o r e the matron and her guests accepted as i n e v i t a b l e t h a t there should be o n l y overhead l i g h t s , every p o s s i b l e means f o r p r o v i d i n g i n d i v i d u a l l i g h t s should be canvassed . P l a i n u t i l i t a r i a n bedlamps which hook to the head o f the bed , or w a l l - b r a c k -e t lamps where the former are not p r a c t i c a b l e , are r e l a -t i v e l y i n e x p e n s i v e . I f the persons o p e r a t i n g the home were unable to meet the c o s t , a s e r v i c e c l u b might h e l p t o do s o , or the inmates might be able t o h e l p themselves i n some measure i n t h i s r e s p e c t . The g r e a t e r o b s t a c l e t o p r o v i d i n g such lamps might w e l l be the l a c k of w a l l - p l u g s and the n e c e s s i t y o f -71 complying w i t h the requirements o f the e l e c t r i c i n s t a l l a -t i o n b y - l a w s . Necessary changes i n w i r i n g might be p r o h i -b i t i v e i n c o s t , or even be i m p o s s i b l e because of o ther f a c -t o r s i n the b u i l d i n g , but these mat ters c e r t a i n l y should be I n v e s t i g a t e d . S e r v i c e c l u b s which were i n t e r e s t e d c o u l d perhaps be h e l p f u l i n meeting c o s t s o f necessary changes as w e l l as i n . s u p p l y i n g the bedroom lamps themselves . The matccn of the I c e l a n d i c O l d P e o p l e ' s Home s a i d she found t h a t o l d people need s t r o n g e r and more d i -r e c t l i g h t s than do younger people w i t h t h e i r s t r o n g e r v i s i o n . Few l i g h t b u l b s i n . t h a t home are under 100 w . , ex-cept i n bedlamps where the person can be q u i t e c l o s e under the l i g h t . Exper ience i n the homes where each guest has h i s own lamp v a r i e s so much t h a t i t p o i n t s up the need f o r t h i s p e r s o n a l touch i n a l l homes. M r s . Blaney r e p o r t s t h a t her f i f t e e n l a d i e s are a lmost always ready f o r s l e e p a t n i n e i n the evening and r a r e l y use the bedlamps, whereas other matrons found some guests r e a d i n g l a t e , or v e r y e a r l y i n the morning i f they c o u l d not s l e e p . The bedlamps are a g r e a t convenience a t n i g h t t o any o l d person who must ge t up i n the n i g h t , whether they are ever used o therwise or n o t . F u r n i t u r e i n the Bedrooms I t goes w i t h o u t say ing t h a t the beds occupied, by the o l d people should be c o m f o r t a b l e , w i t h good s p r i n g s and m a t t r e s s e s . F o r the most p a r t mat t resses should be -72 f a i r l y h a r d ; too s o f t mat tresses make o l d bones ache and l e a v e the person a l i t t l e s t i f f i n the morning . T h i s was the o p i n i o n o f the m a j o r i t y of the matrons i n t e r v i e w e d , and was conf i rmed by s e v e r a l o f the o l d people themselves . B e d d i n g , i n t h e view of the same a u t h o r i t i e s , should be l i g h t and warm and a d j u s t a b l e t o changing temperatures i n one n i g h t . A few homes, f o r t u n a t e l y the m i n o r i t y o f those seen , have some beds w i t h sagging s p r i n g s or lumpy m a t t r e s -s e s , and too o f t e n bedding was heavy enough t o be a burden i n s t e a d of a c o m f o r t . Bedrooms should be a t t r a c t i v e as w e l l as c o m f o r t -a b l e . Many are b r i g h t e n e d by f i g u r e d w a l l paper or c h i n t z c u r t a i n s and bedspreads . I n a. few i n s t a n c e s bare w a l l s , undraped windows and beds covered only by dark b l a n k e t s g i v e the rooms occupied by the b i d people a d r a b , u n i n t e r -e s t i n g appearance t h a t must be most d e p r e s s i n g t o the s p i r -i t . One home, where there i s no common s i t t i n g room, and few comfortable c h a i r s i n the d o r m i t o r i e s , has i t s beds covered w i t h dark grey b l a n k e t s . The men 6pend a good p o r -t i o n o f t h e i r t ime s i t t i n g on t h e i r b e d s , t h e i r f e e t on newspapers. Washable, f i g u r e d bedspreads and b r i g h t c u r -t a i n s , a t the windows, p l u s a few inexpens ive b u t w e l l chosen p i c t u r e s on the w a l l s , c o u l d change the appearance o f the rooms very m a t e r i a l l y , and might Bpur the owners o f the home towards o b t a i n i n g enough easy c h a i r s t o go around. Here a g a i n , s e r v i c e c l u b s might be i n t e r e s t e d i n h e l p i n g t o f i n a n c e such r e l a t i v e l y inexpens ive improvements. -73 6 Church c l u b s and s i m i l a r groups might w e l l be g l a d t o sew bedspreads f o r such homes. Bedside t a b l e s are p r o v i d e d t o p r a c t i c a l l y a l l gues t s i n b o a r d i n g homes; t h e i r absence would be a r e a l p r i v a t i o n . They are v a l u a b l e f o r the comfort of a person when i n b e d , and f o r s t o r i n g s m a l l p e r s o n a l p o s s e s s i o n s . Many keep f a m i l y p i c t u r e s and other s m a l l t r e a s u r e s on them, and they serve to g i v e the on ly homelike touch i n some rooms. Those homes not u s i n g a common d i n i n g room u s u a l l y serve t r a y s a t the beds ide t a b l e , i n which case the low type w i t h no knee space i s a source o f r e a l d i s -comfort a t meal t imes , and some more s u i t a b l e arrangement might be made by an a l e r t matron. Most homes p r o v i d e a comfor tab ly f u r n i s h e d com-mon s i t t i n g room, or an easy c h a i r f o r each inmate i n t h e i r rooms, or b o t h . A t l e a s t two homes do not adequate-l y supply e i t h e r s i t t i n g room or c h a i r w i t h the r e s u l t t h a t the guests have t o s i t on t h e i r beds or on s t r a i g h t c h a i r s . T h i s i s a s e r i o u s l a c k , s ince o l d people are i n need of comfort i n the homes i n which they spend the g r e a t -er p a r t - i f not a l l - o f t h e i r t i m e . The c h a i r s t h a t o l d people appear to f i n d most comfortable are f i r m w e l l padded c h a i r s t h a t a l l o w them t o r e l a x but which g i v e them good support w h i l e they do s o . Deep o v e r s t u f f e d c h a i r s a c c o r d -i n g l y are not so s u i t a b l e as l i g h t e r types o f c h a i r s , such as f o r example, wicker c h a i r s . I n some of the rooms occupied by three or - 7 4 -more persons c l o s e t space was s a d l y l a c k i n g . Some homes have met t h i s problem by i n s t a l l i n g wardrobes or b u i l d i n g c l o s e t s I n c o r n e r s . For the most p a r t rooms h a v i n g two o r even three persons i n them have adequate c l o s e t s , even i f these are o f n e c e s s i t y s h a r e d . Two homes do not even s u p p l y s u f f i c i e n t d r e s s e r space f o r the g u e s t s , but most do manage t o have one d r e s s e r f o r each two p e r s o n s , so t h a t each has a t l e a s t one l a r g e drawer f o r h i s own c l o t h i n g . One matron suggested t h a t I f h e r home were not w e l l s u p p l i e d i n t h i s r e g a r d , she would encourage the two or three men i n her home who are i n t e r e s t e d i n woodwork t o b u i l d u n i t s o f drawers i n each room. I n two or three o f the homes the women have s m a l l d r e s s i n g t a b l e s i n t h e i r rooms. Most matrons thought t h a t a l l rooms should have q u i t e l a r g e m i r -r o r s , f o r men as w e l l as f o r women. A number of the more p r e t e n t i o u s homes have c a r -pe ted bedrooms, w h i l e o thers have e i t h e r bare f l o o r s or l i n o l e u m . One or two of the l a t t e r have s m a l l rugs by each bed so t h a t the aged p e r s o n ' s f e e t do not s t r i k e c o l d f l o o r when he ge ts out o f b e d . Such mats add g r e a t l y t o the a p -pearance of a' room, and i f they are f i r m enough not t o s l i d e e a s i l y under an unsteady s t e p , they are a g r e a t c o m f o r t . They need not be expens ive : hooked and b r a i d e d r a g mats can even be made by i n t e r e s t e d b i d p e o p l e , and can be v e r y p r e t -t y i f a l i t t l e c o l o u r and i m a g i n a t i o n i s u s e d . P r i v a c y f o r the Occupants of Wards For the i n d i v i d u a l i n the l a r g e r rooms and wards -75-p r i v a c y p n a c t i c a l l y does not e x i s t . Among the women p a r -t i c u l a r l y the need f o r p r i v a c y when d r e s s i n g seems i m p o r -t a n t * Some women i n one or two homes e i t h e r t u r n out a l l l i g h t s i n order t o undress , or take t u r n s i n u s i n g the b a t h -room as a d r e s s i n g room. Ye t a measure of p r i v a c y i s v e r y e a s i l y secured by the use o f s c r e e n s . The. K i n g ' s Daughters 1 Restholme, which has up t o f i v e women i n a room, s u p p l i e s a. f o l d i n g screen f o r each woman, and these serve t o make the space around each bed i n t o a s m a l l c u b i c l e . The women use them e x t e n s i v e l y when d r e s s i n g , s l e e p i n g , e n t e r t a i n i n g v i s i t o r s - or when they merely w i s h t o be a lone* The screens are dark wood frames w i t h p l a i n or f i g u r e d c o t t o n c u r t a i n s , and are q u i t e a t t r a c t i v e . A t the I c e l a n d i c O l d P e o p l e ' s Home the c l o t h e s c l o s e t s are v e r y roomy, and s i n c e they are l i g h t e d , are o f t e n used as d r e s s i n g rooms by the gues t s l i v i n g t h e r e . B a t h i n g F a c i l i t i e s R e g u l a t i o n s under the Wel fare I n s t i t u t i o n s L i c e n -s i n g A c t r e q u i r e t h a t an o l d e p e o p l e ' s b o a r d i n g home have one complete bathroom t o every t e n p e r s o n s , w i t h one a t l e a s t on each f l o o r where bedrooms are l o c a t e d . Where p o s -s i b l e the inmates are b e t t e r served by h a v i n g the t o i l e t separate from the r e s t o f the bathroom. B a t h r o o m m f a c i l l -t i e s i n a l l the homes v i s i t e d were adequate ly f i t t e d , some o f them b e i n g t i l e d and q u i t e modern. S e v e r a l matrons s a i d they found rubber mats i n the bottom of the tub i n v a l u a b l e . Some aged persons need t o be he lped i n t o and out o f the t u b , -76 -but others, are q u i t e ab le to l o ok a f t e r themselves , e s -p e c i a l l y i f the rubber mat i s there to g i v e them added s a f e t y . A second q u i t e s imple a d d i t i o n t o the bathroom which i s found to be a r e a l a i d t o the o l d person when u s i n g the t u b , i s a hand r a i l above the t u b . One or more e x t r a t o w e l r a c k s f i r m l y fas tened t o the w a l l can serve very w e l l as supports when e n t e r i n g and l e a v i n g the t u b . Indeed these are s imple p r e c a u t i o n s t h a t c o u l d be used i n any home, which would be i n s t r u m e n t a l i n c u t t i n g down home a c c i d e n t s m a t e r i a l l y . They are not expensive and c o u l d c o n c e i v a b l y be i n s i s t e d upon f o r every b o a r d i n g home by the l i c e n s i n g a u t h o r i t y . long One matron w i t h / e x p e r i e n c e has r e p l a c e d baths w i t h showers t o everybody 's s a t i s f a c t i o n . She found t h a t b a t h i n g f o r most of the twanty o l d men i n h e r home was v e r y d i f f i c u l t . She had t o h e l p most o f them i n t o and out o f the t u b , and t h i s o f t e n meant heavy l i f t i n g f o r h e r . A t no l i t t l e , expense she had the b a t h t u b s taken o u t , and t i l e d showers i n s t a l l e d . Rubber m a t t i n g was i n s t a l l e d on the f l o o r and benches b u i l t i n t o each, so t h a t the men now, however f e e b l e , are ab le to l o ok a f t e r themselves and bathe i n . comfort and s e c u r i t y . She f i n d s they bathe much more w i l l i n g l y and" r e g u l a r l y than p r e v i o u s l y , and hot water i s more p l e n t i f u l f o r t h e i r showers as w e l l . The men l i k e the arrangement immensely. Women, however, would p ro bab l y f i n d t h a t such a shower was u n s a t i s f a c t o r y s ince they do not w i s h to ge t t h e i r h a i r wet.when b a t h i n g . T o i l e t F a c i l i t i e s One owner o f an o l d p e o p l e ' s home puts a l o w -power b u l b i n t o b o t h bathrooms and l e a v e s them a l l n i g h t so t h a t the men can f i n d t h e i r way t o the bathroom on t h e i r n i g h t t r i p s - He has a l s o i n s t a l l e d a l i g h t - w e i g h t gate a t the top o f the s t a i r s as an e x t r a p r e c a u t i o n a t n i g h t - Most aged persons seem t o need t o u r i n a t e d u r i n g the n i g h t , and s e v e r a l matrons and opera tors o f homes r e -p o r t e d some s p e c i a l arrangements they have madeffor t h i s r e a s o n - I n the m a j o r i t y of homes h a l l s are d i m l y l i g h t e d "at n i g h t . S e v e r a l homes supply chambers i n each room so t h a t the guests do not need to leave t h e i r rooms. One matron passes b o t t l e s out t o each man a t n i g h t , empties and s t e r i l i z e s these each morning . I n one home the matron has p r o v i d e d most thought -f u l l y and e f f e c t i v e l y f o r the n i g h t l y needs of her aged women g u e s t s . She has had" chambers set i n t o l i g h t , h a r d -wood arm c h a i r s . The c h a i r s have draped f l o o r - l e n g t h s k i r t s and s e a t - c u s h i o n s o f c h i n t z , so t h a t they make r a t h e r p r e t -t y bedroom f u r n i t u r e . The c h a i r s are taken from each room i n the morning and r e t u r n e d i n the e v e n i n g . She has been s e r i o u s l y c o n s i d e r i n g h a v i n g c h a i r - a r m s added to the r e g u -l a r t o i l e t s , or a t l e a s t p l a c i n g h a n d r a i l s on the w a l l s b e -s i d e the t o i l e t s , s i n c e most of her o l d l a d i e s f i n d s i t t i n g down and g e t t i n g up r a t h e r awkward work. The commode c h a i r s would not be as comfortable and safe f o r the o l d women i f they d i d not have c h a i r arms f o r t h e i r s u p p o r t . '•TO-G e n e r a l Observat ions I t cannot be too e m p h a t i c a l l y s t a t e d t h a t b o a r d -i n g homes f o r o ld . people, should o f f e r p r i v a t e rooms, w i t h double rooms as the e x c e p t i o n s , f o r those who p r e f e r them. Any person or group p l a n n i n g such a home, i f the happiness o f the. o l d people i s the pr imary c o n s i d e r a t i o n , should make every e f f o r t t o meet t h i s s t a n d a r d . I t would be i m -p r a c t i c a l t o make any such s u g g e s t i o n r e g a r d i n g the homes a l r e a d y i n . o p e r a t i o n , but a number o f s imple and r e l a t i v e -l y inexpens ive adjustments might be made t o g i v e the i n -mates as much p r i v a c y as p o s s i b l e and t o g i v e them added c o m f o r t s . Some of these adjustments might be p r o v i s i o n o f bed lamps, f l o o r mats, bedroom screens , and h a n d r a i l s and rubber mats i n . bathrooms. I t does not seem unreason-a b l e t o suggest t h a t a t t r a c t i v e washable bedspreads and c u r t a i n s , and p i c t u r e s f o r the w a l l s , should be s u p p l i e d . C h e e r f u l surroundings have a v e r y happy e f f e c t on the ma-t r o n and other employees o f a home as w e l l as the o l d peo-p l e i n i t . 7 9 -Chapter V l l THE SERVING OF MEALS The " M u l t i p l e " Importance o f Food Food i s o f course e s s e n t i a l to the maintenance o f l i f e . . , but i t i s a l s o the source of a g r e a t d e a l o f p l e a s u r e . O l d people who are no longer a b l e to experience a number o f the p h y s i c a l s a t i s f a c t i o n s en joyed 'by younger p e r s o n s , seem t o f o c u s much of t h e o ther l o s t p l e a s u r e s i n e a t i n g . I n -d e e d , so t r u e i s t h i s t h a t matrons r e p o r t t h a t there a re some who merely e x i s t f rom meal t o meal and take l i t t l e i n -t e r e s t i n a n y t h i n g e l s e . For most people food i s a l s o o f g r e a t importance s o c i a l l y , and t h i s i s e q u a l l y t r u e for ' most o l d p e o p l e . They can enjoy a l u n c h w i t h f r i e n d s , and a l s o a q u i e t "cup of t e a " alone I f they are r e s t i n g or o t h e r -w i s e f e e l i n g l i k e b e i n g a l o n e . Because o f i t s s i g n i f i c a n c e , s p e c i a l a t t e n t i o n was p a i d t o the k i n d s o f . f o o d s e r v e d , how, when and where, as w e l l as t o i t ems such as evening lunches a l l o w e d t o the o l d p e o p l e . Types o f Food Served Whi le most matrons s a i d t h a t they f e l t o l d peo-p l e can and do eat " j u s t about a n y t h i n g " , more d e t a i l e d d i s -c u s s i o n made i t c l e a r t h a t the matrons make s e v e r a l c o n s i d -e r a t e a d a p t a t i o n s i n t h e i r meals f o r the o l d people perhaps w i t h o u t b e i n g a c t u a l l y aware of d o i n g s o . Haw v e g e t a b l e s , which are troublesome t o persons w i t h dentures ( o f t e n i l l -f i t t i n g ) , or wi thout t e e t h a t a l l , are avo ided by most matrons. -80-The. same i s g e n e r a l l y t r u e f o r f r i e d foods and heavy p a s -t r i e s , bo th of which a re q u i t e d i f f i c u l t t o d i g e s t . I t i s i m p o s s i b l e t o g i v e an "average" menu, b u t i t i s i n t e r e s t i n g t o note one or two sample menus. One home r e p o r t e d t h a t each man i s served a bowl o f oatmeal or cream of wheat, two or three s l i c e s o f t o a s t , marmalade, and t e a or c o f f e e , f o r b r e a k f a s t , poached eggs b e i n g added on Sunday mornings . Two homes add b o i l e d or poached eggs to t h i s b a s i c menu every day , and o thers add f r u i t or f r u i t j u i c e , u s u a l l y the l a t t e r . One matron serves bread because • she f e l t unable t o ge t t o a s t t o a l l the gues t s w h i l e i t was s t i l l f r e s h , and she f e l t the harder t o a s t was more d i f f i -c u l t f o r o l d people to eat than b r e a d . Other matrons how-ever b e l i e v e d the o l d people should have t o a s t f o r b r e a k -f a s t f o r the same reason t h a t most other people do - they p r e f e r i t to b r e a d . M r s . Fowler t o a s t s bread f o r the men's b r e a k f a s t s on r a c k s i n the oven, p r o d u c i n g c r i s p t o a s t which does not ge t soggy w i t h s t a n d i n g . The men t e l l her they l i k e the t o a s t made i n t h i s manner. A p p a r e n t l y the present g e n e r a t i o n o f o l d p e r s o n s , a t l e a s t , are a lmost u n i -v e r s a l l y fond of cooked c e r e a l i n the morning, i f i t i s w e l l made. B r e a k f a s t i s a meal which i s e a s i l y made t a s t y and e n j o y a b l e . As i s t r u e w i t h other meals , matrons and t h e i r s t a f f s s h o u l d , where they c a n , make adjustments i n the morn-i n g menu to s u i t i n d i v i d u a l t a s t e s . The noon meal i n about h a l f the homes i s the h e a -vy meal of the day , whereas I n the other h a l f the d a y ' s •81-heavy meal i s served a t n i g h t - The s tandard menu of meat, two v e g e t a b l e s , and a pudding or stewed f r u i t appears to be served i n . a l l homes- Most matrons agreed t h a t f r i e d meats and potatoes are to be a v o i d e d ; they bake or b o i l or cook them i n c a s s e r o l e f o r the most p a r t . The d e s s e r t s are most o f t e n m i l k or r i c e puddings served w i t h or w i t h o u t bread or c a k e , and always accompanied by t e a or c o f f e e . S e v e r a l p o i n t e d out t h a t p a s t r i e s are not e a s i l y enough d i g e s t e d t o be good f o r o l d p e o p l e . The t h i r d m e a l , whether a t noon or a t n i g h t , v e r y o f t e n i n c l u d e s soup, pudding or f r u i t and cake or o ther d e s -s e r t s . A number of luncheon d i s h e s were named as w e l l , such as s p a g h e t t i and c o l d meat w i t h s a l a d s composed most ly o f tomatoes and l e t t u c e (when they were a v a i l a b l e ) which o l d peo-p l e are ab le to chew. S e v e r a l t o l d the v i s i t o r t h a t t h e i r soup k e t t l e was always on the s t o v e , and t h a t t h e i r g u e s t s , p a r t i c u l a r l y the men, are extremely fond of home-made v e g e -t a b l e soups made w i t h meajt s tock* From a l l q u a r t e r s the w r i t e r heard t h a t the aged persons l i v i n g i n boarding homes have m a g n i f i c e n t a p p e t i t e s and w i l l c l e a n up every p l a t e , however heaped i t i s , . Few appear t o have any d i g e s t i v e upsets as f a r as the matrons are aware, but they u s u a l l y f e e l the need o f a nap or r e s t f o r a p e r i o d f o l l o w i n g each mea l . Matrons might be g i v e n some h e l p i n p l a n n i n g meals f o r the aged and ssome i n f o r m a -t i o n as t o what type of meals , and what q u a n t i t i e s a re b e s t s u i t e d t o the aged. The meals as d e s c r i b e d seem t o be - 8 2 f o r the most p a r t somewhat heavy, and l a c k i n g i n some i tems - e s p e c i a l l y i n f r e s h f r u i t e , m i l k and v e g e t a b l e s . P o s s i -b l y some i n v e s t i g a t i o n needs t o be made i n t o the problem o f menus and cooking methods most s u i t e d t o aged p e r s o n s . I t must n o t , however, be f o r g o t t e n t h a t many o l d people w i l l have no d e s i r e t o be f e d c o r r e c t l y ba lanced m e a l s . The matrons, p a r t i c u l a r l y those c a r i n g f o r men, r e p o r t e d t h e i r exper ience as b e i n g t h a t the o l d people want above a l l "meat -and-potato" meals , r e a l l y " s o l i d m e a l s " , i n s p i t e o f t h e i r sedentary e x i s t e n c e . T h e i r meals seem t o a f f o r d them the g r e a t e s t enjoyment o f t h e i r l i v e s , n e v e r -t h e l e s s , i t seems t h a t f u r t h e r i n v e s t i g a t i o n and exper imen-t a t i o n would be r e w a r d i n g . Between-meal Snacks S e v e r a l homes serve lunches or t e a t o t h e i r gues t s e i t h e r i n the a f t e r n o o n or the e v e n i n g , or b o t h . A t the Soroptomist House t e a and s m a l l cakes or b i s c u i t s are served t o the group i n the d i n i n g room or l i v i n g room i n the a f te rnoons and e v e n i n g s . M r s . D e a l , who has s i x men i n her home, has e i t h e r / o r t e a on the s tove a l l the t i m e , and the men take t h i s whenever they w i s h , e s p e c i a l -l y , M r s . D e a l s a y s , a f t e r they have been out w a l k i n g . She serves e i t h e r cocoa or m i l k every e v e n i n g , w i t h bread and b u t t e r f o r those who wish i t . Other homes serve s i m i l a r l u n c h e s . I n a few homes these are occas ions f o r c h a t t i n g and v i s i t i n g , w h i l e i n o t h e r s the o l d people take t h e i r snacks alone i n t h e i r rooms. -83-Methods of S e r v i n g Meals S i x of the homes v i s i t e d s e r v e a l l meals i n a common d i n i n g room, s i x serve a l l meals on. t r a y s i n the g u e s t s ' rooms, w h i l e the remain ing . four combine the two methods. B o t h have t h e i r advantages , o f c o u r s e , b u t how p l e a s a n t e i t h e r method i s f o r the inmates depends v e r y much upon the e x t r a e f f o r t s the s t a f f s o f the homes are prepared to make. Meals served t o the group i n a common d i n i n g room can be p l e a s a n t s o c i a l events i f the s e t t i n g i s made a t t r a c t i v e and t ime i s a l l o w e d f o r some t a l k i n g over meals . "She Soroptomist House meal t imes appear t o be o f t h i s n a t u r e . I t i s worth n o t i n g i n t h i s c o n n e c t i o n t h a t on ly i n t h i s home among those v i s i t e d do the gues t s have a share i n p r e p a r i n g and s e r v i n g m e a l s . The cook comes only from t e n a .m. u n t i l 2 p . m . , t o cook and serve the l a r g e noonday m e a l . The matron and a r o t a t i n g commits t e e o f three women prepare b r e a k f a s t , and a l s o the eve-n i n g m e a l , which I s l e f t . p a r t i a l l y ready by the cook, o f -t e n c o n s i s t i n g of c a s s e r o l e d i s h e s . The t a b l e i s covered w i t h a w h i t e c l o t h , and l i t t l e p e r s o n a l touches b r i g h t e n each m e a l . Another home which c a t e r s t o men, however, does not appear t o achieve t h i s f r i e n d l y atmosphere. The men e a t i n two s h i f t s - - those who are n e a t , q u i c k e a t e r s f i r s t , those who are s l o w , messy ea ters second. Too o f -t e n , i n more than one house, mealt imes seem tone o c c a -s i o n s f o r a i r i n g c o m p l a i n t s , and are h u r r i e d and u n s a t i s --84 -f a c t o r y , i n . s p i t e o f the f a c t t h a t i n a l l homes so f a r as the w r i t e r was able t o a s c e r t a i n , the- food i s w e l l prepared and p l e n t i f u l . R e l a t i o n s between the s t a f f and inmates , and between the inmates themselves , would seem t o be the most impor tant f a c t o r i n d e t e r m i n i n g whether mealt imes are s a t i s f a c t o r y or o t h e r w i s e . As an i l l u s t r a t i o n o f t h i s p o i n t , a t the home i n which the t a b l e appointments appear t o be more a t t r a c t i v e than i n any other home v i s i t e d , meals a r e n e v e r t h e l e s s unpleasant t imes f o r a l l concerned. There a r e small t a b l e s i n a l a r g e b r i g h t room, the t a b l e s s e t charmingly w i t h good c h i n a and s i l v e r , and w i t h i n d i v i d u a l s e r v i e t t e s ; the meals are a lmost sumptuous. However, the matron s t a t e s e m p h a t i c a l l y t h a t she does not l i k e o l d p e o -p l e and c o n s i d e r s t h a t they are worse t h a n a group o f naugh-t y c h i l d r e n ^ However c o n g e n i a l the o l d people might o t h e r -wise b e , h e r a t t i t u d e cannot f a i l t o d i s t u r b them. Com-p l a i n t s i n the home are i n c e s s a n t , and p a r t i c u l a r l y so a t meals . T h i s matron i s not e n t i r e l y t o blame f o r the s i t u -a t i o n , which w i l l be more f u l l y d i s c u s s e d i n a l a t e r chap-t e r . C l e a r l y , the p h y s i c a l s e t t i n g o f the meals and the e x c e l l e n c e o f the f o o d are not enough i n themselves t o ensure en joyable mealtimes f o r the o l d p e o p l e . However, they are important enough t o warrant more e f f o r t than some homes g i v e t o them. There i s g e n e r a l agreement t h a t t a -b l e s s e a t i n g too many g i v e an i n s t i t u t i o n a l a i r t o a home and i f p o s s i b l e should be r e p l a c e d by s m a l l e r t a b l e s s e a t -- 8 5 -i n g f o u r or s i x . S i n c e t h i s n e c e s s i t a t e s l a r g e r d i n i n g rooms than l o n g t a b l e s d o , i t i s o b v i o u s l y i m p o s s i b l e f o r some homes to a l t e r t h e i r arrangements . The matron a t S o r -optomist House f e l t t h a t f o r the c l o s e c o n g e n i a l group l i v - . i n g t h e r e the t a b l e l a r g e enough t o s e a t a l l o f them was a p p r o p r i a t e , but f o r most groups i t would seem to be t r u e t h a t s m a l l e r t a b l e s are mose s a t i s f a c t o r y . Use o f the new type o f p l a s t i c t a b l e c l o t h s or i n d i v i d u a l p l a c e mats should -make i t p o s s i b l e t o se t a t a -b l e n i c e l y w i t h o u t i n c r e a s i n g the l a u n d r y problems . One matron was p l a n n i n g t o purchase f i g u r e d p l a s t i c c l o t h s a t the t ime h e r home was v i s i t e d . She p o i n t e d out t h a t w h i l e h e r d i s h e s are a conglomerat ion o f l e f t - o v e r s from many s e t s , they are not a heavy, u g l y type o f c r o c k e r y , and w i t h paper t a b l e s e r v i e t t e s and a s m a l l bowl o f f l o w e r s or a p l a n t i n the c e n t r e , her aged g u e s t s can always s i t down t o a c h e e r f u l l o o k i n g t a b l e . Without e x c e p t i o n , whether they served meals a t a t a b l e or on t r a y s , matrons f a v o r s e r v i n g the meal i n the k i t c h e n and b r i n g i n g the p l a t e s t o the o l d p e o p l e . E v e r y -one i s served the same amount i n t h i s way, e l i m i n a t i n g many occas ions of 111 f e e l i n g , and those who d e s i r e second h e l p i n g s are ab le to ask f o r them. M r s . B a i l e y s a i d t h a t w h i l e s e v e r a l men ask f o r second h e l p i n g s a f t e r the f i r s t v e r y s u b s t a n t i a l s e r v i n g , she f i n d s t h a t t h i s method, i n a d d i t i o n t o a v o i d i n g q u a r r e l s , a l s o r e s u l t s I n a s a v i n g o f f o o d , s i n c e a number o f men used t o heap t h e i r p l a t e s and - 8 6 -t h e n l e a v e a good p a r t o f the f o o d . The l a s t to be served from the s e r v i n g bowls on "be t a b l e were i n danger o f g o i n g hungry , t o o . I t I s the experience o f many a l s o , t h a t the whole t a b l e l o o k s much neater when meals are served from the k i t c h e n . Meals Served on Trays S i x homes serve a l l meals on t r a y s . Where, the o l d people have comfortable p l e a s a n t rooms, however, t r a y s e r v i c e seems t o be a p p r e c i a t e d . M r . Cunningham, s a i d t h a t the men who formed f r i e n d s h i p s enjoy b e i n g ab le t o share t h e i r meals i n one another f s rooms and he; f e e l s the t r a y s e r v i c e method g i v e s the i n d i v i d u a l the b e s t o p p o r t u n i t y t o eat as he l i k e s b e s t t o d o . M r s . Fowler e s p e c i a l l y p o i n t e d out t h a t those who have become u n c e r t a i n and shaky i n t h e i r movements are s e n s i t i v e and unhappy when f o r c e d t o eat a t t a b l e w i t h o t h e r s , w h i l e w i t h t h e i r own t r a y they need not worry about the s c r u t i n y o f o ther p e r s o n s . One home i n p a r t i c u l a r , however, has o n l y s m a l l beds ide t a b l e s where the inmates set t h e i r t r a y s , and they are u n -a b l e t o s i t w i t h t h e i r knees under the t a b l e s . M i s s F o r t u n e , who a l s o b e l i e v e s the o l d people p r e f e r t r a y s t o d i n i n g room s e r v i c e , keeps each woman's t r a y and d i s h e s separate a t a l l t i m e s . & t r a y and i t s c o n -t e n t s are washed and the t r a y r e s e t be fore the next t r a y i s washed, and each has i t s own n a p k i n and n a p k i n r i n g . The l a d i e s a t t a c h g r e a t importance to always h a v i n g t h e i r own d i s h e s , and s m a l l touches t o b r i g h t e n up the t r a y now anH - 8 7 -then i n c r e a s e s t h e i r p l e a s u r e i n t h e i r mea ls . Sometimes M i s Fortune adds one f l o w e r t o each t r a y , now and then she serves a j e l l y t h a t has been s e t i n a. mold, or perhaps f o l d s the c l e a n n a p k i n i n a n o v e l wat . S e v e r a l homes u s i n g t r a y s e r v i c e g i v e a l l the g u e s t s b r e a k f a s t i n b e d . In . most cases, some member o f the s t a f f goes around w i t h e x t r a t e a and c o f f e e , w h i l e one g i v e s eacji person a two-cup p o t o f beverage^ M r s . Fowler l e t s the men r e t u r n t h e i r own t r a y s t o the k i t c h e n , and they enjoy the t r i p v e r y much, e s p e c i a l l y as the cook f r e -q u e n t l y has cookies or o ther t h i n g s as a t r e a t f o r them. F o u r homes combine t r a y and d i n i n g room s e r v i c e . A t the K i n g ' s Daughters 1 Restholme b r e a k f a s t i s served i n b e d , the other meals i n the d i n i n g room. M r s . Blaney serves b r e a k f a s t I n b e d , and the guests have the o p t i o n o f coming t o the d i n i n g room or h a v i n g a: t r a y f o r the other m e a l s . Some always take t r a y s , o thers always come t o the d i n i n g room, w h i l e two or three do one or the o ther a c c o r d i n g t o t h e i r d e s i r e s a t the moment. M r s . Blaney f e l t t h a t com-b i n i n g the two methods o f s e r v i n g does not m a t e r i a l l y i n -crease the work o f the s t a f f , and each guest i s g i v e n the o p p o r t u n i t y t o eat i n the manner which she p r e f e r s . M r s . D e a l makes t r a y or d i n i n g room s e r v i c e o p t i o n a l a t a l l m e a l s , and f i n d s t h a t t h e r e i s l e s s p a t t e r n t o the way her g u e s t s take t h e i r meals than i n M r s . B l a n e y 1 s c a s e , due p r o b a b l y t o the f a c t t h a t there are on ly s i x i n M r s . D e a l ' s home. She a l s o f e e l s the work I s not g r e a t l y i n c r e a s e d by - 8 8 -f o l l o w i n g both methods, and she f e e l s the men a p p r e c i a t e the- p r i v i l e g e o f e a t i n g alone or i n company depending on t h e i r moods. 1 The g e n e r a l t ime schedule for. meals i s b r e a k f a s t a t o r near 8 a . m . , d i n n e r or l u n c h a t noon, and d i n n e r or supper a t 5 .30 o r 6 p . m . Two homes serve b r e a k f a s t a t a l a t e r h o u r , but most homes f o l l o w t h i s s c h e d u l e . G e n e r a l Observat ions The w r i t e r was w e l l , impressed w i t h the q u a l i t y and q u a n t i t y of the meals served i n a l l the homes* Most serve s u b s t a n t i a l p l a i n meals and a v o i d f r i e d foods and the rougher raw Vegetab les - More f r u i t and m i l k might be added i n some homes- One or two homes serve r e a l l y q u i t e sumptuous meals- I n a l l homes v i s i t e d the s t a f f s eat p r e -c i s e l y the same meals as are served t o the inmates . The manner i n which meals are served v a r i e s , ' but a few g e n e r a l recommendations can be made on "tithe b a s i s o f the i n f o r m a t i o n c o l l e c t e d and o b s e r v a t i o n s made: i n the course o f t h i s s t u d y . Both t r a y and t a b l e s e r v i c e can be p l e a s i n g t o the o l d people i f they a r e not rushed through meals and i f the t a b l e or t r a y and the surroundings are c h e e r f u l * Where p o s s i b l e i t would probab ly be b e s t to have s m a l l t a b l e s i n a d i n i n g room r a t h e r than one l a r g e one -a l t h o u g h f o r c l o s e - k n i t groups the l a r g e t a b l e i s d e s i r a b l e . The most s a t i s f a c t o r y system of s e r v i n g meals , a c c o r d i n g to b o t h the o l d people and the matrons i n the homes u s i n g i t , i s t h a t combining t r a y and d i n i n g room s e r v i c e , a l l o w i n g - 8 9 -the o l d people t o use e i t h e r as they p l e a s e . T h i s means s l i g h t l y more work f o r the s t a f f , but both M r s . D e a l and M r s . B laney agreed t h a t the r e s u l t s make the e x t r a work v e r y much w o r t h w h i l e . E x p e r t advice on the n u t r i t i o n a l needs o f the o l d , and p o s s i b l y sample menus, might be used p r o f i t a b l y by the matrons o f b o a r d i n g homes. T h i s would be e s p e c i -a l l y v a l u a b l e f o r new a r r i v a l s i n b o a r d i n g homes, i n the l i g h t o f i n f o r m a t i o n from one matron. She and her husband operate two homes q u i t e c l o s e t o one a n o t h e r , and she has found t h a t the m a j o r i t y o f o l d people on f i r s t e n t e r i n g t h e i r homes are run-down and s e r i o u s l y i n need o f s p e c i a l b u i l d i n g - u p through proper d i e t . I n the main those who are run-down have been l i v i n g alone and w i t h e r through l a c k o f money or through i n a b i l i t y t o prepare f o o d , have been on v e r y inadequate d i e t s . I n one i n s t a n c e seen by the w r i t e r , an extremely undernourished o l d l a d y was a d -m i t t e d t o the home, who soon a f t e r w a r d had t o be sent on t o h o s p i t a l because she d i d hot respond t o the care i n the b o a r d i n g home. The matron thought i t would take s e v e r a l weeks o f h o s p i t a l care before the o l d l a d y would be w e l l enough t o accept o r d i n a r y f o o d . T h i s was an extreme c a s e , but i l l u s t r a t i v e o f the f a c t t h a t matrons need to be w e l l informed about n u t r i t i o n . -90-Chapter V l l l USE OF LEISURE TIME IH  BOARDING . HOMES I t c o u l d be c a l l e d one o f the t r a g e d i e s o f l i f e t h a t by the time, people reach the p o i n t i n l i f e when they have an u n l i m i t e d amount o f l e i s u r e , t h e i r i n t e r e s t s have u s u a l l y narrowed u n t i l they i n c l u d e l i t t l e more than t h e p r o v i s i o n s f o r the i n d i v i d u a l ' s own comfort* Somewhere a l o n g the way s o c i e t y has f a i l e d the i n d i v i d u a l i f he has never had the t ime or o p p o r t u n i t y t o develop i n t e r e s t s and hobbies t h a t can serve him l a t e r i n l i f e . The t o t a l i m -p r e s s i o n - one g a i n s through v i s i t i n g o l d p e o p l e , whether i n b o a r d i n g homes or i n t h e i r own or r e l a t i v e s ' homes, i s t h a t most o f them have never l e a r n e d how t o occupy l e i s u r e hours i n s a t i s f y i n g ways. Too many? perhaps , have worked l o n g hours a l l t h e i r l i v e s , and never had the t i m e , money or the o p p o r t u n i t y needed t o develop leisufce t ime a c t i v i t i e s . Most have had too l i t t l e o p p o r t u n i t y f o r informed c o n s t r u c t i v e d i r e c t i o n i n f i n d i n g out t h e i r i n t e r e s t s and b u i l d i n g up s k i l l s which might serve them w e l l i n t h e i r l a t e r y e a r s , as w e l l as g i v i n g them a f u l l e r l i f e i n t h e i r e a r l i e r y e a r s . A g r e a t d e a l might be s a i d about the p a r t the s c h o o l s c o u l d and should p l a y i n t h i s a rea o f c h i l d r e n ' s l i v e s , as w e l l as about the v e r y r e a l need f o r government sponsored, p r o -f e s s i o n a l l y s t a f f e d r e c r e a t i o n cent res which are a v a i l a b l e t o a l l . I t i s a s e r i o u s commentary on the l a c k o f oppor -- 9 1 -t u n i t i e s f o r i n d i v i d u a l growth and development i n a s o c i e t y t o f i n d the m a j o r i t y o f i t s aged persons w i t h few or no r e -sources w i t h which to meet the days and years o f f u l l - t i m e l e i s u r e which they face i n t h e i r o l d age.. Common Rooms i n the Boarding Homes The f i r s t concern o f the boarding home i s t o p r o -v i d e comfortable q u a r t e r s , good f o o d and a minimum o f s u p e r -v i s i o n t o the aged immates. P r o v i s i o n f o r t h e i r l e i s u r e t ime i s q u i t e secondary and i s even regarded by some matrons as b e i n g unimpor tant . So t r u e has t h i s been t h a t o n l y r o u g h -l y o n e - t h i r d o f the boarding homes v i s i t e d p r o v i d e d common s i t t i n g rooms f o r the o l d p e o p l e . T h i s w i l l not be so i n the f u t u r e as the l i c e n s i n g body i s now r e q u i r i n g t h a t one room be s e t a s i d e i n each n e w l y - l i c e n s e d home as a s i t t i n g room. Three o p e r a t o r s s a i d they f e l t a common room t o be q u i t e unnecessary i f the o l d people are p r o v i d e d w i t h com-f o r t a b l e c h a i r s i n t h e i r bedrooms, and i f they a l s o have r a d i o s and other means of amusing themselves i n t h e i r rooms. Indeed, one opera tor s a i d he f e l t a common room o n l y he lped t o f o s t e r arguments and d i s s e n s i o n , whereas i f the bedrooms are comfortable enough the gues t s may v i s i t as they please among themselves and achieve group a c t i v i t i e s i n t h a t way. T h i s o p e r a t o r ' s home f o r aged men has s i n g l e rooms com-f o r t a b l y and c h e e r f u l l y f u r n i s h e d so t h a t the men are p e r -haps b e t t e r ab le t o f i l l i n t h e i r t ime agreeably i n t h e i r own rooms than they might be i n some o ther homes, Other o p e r a t o r s f e l t the lack, o f a s i t t i n g room was u n f o r t u n a t e - 9 2 -and one which should he remedied i f a t a l l p o s s i b l e * Some of the homes would need some a l t e r a t i o n s t o p r o v i d e such a room, a l though i n one or two a p a r t i t i o n or h a l f - p a r t i t i o n would be s u f f i c i e n t ; however i n each case i t would mean g i v i n g up two or more b o a r d e r s , and the income, from them. The main s i t t i n g room a t T a y l o r Manor i s a l o n g room w i t h a stage a t one end, and i t has a. number o f com-f o r t a b l e c h a i r s and couches arranged i n f o r m a l l y . F l o o r lamps are p l e n t i f u l enough so t h a t s u f f i c i e n t l i g h t i s a v a i l a b l e f o r everyone u s i n g the room. There i s q u i t e a l a r g e c o l l e c t i o n of books , some magazines , a p i a n o , a r e -c o r d p l a y e r and r a d i o , a l l there f o r the use of the o l d p e o p l e a s they w i s h . C a r d s , c r ibbage boards and checker boards a re a l s o p a r t of the equipment of the room, as w e l l as a few s m a l l t a b l e s on which the. games can be p l a y e d . There are i n a d d i t i o n s e v e r a l verandahs w h i c h , e s p e c i a l l y i n the warmer months, are useu" as s i t t i n g rooms by the o l d p e o p l e . The verandahs can be adapted f o r use by anyone w i t h s p e c i a l i n t e r e s t s . A year ago the w r i t e r watched an o l d man on h i s own long work t a b l e a t one end o f a second-s t o r y - v e r a n d a h working on an e l a b o r a t e l y carved box . T h i s y e a r a t the t ime of her v i s i t another s m a l l e r t a b l e on the same verandah h e l d a row of f l o w e r p o t s which a guest i s p a i n t i n g a b r i g h t c o l o r . The I c e l a n d i c O l d P e o p l e ' s Home has a l a r g e l i v -i n g room, v e r y w e l l f u r n i s h e d , on the main f l o o r , and the o l d people a l s o use the couch and c h a i r s i n the l a r g e f r o n t •93 h a l l . There i s r e a d i n g m a t e r i a l and a r a d i o a v a i l a b l e i n the s i t t i n g room, as w e l l as cards and some other games. I n t h e basement a second r e a d i n g room i s be ing ' e q u i p p e d . The Soroptomist House has a l i v i n g room on the main f l o o r which i s comfor tab ly f u r n i s h e d , and here the women s i t t o k n i t and t a l k and have t e a , as w e l l as t o l i s -t e n to the r a d i o or to r e a d . Another home has a v e r y l u x -u r i o u s s i t t i n g room which i s a p p a r e n t l y used by the l a d i e s o n l y on r e q u e s t , f o r e n t e r t a i n i n g v i s i t o r s . One or two other homes have s i t t i n g rooms which appear t o be used some-t imes by the o l d people a l though they are a c t u a l l y p a r t o f the m a t r o n ' s l i v i n g q u a r t e r s . A t one o f t h e s e , f o r i n s t a n c e , some of the o l d l a d i e s come i n t o the matron ' s l i v i n g room ( a l s o her bedroom) whenever h e r daughter I s p r a c t i s i n g or p l a y i n g t h e p i a n o . The l i c e n s i n g board f e e l s t h a t i t i s e s s e n t i a l t h a t any new home b e i n g l i c e n s e d should be r e q u i r e d t o have a common s i t t i n g room f o r i t s inmates . No matter how com-f o r t a b l e or c h e e r f u l a bedroom may b e , or how convenient f o r v i s i t i n g , r e a d i n g or p l a y i n g c a r d s , i t remains a bedroom. A person who must be e i t h e r i n h i s bedroom or out of the house a l t o g e t h e r would- unders tandably become bored and d i s -c o n t e n t e d . A common room o f f e r s more o p p o r t u n i t y f o r p e r -sons to meet and become f r i e n d l y and p a r t i c i p a t e i n group a c t i v i t i e s . The inmates o f a home can share t h e i r en joy-ment i n r a d i o programs, i n games, i n " j u s t t a l k " , i n a com-mon room where they can meet c o m f o r t a b l y . - 9 4 -The equipment i n . a common B i t t i n g room should he such as t o a l l o w f o r both comfort and a c e r t a i n amount of m o b i l i t y . A number of easy c h a i r s would seem to be p r e f e r -able to c h e s t e r f i e l d s , although one or two c h e s t e r f i e l d s c o u l d be u s e f u l and comfortable. Easy c h a i r s a l l o w f o r group-i n g around a t a b l e f o r cards, or around a f i r e p l a c e f o r d i s -c u s s i o n , sewing o r having t e a and f o r p u l l i n g c l o s e under a lamp f o r reading. Easy c h a i r s and c h e s t e r f i e l d s meant f o r the use of o l d people should not be too deep or s o f t , f o r the o l d people f i n d them d i f f i c u l t to get i n t o and out of, and not too r e s t f u l or comfortable to s i t i n . L i k e a very s o f t bed, an over-stuffed., deep c h a i r tends to make o l d bodies s t i f f and weary. A common room should be provided w i t h a r a d i o , books, magazines, and a r e c o r d - p l a y e r and a piano i f the l a t t e r are p o s s i b l e . The r a d i o should be i n one corner of the room r a t h e r than near the c e n t r e , one matron suggested, so t h a t some might p l a y a t cards or read a t one end of the room without being s e r i o u s l y d i s t u r b e d by others l i s t e n i n g to the r a d i o . The l i g h t i n g should be adequate enough so t h a t a l l the c h a i r s i n the room could be used f o r reading a t one time. F l o o r lamps are probably the most convenient means of l i g h t i n g , since they can be adjusted to throw the l i g h t over the reader* s shoulder and can be moved about f o r other reasons. Overhead l i g h t i n g i s most undesirable f o r a common room; wa.ll b r a c k e t s and t a b l e lamps are much more convenient and comfortable, i f f l o o r lamps cannot be used - 9 5 f o r any r e a s o n . I n a d d i t i o n t o p r o v i d i n g a p l a c e where the o l d p e o p l e can meet and share a c t i v i t i e s , even i f they are i n d i -v i d u a l p u r s u i t s such as r e a d i n g , a common room p r o v i d e s a p l a c e where v i s i t o r s might be e n t e r t a i n e d , e s p e c i a l l y by persons who share a room w i t h s e v e r a l o t h e r s . The w r i t e r asked whether a separate room or two might not be f u r n i s h e d t o be used f o r v i s i t s o f f r i e n d s or r e l a t i v e s . Most matrons agreed i n p r i n c i p l e b u t p o i n t e d out why such a room c o u l d not b e made a v a i l a b l e i n . t h e i r own c a s e s . Three answered, d e f i n i t e l y n o t ; they f e l t t h a t each o l d person should have h i s own p r i v a t e room w i t h adequate enough f u r n i s h i n g s so t h a t he c o u l d e n t e r t a i n h i s v i s i t o r s i n h i s own home. T h i s o f course i s the most d e s i r a b l e s i t u a t i o n , but a s m a l l room f o r h o l d i n g v i s i t s i n p r i v a c y might be a p p r e c i a t e d by those not f o r t u n a t e enough t o be i n a home where, they can have t h e i r own p r i v a t e room. R e c r e a t i o n I n d o o r s : Reading I t must be remembered d u r i n g the f o l l o w i n g d i s -c u s s i o n t h a t the a c t i v i t i e s recorded here are those pursued by persons who have the e n t i r e day t o do w i t h as they see f i t . W i t h perhaps two except ions they do n o t , even, i n the b o a r d i n g homes make t h e i r own beds or t i d y t h e i r own rooms. The hours d u r i n g which they are a o t i e a t i n g or s l e e p i n g are t h e i r own fio do w i t h e n t i r e l y as they see f i t - t h i s cannot be empha$i£d too s t r o n g l y . - 9 6 -The f a v o r i t e i n d o o r a c t i v i t y o f a m a j o r i t y o f the o l d people i n the s i x t e e n homes v i s i t e d would appear t o be r e a d i n g , a l though i t i s d i f f i c u l t t o g e n e r a l i z e s i n c e whole groups o f o l d people i n some homes are r e p o r t e d t o never r e a d even a. newspaper, w h i l e other groups read a v i d l y and c o n t i n u o u s l y . A l l homes have some k i n d o f a book c o l -l e c t i o n , b u t a number o f these which were seen by the w r i t e r were made up of very o l d books , few of them good. For some reason most homes seem to have accumulated a supply o f the p e c u l i a r l y sacchar ine romances o f the e a r l y y e a r s o f t h i s c e n t u r y . However some o f the homes have had r e c e n t pocket s i z e e d i t i o n s of more modern books - mainly western and murder s t o r i e s - added t o t h e i r c o l l e c t i o n s . The Vancouver P u b l i c L i b r a r y v i s i t s the M a y f a i r N u r s i n g Home once each month, b r i n g i n g a new s e l e c t i o n o f books , and t a k i n g back the books l e f t the month p r e v i o u s . The l i b r a r y s t a f f endeavors t o f i l l r eques t s f o r p a r t i c u -l a r books i f the o l d people make any . Such an arrangement w i t h the L i b r a r y w o u l d ' b r i n g newer books to the o l d people and do away w i t h the compla int so o f t e n h e a r d , t h a t they have read a l l the books i n the b o a r d i n g home s e v e r a l t i m e s . The w r i t e r suggests t h a t i f the l i b r a r y i s unable tto g i v e a s i m i l a r s e r v i c e t o other homes, t h a t the matron c o u l d arrange t o have two or more l i b r a r y c a r d s , which a l l o w ten books t o be taken out a t once f o r a p e r i o d o f twenty-e i g h t d a y s , and r e a d i n g m a t e r i a l f o r the home c o u l d be obta ined through these c a r d s . I t would be p a r t i c u l a r l y •97-desirable to i n t e r e s t the old people themselves i n p a r t i c i -pating i n such an arrangement, and doing the selec t i n g of the books at the l i b r a r y themselves, This should not be done by d i r e c t urging i f the old people are reluctant to take on such a task, but i n t e r e s t i n t r i p s to the l i b r a r y f o r books for the home could be roused, for example, by asking help i n preparing a. guide l i s t from which to choose. The: passive acceptance apparently shown by the old people i n the homes where, the books were decades old and there was no c i r c u l a t i o n of books seemed more unhealthy than the i n -e r t i a shown bja the operators, but i t should be possible to overcome both with a l i t t l e e f f o r t . Such e f f o r t should not be expected of the personnel of the l i c e n s i n g and inspec-t i o n department, who already are faced with heavy work loads, but might be undertaken by interested lay persons or club or other groups. Hbre variety i n reading matter could be introduced also through c o l l e c t i o n of current magazines and pocket novels by such clubs and groups, but i t i s the opinion of t h i s writer that the more p o s i t i v e course would be to i n t e r e s t the old people i n selecting t h e i r own reading material through the l i b r a r y . This could then be supplemented by g i f t s of books and other reading material. Several homes supply one or more d a i l y newspa-pers to t h e i r inmates. Mrs. Bailey, for example, sub-scribes to a l l three l o c a l d a i l y papers, and these are read thoroughly, and discussed at length, by a number of men i n -98-t h e home. Neighbors c o n t r i b u t e c u r r e n t cop ies of s e v e r a l magazines as w e l l , so t h a t there i s always a good d e a l o f new r e a d i n g matter on hand. M r s . Blaney a l s o s u p p l i e s a d a i l y paper f o r her gues ts but f i n d s t h a t i t i s read v e r y l i t t l e . S e v e r a l papers d a i l y a r r i v e a t T a y l o r Manor - c o -p i e s o f a l l three l o c a l d a i l y p a p e r s . On the whole men a p -pear to spend a g r e a t e r p r o p o r t i o n o f t h e i r t ime r e a d i n g t h a n do the women i n b o a r d i n g homes, and t h i s i s e s p e c i a l -l y t r u e o f the newspapers. Those l a d i e s who do r e a d appear , f rom the few i n q u i r i e s the w r i t e r made, t o p r e f e r l o v e s t o r -i e s to a l l o ther k i n d s of r e a d i n g . The men l o o k f o r m y s t e r -i e s , wes terns , adventure s t o r i e s . A s m a l l m i n o r i t y r e a d b i o g r a p h i e s , books on t r a v e l and on s e r i o u s s u b j e c t s . Only one man was mentioned as l i k i n g t o read a l o u d , and he has formed a f r i e n d s h i p w i t h a f o r m e r l y v e r y l o n e l y b l i n d man who l i v e s i n the same home. Use o f Radios i n the Boarding Home Those homes which have common rooms have r a d i o s ' i n these rooms and these r a d i o s a r e . u s e d a good p a r t o f the d a y . Men are p a r t i c u l a r l y i n c l i n e d to f o l l o w news broadcas t s and news commentators. Some matrons s a i d the guests, l i s t e n i n groups t o c e r t a i n comedians, to p l a y s and t o some m u s i c a l programs, and on the whole p r e f e r p o p u l a r music when they are not l i s t e n i n g to a d e f i n i t e program. Some of the men i n two. or three homes are p a r t i c u l a r l y fond of western m u s i c . M r s . B a i l e y has found t h a t the men ' w i s h t o keep the r a d i o g o i n g s t e a d i l y , and she has found -99-i t necessary t o p r e s c r i b e the f o l l o w i n g l i m i t s t o t h e i r l i s t e n i n g ; the r a d i o i s not turned on e a r l i e r than 7.30 a . m . , and i s turned o f f between 1 p . m . and 3 .30 p . m . , which i s used as an a f t e r n o o n r e s t p e r i o d f o r most o f her g u e s t s , and the r a d i o i s p l a y e d s t e a d i l y from 3.30 p . m . u n t i l about 8.30 p . m . , when some of the men r e t i r e . I n some of the other homes there i s a t l e a s t one r a d i o i n . each bedroom, these b e l o n g i n g to the o l d peo-p l e themselves . Some matrons f i n d i t i s necessary t o i n -s i s t on r a d i o s , b e i n g turned o f f a t a reasonable hour a t n i g h t , w h i l e o thers are ab le to l eave t h i s to the d i s c r e -t i o n of the o l d p e o p l e , most o f whom are q u i t e ready t o r e s p e c t the d e s i r e s of the other persons s h a r i n g t h e i r rooms, fladios are w o n d e r f u l company f o r many of the o l d p e o p l e , a l though a p p a r e n t l y few. are p a r t i c u l a r l y d i s c r i m -i n a t i n g i n t h e i r cho ice o f program; they tend t o t u r n the r a d i o on and j u s t leave i t g o i n g a t the one s t a t i o n . One or two homes c o u l d make good use o f r a d i o s i n rooms where s e v e r a l l i v e , but the o l d people are unable t o a f f o r d these themselves . I n t e r e s t e d s e r v i c e c l u b s might be ab le t o h e l p o b t a i n a few. r a d i o s where they seem t o be needed. Other Amusements and Occupations. Indoors Cards a f f o r d a g r e a t d e a l o f p leasure to many of the aged people i n b o a r d i n g homes. Women p l a y br idge , and double s o l i t a i r e more than any other games, w h i l e men p l a y rummy, c r ibbage and other games b e s i d e s the two a l r e a d y named. I n the homes where t h e r e are common rooms, c a r d -100-games are i n p r o g r e s s every n i g h t , and o f t e n there i s a good d e a l o f f r i e n d l y r i v a l r y and i n some i n s t a n c e s games go on on an almost tournament "basis- In. o ther homes, c e r t a i n bedrooms have come to be used every n i g h t f o r c a r d games. One matron observed t h a t she has found she has t o make the e f f o r t t o get the o l d people t o b e g i n a game, b u t t h a t i t i s i n v a r i a b l y w o r t h w h i l e . She has l earned over her e l e v e n y e a r s o f e x p e r i -ence t h a t o l d people ( l i k e many o thers o f us) have t o be u urged and even, she a a i d "badgered a l i t t l e " , be fore they w i l l engage i n any group a c t i v i t i v e s but t h a t they enjoy i t once they b e g i n . Other games such as c h e c k e r s , dominoes and draughts are a l s o p o p u l a r i n a few. of the homes. S u r p r i z i n g l y few of the women l i v i n g i n the b o a r d -i n g homes k n i t or sew.. A f a c t o r may be f a i l i n g s i g h t and s t i f f f i n g e r s , a l though most matrons were i n c l i n e d t o blame t h i s c o n d i t i o n on sheer l a z i n e s s . I t seems reasonable t h a t a number o f them may j u s t have l o s t i n t e r e s t f o r l a c k of i n -c e n t i v e . There must be some s o r t o f purpose i n an a c t i v i t y o f t h i s s o r t . For a few. the achievement o f a. wel l -made or f i n e - l o o k i n g a r t i c l e may be enough. M i s s Fortune formed a k n i t t i n g c l u b among her . l a d i e s , which met far- two hours every week d u r i n g , t h e r e c e n t war . The l a d i e s enjoyed i t v e r y much, but i n t e r e s t lagged v e r y q u i c k l y a f t e r the war ended, and a t present none of her guests k n i t or sew. On the other hand, the women a t Sbroptomist House, who form almost a f a m i l y group , do q u i t e a b i t o f handwork, i n c l u d -i n g t a t t i n g l a c e . One woman of s e v e n t y - f o u r , who has always. - 1 0 1 -l e d an a c t i v e l i f e , c roche ts and makes h a t s , and en joys d o -i n g so v e r y much. M r s . D e a l s a i d t h a t two years ago she was able to i n t e r e s t the group of men l i v i n g i n her home a t t h a t t ime i n l e a r n i n g t o k n i t . They got a. l o t o f enjoyment f rom t h e i r k n i t t i n g , and concent ra ted main ly on s o c k s . The same group l e a r n e d to operate the sewing machine, and ga ined q u i t e a l o t of s a t i s f a c t i o n from doing s o . The men a t p r e s e n t l i v i n g i n her home are a p p a r e n t l y extremely apathe-t i c and r e f u s e t o take an i n t e r e s t i n a n y t h i n g , even i n watch ing boats on the F r a s e r E i v e r , which the home o v e r l o o k s . F u r t h e r A c t i v i t i e s w i t h i n the Home. T a l k i n g w i t h one another about the p a s t , p r e s e n t i n t e r e s t s , and so on and on, absorbs a l o t o f the t ime o f some o l d p e o p l e . I n some homes e v i d e n t l y the d i s c u s s i o n s and f r i e n d l y arguments are v e r y l i v e l y and g i v e a g r e a t d e a l o f enjoyment t o the inmates . I n o ther homes i t seemed a p -parent t h a t most o f the t a l k i n g among the inmates cons i s t s -o f " g r i p i n g n and q u a r r e l i n g , thus r e f l e c t i n g t h e i r g e n e r a l d i s s a t i s f a c t i o n w i t h l i f e and themselves . Homes which r e -p o r t e d t h a t the o l d people d i s c u s s many t h i n g s on a f r i e n d -l y b a s i s and w i t h enjoyment, a l s o r e p o r t e d the g r e a t e s t number of other a c t i v i t i e s and i n t e r e s t s pursued by the i n -mates, and d i s c o n t e n t and q u a r r e l i n g i n c r e a s e d as the i n -t e r e s t s decreased . R e l a t i o n s h i p s w i t h i n b o a r d i n g homes are improved as the o l d people l i v i n g i n them broaden t h e i r i n -t e r e s t s and f o r g e t t h e i r own s m a l l g r i e v a n c e s . There are a few s p e c i a l hobbies o f o l d people i n -102-the homes t h a t seem worth m e n t i o n i n g . One o l d woman c u t s out and. saves p r e t t y p i c t u r e s and pastes them i n t o s c r a p -books which she l a t e r g i v e s away. Another o l d woman who has become too s e n i l e t o c a r r y on any k i n d o f c o n v e r s a t i o n ) spends happy hours v e r y e f f i c i e n t l y r i p p i n g up w o o l l e n g a r -ments and p i l i n g up the p i e c e s which are used by a. church group f o r q u i l t s . One man whom the w r i t e r met d e l i g h t s i n B e t t i n g up b r i d g e hands and chess l a y o u t s , and working out how they c o u l d be p l a y e d . One: matron i n a home which has a s m a l l workshop i n the basement i s c o n s t a n t l y p e s t e r e d f o r j o b s to be done around the house by the two o l d men who e n -j o y u s i n g the workshop. They want the work they do t o be u e e f u l to someone. Almost a l l homes r e p o r t e d t h a t the o l d people take a r e s t or a nap a f t e r the noon meal , which i s a d e s i r -ab le t h i n g . The men and women who do n o t h i n g but r e s t , how-e v e r , are i n need of some k i n d of h e l p i n expanding t h e i r i n t e r e s t s and s o l v i n g some of t h e i r g r e a t e s t p e r s o n a l d i f -f i c u l t i e s , and, as has been suggested above, t h i s i s a d i f -f i c u l t and d e l i c a t e task which may be taken on by someone, i n a t l e a s t a l i m i t e d way i n the f u t u r e . R e c r e a t i o n Outdoors Most of the homes v i s i t e d are w i t h i n easy reach of shopping d i s t r i c t s and p a r k s or beaches . Many, perhaps most , o l d people i n the homes v i s i t e d , g o r f o r d a l l y w a l k s . Some take a c t i v e i n t e r e s t i n . window-shopping , i n meeting and t a l k i n g w i t h others^ i n the p a r k s or on the beaches, 103-i n . watching c h i l d r e n ' s games, and so on and o n . Others merely engage i n a form of mechanica l e x e r c i s e by w a l k i n g so f a r every day , o f t e n the same .route day a f t e r day f o r y e a r s , or go and s i t on a. park bench, where they a c t u a l l y do n o t h i n g but s i t . I t i s a. f a c t t h a t , as has been p r e v i o u s l y s t a t e d , o l d people p r e f e r t o be w i t h i n easy reach o f shopping and o ther f a c i l i t i e s . I n s p i t e of the v e r y gloomy p i c t u r e p a i n t e d above o f the a p a t h e t i c o l d age o f so many p e o p l e , a good p r o p o r t i o n o f the aged do not w i s h t o be out o f t o u c h w i t h the more a c t i v e w o r l d around them. Indeed q u i t e a number seem t o p a r t i c u l a r l y enjoy watching c h i l d r e n a t p l a y and are even ab le to en ter t h e i r games, a l though many o ther o l d people f i n d c h i l d r e n too n o i s y and i r r i t a t i n g t o be b o r n e . The p i t y i s t h a t many of the e x c u r s i o n s o f the o l d people are p u r p o s e l e s s and w i t h o u t much p l e a s u r e . T h i s i s f a r from t r u e f o r a l l . Many who have c h i l d r e n or r e l a t i v e s i n the c i t y v i s i t them r e g u l a r l y , as w e l l as r e c e i v i n g v i s i t s from them. The more contented inmates are o f t e n those who are on good terms w i t h t h e i r f a m i l i e s and ab le to. see q u i t e a b i t of them. M i s s F o r -tune s a i d t h a t a number of her guests are p a r t i c u l a r l y fond of s t r e e t car and bus r i d i n g , and o f t e n go o f f i n groups o f two, three or f o u r f o r whole a f t e r n o o n s , e s p e c i -a l l y Sunday a f t e r n o o n s . They p l a n out r o u t e s beforehand and exchange exper iences on t h e i r t r i p s l a t e r . She a l s o f i n d s the o l d l a d i e s enjoy the nearby beach, and o f t e n M i s s -104-F o r t u n e , on a n i c e summer day, w i l l pack a l u n c h f o r t h e e n t i r e group and take them down to the beach f o r a p i c n i c . Sometimes two or three w i l l take l u n c h t o a park or to the beach on t h e i r own. A l l homes have e i t h e r verandah or l a w n , or b o t h , on which the o l d people spend much of t h e i r time d u r i n g the snmmer. Here they r e a d , t a l k or sew, or p l a y c a r d s , j u s t as they do i n d o o r s . M r s . S e a l f i x e s up the verandah w i t h c h a i r s each summer, as w e l l as p r o v i d i n g c h a i r s , a c a r d t a b l e , c u s h i o n s , and p i e c e s of carpe t f o r the l a w n , so t h a t the men can l i e down or s i t on c h a i r s w h i l e out o f d o o r s . M r s . B a i l e y serves noon or evening meals on the lawn i f the men request i t and h e l p w i t h the necessary mov-i n g of f u r n i t u r e . They take advantage o f t h i s q u i t e o f t e n and enjoy a s e m i - p i c n i c meal very much i n d e e d . A few o l d men enjoy gardening and do some i n the grounds around the b o a r d i n g home. Much o f the care g i v e n the y a r d and garden a t M r s . F o w l e r ' s home I s g i v e n by one a c t i v e o l d man, and a t the I c e l a n d i c O l d P e o p l e ' s Home, the gardening and j a n i -t o r work i s done by a man of about seventy . He has not a c -cepted j o b s o f f e r e d him by ne ighbors because he l i k e s t o work a t h i s own speed and p l a n the garden h i m s e l f . S e v e r a l men a t T a y l o r Manor are i n t e r e s t e d i n working i n the y a r d and a r e encouraged to do so . A c t i v i t i e s brought i n t o the Homes On the whole r e l a t i v e l y few of the o l d people a t -tend Church r e g u l a r l y , but v e r y many o f t e n l i s t e n t o and -105-a p p r e c i a t e v e r y much, the Church s e r v i c e s "broadcast over the r a d i o every Sunday. More of them go t o s e r v i c e s d u r -i n g the summer than d u r i n g the l e s s p l e a s a n t w i n t e r wea-t h e r v . A. few m i n i s t e r s make f requent v i s i t s t o homes to spend a few minutes w i t h an i n d i v i d u a l g u e s t , and f o r a few men and women these v i s i t s mean a g r e a t d e a l . As f a r a s t h e w r i t e r c o u l d a s c e r t a i n , those o l d people who p l a c e a l o t o f va lue on r e l i g i o n and on keeping up c o n t a c t w i t h t h e i r Church , are a l l people who have always g i v e n r e l i -g i o n a r e a l p l a c e i n t h e i r l i v e s . I n the M a y f a i r and one o r two o ther homes, r e g u l a r Church s e r v i c e s are conducted by v i s i t i n g c lergymen, and these are w e l l a t t e n d e d . Other groups o c c a s i o n a l l y v i s i t c e r t a i n homes t o e n t e r t a i n the o l d p e o p l e . T a y l o r Manor has a stage a t one end of the common room, and has c o n c e r t s w i t h some r e g -u l a r i t y . M r s . Douglas , matron a t T a y l o r Manor, s a i d t h a t she had observed t h a t c o n c e r t s should be f a i r l y s h o r t f o r o l d people t o be able to s i t through them i n comfor t , and they appear t o p a r t i c u l a r l y enjoy c h i l d r e n p e r f o r m i n g , and h e a r i n g f a m i l i a r m u s i c . S ing-songs are always p o p u l a r . A t the M a y f a i r home, a group of Mennonite g i r l s come every two weeks to s i n g f o r about f o r t y - f i v e minutes , and t o l e a d i n some group s i n g i n g . T h i s program i s v e r y en joyable t o the inmates . A t C h r i s t m a s , t o o , the L y t t o n S t u d i o s brought a concer t to the home and the inmates had r e f r e s h -ments and a s h o r t p a r t y f o l l o w i n g i t . The I c e l a n d i c Old P e o p l e ' s Home has been used by the Lutheran Women's A u x i --106-l i a r y f o r h o l d i n g a. w h i s t d r i v e , and the o l d people had a l o v e l y t i m e . Some p l a y e d w h i s t , o t h e r s watched the p l a y i n g - , and two h e l p e d prepare the l u n c h . Other o r g a n i z a t i o n s a l s o use the home f o r s i m i l a r p u r p o s e s . The w r i t e r was unable t o determine , however, whether the o l d people themselves are c o n s u l t e d about enter ta inments t o be h e l d t h e r e , or whether they are merely n o t i f i e d a f t e r p l a n s are made. Two matrons have a p p a r e n t l y done some f i n e work i n h e l p i n g a few o l d people overcome d i s a b i l i t i e s . One, who i s a h e a r t y c h e e r f u l p e r s o n , and who says she " k i d s and b u l l i e s " many men i n t o t a k i n g up some k i n d o f a c t i v i t y , says ,she has had one or two enter her home w i t h t h e i r hands a l l k n o t t e d u p , and t h a t now they are able to work a l i t t l e i n the garden and t o feed and c l o t h e themselves w i t h l e s s t r o u b l e . " P a t i e n t , unders tanding nagging d i d the t r i c k " , she s a i d . One man i n another home, who i s p a r a l y z e d on one s i d e , has l e a r n e d , w i t h the matron ' s h e l p , t o thread n e e d l -es u s i n g h i s t e e t h , and t o do rough mending. A v e r y spe-c i a l e f f o r t on the matron ' s p a r t i s needed t o a c c o m p l i s h such t h i n g s , and i s 4 r e a l l y more than can be expected o f matrons who are charged w i t h a l l the many d u t i e s o f r u n -n i n g a b o a r d i n g home. The Problem of the A p a t h e t i c O l d People Most o f the matrons spoke almost w i t h d e s p a i r of the inmates who s i t by the hour d o i n g n o t h i n g and t o a l l appearances t a k i n g no i n t e r e s t i n anyone or a n y t h i n g . They f e e l , p a r t i c u l a r l y w i t h r e f e r e n c e t o women, t h a t i t i s ex --107-t remely u n f o r t u n a t e t h a t they should have g i v e n up a l l a c -t i v e i n t e r e s t s so complete ly t h a t they no longer take any p a i n s w i t h themselves or t h e i r rooms. Most women have a t one. time or another kept house and might be expected t o have, some l i n g e r i n g i n t e r e s t i n the appearance o f t h e i r rooms. Most matrons gave the i m p r e s s i o n t h a t they f e e l a c e r t a i n i n t o l e r a n c e , and even d i s g u s t , towards other women who have become so a p a t h e t i c ; and undoubtedly they convey t h e i r a t t i t u d e s t o the o l d women, who might be expected to r e s i s t e f f o r t s to engage them i n a c t i v i t i e s such as making t h e i r own beds or t i d y i n g t h e i r own rooms. Men, t o o , g i v e up a l l a c t i v i t i e s and i n t e r e s t s save perhaps a d a i l y walk and a l i t t l e d e s u l t o r y t a l k w i t h o ther men, but t h i s does not seem to rouse q u i t e the amount o f antagonism and concern t o matrons. T r a d i t i o n a l l y men are expected to r e s t a t home. The opera tors of the homes who were i n t e r v i e w e d a l l expressed concern over the l a c k o f i n i t i a t i v e and i n t e r e s t " i n so many o l d p e o p l e , and two were able to express the o p i n i o n t h a t those who s e t t l e d i n t o a n e a r - v e g e t a t i v e s t a t e on e n t e r i n g a h o a r d i n g home "grew Q l d " much more r a p i d l y t h a n they might have done i n a s e t t i n g t h a t demanded more from them- The t e r r i b l e waste i n v o l v e d i n so many persons almost l i t e r a l l y s i t -t i n g down i n a corner and w a i t i n g f o r death b o t h e r s some of the matrons a. good d e a l , and i n a l l l i k e l i h o o d i n f l u -ences t h e i r a t t i t u d e towards the o l d p e o p l e . S e v e r a l v o i c e d the need they f e l t f o r someone who c o u l d " s t i r them -108-up" and g e t them doing something - a n y t h i n g - j u s t as l o n g as they showed some enthusiasm f o r i t . The problem i s one which might c h a l l e n g e the most s k i l l e d worker . P e r s o n a l unhappiness due t o n e g l e c t by t h e i r . fami ly and f r i e n d s , p e r s o n a l i t y d i f f i c u l t i e s which may have always e x i s t e d and now are on ly p o i n t e d up by age and other t r o u b l i n g f a c t o r s , and many other t h i n g s , added t o the r a t h e r d e s t r u c t i v e a t t i t u d e o f s o c i e t y t o o l d age, p r o b a b l y a l l operate i n some degree t o cause the aged i n d i -v i d u a l to g i v e up e v e r y t h i n g but concern w i t h h i s own com-f o r t . I t may be t h a t group work techniques w i t h i n a b o a r d -i n g home might h e l p some a t l e a s t to face l i f e w i t h a h e a l -thy c u r i o s i t y and a d e s i r e t o take t h e i r p l a c e s to the b e s t o f t h e i r a b i l i t i e s . But f o r many, i n t e n s i v e case work might be needed t o h e l p the o l d people t o f a c e the r e a l i t i e s o f o l d age and the present s i t u a t i o n , and r e s o l v e some of t h e i r f e a r s . Perhaps w i t h some, h e l p i n b r i n g i n g about b e t -t e r r e l a t i o n s w i t h f a m i l y or o t h e r s i n the community might • make them able t o move out i n t o some k i n d of a c t i v i t y . There would o f course a lways be some who c o u l d only be h e l p e d , i f a t a l l , by a p s y c h i a t r i s t . S ince there I s l i t t l e p o s s i b i l i t y t h a t such s e r -v i c e s w i l l be a v a i l a b l e t o o l d people i n b o a r d i n g homes f o r s e v e r a l y e a r s to come, i t would seem a d v i s a b l e t h a t some t h i n k i n g be done a s t o what methods might be used to teach o l d people i n . the homes and t o h e l p them b e g i n t o make use o f t h e i r t i m e . S i n c e t h i s i s a matter which would c a l l f o r -109-s k i l l and a g r e a t d e a l o f t ime and p a t i e n c e , i t might be something which c o u l d be c l o s e l y s u p e r v i s e d by the p r o f e s -s i o n a l worker whom the Committee on the. Care o f the Aged hope t o engage i n the near f u t u r e . As has been suggested so many t imes before i n t h i s s t u d y , a s e r v i c e c l u b might attempt -a program i n one home b u t i t would o n l y be e f f e c -t i v e I f done i n a sound and s k i l l e d way, and t h e r e f o r e i t would seem a d v i s a b l e to suggest t h a t i t needs t o be a t l e a s t s u p e r v i s e d by a p r o f e s s i o n a l group l e a d e r . Summary G e n e r a l l y , o l d people spend a good d e a l o f t h e i r time, r e a d i n g , l i s t e n i n g t o t h e i r r a d i o s , t a l k i n g , p l a y i n g c a r d s , w a l k i n g and s i t t i n g out o f d o o r s . The m a j o r i t y have no a c t i v e hobbies such as g a r d e n i n g , sewing or k n i t t i n g , a l t h o u g h there are u s u a l l y one or two i n each home who do pursue some such a c t i v i t y . I t would appear from a few ex-amples c i t e d , as f o r i n s t a n c e where a group of men were persuaded t o t a k e up k n i t t i n g , t h a t where someone i s ab le t o g i v e l e a d e r s h i p , the o l d p e o p l e ' s i n t e r e s t s can be a -r o u s e d . I t i s p o s s i b l e t h a t i n f u t u r e such l e a d e r s h i p might come through the s o c i a l worker who w i l l be employed by the Committee on the Care o f the Aged, who would p r o b a -b l y l e a d and h e l p a group of v o l u n t e e r s , who might be drawn from i n t e r e s t e d s e r v i c e c l u b s . What k i n d s o f programs and • a c t i v i t i e s might b e s t be brought t o o l d people i n b o a r d i n g • homes, and what methods used i n awakening t h e i r i n t e r e s t , - 1 1 0 -might w e l l be mat ters f o r f u r t h e r s t u d y , p ro bab l y by a group w o r k e r . C e r t a i n l y the apathy and i n d i f f e r e n c e t o o ther persons and a c t i v i t i e s around them t h a t i s shown by so many o l d people i n b o a r d i n g homes i s to be d e p l o r e d , s i n c e i t means unhappy boredom f o r the o l d , and a r e a l waste of energ ies and c a p a c i t i e s t h a t might be used t o make v a l u a b l e c o n t r i b u t i o n s t o the community. - I l l -Chapter I X RELATIONSHIPS WITHIN BOARDING HOMES A good d e a l o f t ime and a t t e n t i o n has been g i v e n t o e v a l u a t i n g environmenta l f a c t o r s i n b o a r d i n g homes f o r the aged i n the p r e c e d i n g c h a p t e r s ; so much, i n d e e d , t h a t i t might seem t h a t the p h y s i c a l appointments are o f p r i m -a r y importance i n a b o a r d i n g home* That t h i s i s not so i s a t t e s t e d t o by the f a c t t h a t the l i c e n s i n g a d m i n i s t r a -t o r s w i l l not approve a new home f o r l i c e n s e i f i t appears t h a t the person a p p l y i n g f o r l i c e n s e does not have the type o f p e r s o n a l i t y t h a t would make h im or her s u i t a b l e f o r work o f t h i s k i n d , however i d e a l the proposed premises may b e . That a minimum s tandard f o r b o a r d i n g home f a c i l i t i e s i s v e r y necessary has been s t a t e d b e f o r e , and the W e l f a r e I n -s t i t u t i o n s L i c e n s i n g A c t guarantees such a s tandard i n t h i s p r o v i n c e . P h y s i c a l comfort i s a r e q u i s i t e f o r happiness and contentment, but i t can only supply the background f o r such contentment. I f an aged p e r s o n f e e l s he i s an i n t e r l o p e r or a b a r e l y t o l e r a t e d guest i n a l u x u r i o u s and c a r e f u l l y planned home, the comfor ts he enjoys w i l l mean l i t t l e t o h i m , or w i l l come t o mean too much. Or i f he I s t r e a t e d l i k e a p r e c i o u s but u s e l e s s person who must be spared a l l r e s p o n s i b i l i t i e s and e f f o r t s , he would be q u i t e j u s t i f i e d i n f e e l i n g he has been she lved and no l o n g e r has any c o n -t r i b u t i o n to make to the w o r l d . i -112> E v e r y matron who waa i n t e r v i e w e d , however a f -f e c t i o n a t e and a c c e p t i n g h e r a t t i t u d e i a towards o l d peo-p l e , s t a t e d t h a t i n . order t o make a success o f a b o a r d i n g home f o r the aged, one must f i r s t of a l l " u n d e r s t a n d " o l d p e o p l e . Even the two matrons who are probab ly c l o s e to seventy themselves seemed t o r e g a r d the aged as b e i n g a race or k i n d a p a r t from other humans., as though p l a c i n g " o l d " and " p e o p l e " together i n a phrase changes the mean-i n g of the two words as much as the mRfln'tng o f " n i g h t " and "mare" change when they are used t o g e t h e r . There seemed t o be no r e c o g n i t i o n of the f a c t t h a t the e l d e r l y man or woman i s s imply a. man or woman who has l i v e d q u i t e a l o n g t i m e , and who can be expected to have the same k i n d s o f p e r s o n a l i t y s t r u c t u r e s and needs and d e s i r e s and r e a c t i o n s as other people\have not l i v e d qui te , so l o n g . I t seems l o g i c a l t o say t h a t p r o b a b l y many of the problems t h a t a r i s e w i t h aged persons would never a -r i s e i f the o l d were not made to f e e l by the r e s t o f the w o r l d t h a t they are no l o n g e r q u i t e of the w o r l d . The work ing w o r l d has no job to o f f e r to the l e s s a g i l e and q u i c k person whose p h y s i c a l s t r e n g t h and stamina have d e -creased 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 there i s no room f o r an o l d e r p e r s o n , whose own home has perhaps been broken by d e a t h . Hew ideas and methods have come i n t o use f a s t e r than he has been able to keep a d j u s t i n g h i m s e l f t o them, 113-and he i s regarded merely as an " o l d fogey" by the young-e r g e n e r a t i o n s , who have no d e s i r e to hear h i s o p i n i o n s , or respecty'them i f he does speak up- G r a d u a l l y i t i s borne i n to him from, a l l s i d e s t h a t he I s s u p e r f l u o u s - 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 , or a t r e a s u r e d and b e l o v -ed s u p e r f l u i t y , or perhaps a r a t h e r "amusing" ,one. The n a t u r a l r e a c t i o n s t o a. f e e l i n g o f no l o n g e r b e l o n g i n g t o the w o r l d or hav ing a. r e a l p a r t to p l a y i n i t are the ones which cause some of the d i f f i c u l t i e s t h a t are met w i t h by those working w i t h the aged- They perhaps f i g h t back by be ing i r r i t a b l e and o v e r - c r i t i c a l , or seek a v i c a r i -ous s h a r i n g of 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 the a f f a i r s , of o t h e r s . They may r e t r e a t to a p o s i t i o n o f s u p e r -i o r i t y from which they 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 i s 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 are ab le t o meet the attempt o f the w o r l d t o she lve 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 them-s e l v e s , l e a r n i n g new t h i n g s , perhaps , or i n some way demon-s t r a t i n g t h a t they most, e m p h a t i c a l l y are not " d o n e " . What-ever the r e a c t i o n o f an i n d i v i d u a l may b e , i t i s l a r g e l y d e -termined by the degree of m a t u r i t y he had reached d u r i n g h i s a d u l t h o o d , and the p a t t e r n of r e a c t i o n s he had e s t a b l i s h e d l o n g y e a r s s i n c e . The aged person meets the c r i s e s of l i f e a t t h i s stage the way t h a t he has always met them; he meets t h e r e -f o r e the c r i s i s o f o l d age i n the manner t h a t i s , and has -114-been, c h a r a c t e r i s t i c f o r h i m . O l d age and r e t i r e m e n t too o f t e n b r i n g w i t h them d u l l and u s e l e s s d a y s , f o r many and 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 . S ince o l d age i s "a. phase of l i f e w i t h the fewest a d a p t a t i o n p o s e i -1 b i l l t i e s " when "the. p l a s t i c i t y of the ego i s gone, as 2 w e l l as the a b i l i t y t o modify the environment" , the i n -d i v i d u a l meets the d i f f i c u l t i e s t h a t o l d age b r i n g s w i t h i t w i t h an i n t e n s i f i e d v e r s i o n o f h i s c h a r a c t e r i s t i c way. o f r e a c t i n g t o l i f e . Old age c a r r i e s i n i t s wake f r u s -t r a t i o n s and l o s s e s i n most areas of l i v i n g . P h y s i c a l s t r e n g t h I s decreased , and f o r many there i s a f a i l i n g of 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 both f i n a n c i a l and p h y s i c a l dependence i n some degree to a g r e a t many p e r s o n s . P o s s i b l y most s e r i o u s o f a l l the c a l a m i t i e s age can v i s i t on the o l d i s e m o t i o n a l s t a r -v a t i o n , which so o f t e n comes a t a t ime when a l l the o t h -e r d isadvantages o f o l d age are making themselves f e l t . The o l d a r e people who have l i t t l e t ime l e f t on t h i s e a r t h , a f a c t which i s f a c e d w i t h r e l u c t a n c e . They are made to f e e l u s e l e s s and o f t e n unloved-. " O l d age i s r a r e l y a t t r a c t i v e to o thers or p l e a s a n t t o the o l d , even when i t can pay i t s way and r e t a i n i t s w i t 1 . P o w e l l , Amy S . and Fox , F l o r a , "Growth i n Old A g e " , The F a m i l y , V o l . 20 , P . 119 2 . L o c . C i t . 115-1 and h e a l t h . B u t the. f l a v o u r of l i f e l a s t s a l o n g w h i l e " . The aged do not want to be apar t f rom the w o r l d around them, or t o oease f u n c t i o n i n g as c i t i z e n s and members o f f a m i l i e s , b u t the cumulative ' e f f e c t o f the i l l s and d i s a -b i l i t i e s , p h y s i c a l l y , of age, p l u s a l l the s o c i a l and eco-nomic pressures which tend to i n c r e a s e w i t h age, d r i v e s many aged persons, i n t o one k i n d o f r e t r e a t or a n o t h e r . That t h i s p r o c e s s has been under way f o r some t i m e , o f t e n f o r y e a r s , before the o l d person f i n d s h i s way i n t o a b o a r d i n g home, makes the task of a c h i e v i n g a h e a l t h y k i n d o f a d j u s t -ment a c h a l l e n g i n g and d i f f i c u l t one. A t t i t u d e s , o f Operators t o Old Age The w r i t e r ga thered from the content o f c o n v e r s a -t i o n s and the manners of. the matrons w h i l e t a l k i n g , t h a t most of them see the o l d people as d i s p l a y i n g , w i l f u l l y or o t h e r w i s e , t r a i t s t h a t are p e c u l i a r to the o l d , - o r The O l d - as d i s t i n g u i s h e d from, t r a i t s d i s p l a y e d by p e o p l e . S ince t h i s seems to be the t h i n k i n g of most people i t i s q j i i t e n a t u r a l t h a t i t i s shared by the matrons of o l d p e o p l e ' s homes. S e v e r a l matrons and opera tors s a i d , c a t e g o r i c a l l y , t h a t they l i k e o l d p e o p l e . Probably t h i s means t h a t they l i k e p e o p l e , t h e r e f o r e they a l s o l i k e people who are o l d . 1 . Banning , Margaret C u l k i n , " P e r s o n a l I n s p e c t i o n " Survey Mjdmonthly, S e p t . 1941. -116-There was g e n e r a l r e c o g n i t i o n amongst the o p e r a -t o r s of the h o a r d i n g homes \ z i s i t e d / t h e p h y s i c a l needs o f o l d people b e i n g the same as1 those of a l l p e o p l e , w i t h m o d i f i -c a t i o n s due to d e c l i n i n g s t r e n g t h and e f f i c i e n c y - The spe-c i a l needs of o l d people are needs f o r adjustments i n the environment to gear i t to t h e i r shower and l e s s sure b o d i e s : fundamenta l ly the needs remain the same as f o r a l l of u s . T h e r e f o r e , t h e o r e t i c a l l y a t l e a s t , the problems of a d j u s t -ment t o be met w i t h i n a b o a r d i n g home should be much the same as those which are met w i t h i n more normal c i r c u m s t a n -c e s . Because, the matron or operator occupies such a "re-s p o n s i b l e p o s i t i o n i n the b o a r d i n g home h i s or her p e r s o n -a l i t y and a t t i t u d e s have a very g r e a t d e a l to do i n c r e a t -i n g the atmosphere i n the home. As has been p o i n t e d o u t , the matrons on t h e whole expressed a. l i k i n g f o r o l d p e o p l e . One, however, s a i d f r e n k l y t h a t she d i s l i k e d them. A second i n d i c a t e d almost as c l e a r l y by her e x p r e s s i o n when t a l k i n g , and the s u b j e c t s o f her t a l k , t h a t she i s r a t h e r s t r o n g l y r e p e l l -ed by aged p e o p l e . The e f f e c t s of these f e e l i n g s on the: p a r t of the person i n charge were d i s c e r n i b l e even t o the r e l a t i v e l y c a s u a l o b s e r v e r . The j o l l y , r a t h e r b l u f f ma-t r o n who t r e a t e d her "boys" w i t h an a f f e c t i o n a t e condescen-s i o n , ach ieved r a t h e r a j o l l y atmosphere i n the whole b o a r d i n g home. The o l d men do respond to her h e a r t i n e s s , and enjoy her motherly k i n d n e s s . They keep themselves and -117-t h e i r rooms q u i t e n e a t , they s i t i n l i t t l e groups and t a l k , and look up g l a d l y when t h e i r matron comes a l o n g . But they are d i s p i r i t e d and hopeless f o r a l l t h a t . T h e i r matron, who l i k e s them and cares f o r them even t e n d e r l y , and who b r i n g s them a c h e e r f u l v i t a l i t y , n e v e r t h e l e s s f e e l s they are i n f e r i o r b e i n g s , and r e f l e c t s i t i n her a t t i t u d e t o -wards them. Almost every matron or opera tor of a b o a r d i n g home who was i n t e r v i e w e d d u r i n g the course of t h i s s t u d y , conveyed, more or l e s s s u b t l y , h i s or her sense o f the i n -f e r i o r i t y of the aged. One matron spoke o f them a f f e c t -i o n a t e l y as b e i n g l i k e c h i l d r e n to h a n d l e , and s a i d one became v e r y much a t tached t o them. Her v o i c e h e l d much the same note o f tender amusement i t might have h e l d i f she had been r e f e r r i n g to p e t s . S second matron p u t t h i s a t t i t u d e i n t o words when she s a i d , "They are on ly grown-up c h i l d r e n , " and i n d i c a t e d t h a t she uses c a j o l e r y and p e r s u a s i o n r a t h e r than a more mature approach whenever she has o c c a s i o n t o have d i r e c t c o n t a c t w i t h any o f h e r o l d l a d i e s . A number of l i k e examples c o u l d be quoted t o g i v e emphasis to the statement t h a t opera tors do not see t h e i r b o a r d i n g home inmates as b e i n g f u l l y human. W i t h the most e x c e l l e n t o f i n t e n t i o n s almost a l l speak t o t h e i r aged r e s i d e n t s w i t h a. s l i g h t l y a r t i f i c i a l h e a r t i -n e s s , i n a m o d i f i e d form of the manner so many otherwise -118-p l e a s a n t and i n t e l l i g e n t people assume when they speak t o c h i l d r e n . The v e r y way i n which r e c o g n i t i o n and a p p r o v a l a re g i v e n to the o l d u n d e r l i n e s the f e e l i n g t h a t these are a group of i n f e r i o r b e i n g s . I t i s a matter of p l e a s e d s u r p r i z e on the p a r t of We, the s u p e r i o r b r e e d , t h a t t h i s o l d lady c o n t i n u e s to sew and c r o c h e t , t h a t t h a t o l d man does an e x c e l l e n t job of keeping equipment r e p a i r e d , t h a t a group of men keep up an i n t e l l i g e n t i n t e r e s t i n c u r r e n t e v e n t s . Operators of b o a r d i n g homes f o r the aged are not alone g u i l t y o f t h i s a t t i t u d e , o f c o u r s e . Our whole c u l t u r e c o n d i t i o n s us to expect l i t t l e from the aged b u t a d e s i r e f o r p h y s i c a l comfor ts - I t would seem d e s i r e -a b l e - r a t h e r , necessary - t h a t persons who are r u n n i n g or p l a n n i n g t o r u n homes f o r the aged should be g i v e n some k i n d of o r i e n t a t i o n c o u r s e . They might be h e l p e d t o r e a l i z e t h a t , w h i l e there are obvious and i n e v i t a b l e l o s s e s of p h y s i c a l s t r e n g t h and c o o r d i n a t i o n , mental pow-e r s a r e l o s t very s l o w l y . Old people t e s t equal w i t h young on vocabulary and g e n e r a l i n f o r m a t i o n t e s t s , and o n l y s l i g h t l y lower i n such t h i n g s as mathematics' where speed and mental a g i l i t y p l a y a p a r t . Moreover , such f a c t o r s as the remoteness o f the p e r s o n s 1 s c h o o l d a y s , t h e l a c k of e d u c a t i o n a l o p p o r t u n i t i e s , and l a c k of i n -c e n t i v e may p l a y a l a r g e p a r t i n such d i f f e r e n c e s i n m e n t a l and i n t e l l e c t u a l powers a s are shown between -119-1 the young and the o l d . I f the o p e r a t o r s knew the p o t e n t i -a l i t i e s of o l d people they mightbe a b l e to meet the aged on an equal f o o t i n g and h e l p the o l d people t o a h a p p i e r a d -j u s t m e n t . However k i n d l y and c o n s i d e r a t e the s t a f f of a home may b e , so long as they see t h e i r aged inmates as s l i g h t l y sub-human incompetents o f whom l i t t l e can be ex -p e c t e d , they w i l l r e f l e c t t h i s i n t h e i r t reatment o f them. The aged cannot h e l p r e a c t i n g t o t h i s a c c o r d i n g to t h e i r i n d i v i d u a l p e r s o n a l i t i e s , ' p e r h a p s by r e s i s t i n g r a t h e r a n -g r i l y , perhaps by b e i n g i n g r a t i a t i n g and a l i t t l e humble. But t h e i r sense o f i n f e r i o r i t y i s he ightened by i t . One o f the g r e a t e s t s teps toward p r o v i d i n g a h a p p i e r o l d age f o r inmates o f b o a r d i n g homes, i n d e e d , f o r a l l o l d p e o p l e , would be t h e r r e c o g n i t i o n by a l l ( i n c l u d i n g the aged) t h a t an o l d person i s as t r u l y a person as he was when young. The o l d have much t o c o n t r i b u t e , i n exper ience and s t e a d i -ness and s k i l l s , but they are b l o c k e d by the l a c k o f r e -c o g n i t i o n of t h e i r a s s e t s by the g e n e r a l p u b l i c , and by t h e i r own f e e l i n g s o f i n s e c u r i t y and i n f e r i o r i t y . A t t i t u d e s of Operators to t h e i r R e s i d e n t s As has been p o i n t e d o u t , most o p e r a t o r s r a t h e r ""talk down t o " the o l d p e o p l e , even when they l i k e them 1 . L o r g e , I r v i n g "The E v a l u a t i o n o f M e n t a l S ta tus as a F u n c t i o n of the M e n t a l Tes t " J o u r n a l o f O r t h o p s y c h i - a t r y , George Banta P u b l i s h i n g C o . , Menasha, Wiscon-s i n , J a n . , 1940. -120 v e r y much. T h i s i s a g e n e r a l o b s e r v a t i o n and i n t h i s w r i t e r ' s o p i n i o n must, b r i n g a r e a c t i o n from the o l d p e o -p l e themselves . However, the f e e l i n g t h a t the o l d are b o t h d i f f e r e n t from and i n f e r i o r to o ther people appears t o be so thoroughly b a s i c i n . many minds t h a t i t may be, i m p r a c t i c a l t o suggest e d u c a t i n g i t out of those minds . On an i n d i v i d u a l b a s i s , probab ly a case worker w i t h the t i m e t o devote to work ing w i t h each matron or opera tor s e p a r a t e l y c o u l d h e l p h i m or her t o r e c o g n i z e and a c -knowledge the f a c t that , an unconsc ious c o n v i c t i o n has l e d h im ( o r her ) t o t r e a t the o l d w i t h condescension r a t h e r than a s e q u a l s . One or two matrons regard, t h e i r r e s i d e n t s as n o t h i n g more than c h i l d r e n . They have a f f e c t i o n f o r them and a degree o f u n d e r s t a n d i n g , but they do appear t o dfeel t h a t they are no l o n g e r capable o f making even minor d e -c i s i o n s f o r themselves . They arrange t h i n g s f o r the o l d people t h a t they are p e r f e c t l y a b l e t o take c a r e o f them-s e l v e s , and which they would p r o b a b l y be p l e a s e d to do i f they were g i v e n a l i t t l e encouragement. They "manage" them by d i v e r t i n g t h e i r a t t e n t i o n t o something new when the o l d people are "compla in ing , or d o i n g a n y t h i n g which does, not p lease the o p e r a t o r s . T h i s i s done on the a s -sumption - a t r u e one f o r some, no doubt - t h a t the e l d e r -l y man or woman on whom such t a c t i c s are used does not r e c o g n i z e the maneuver when he or she sees i t . An a p -proach which i m p l i e s t h a t the opera tor or matron c r e d i t s - 1 2 1 -the o l d person w i t h o r d i n a r y n a t i v e i n t e l l i g e n c e would be much h e a l t h i e r and should e l i c i t an eager response . The o l d person who i s f o r c e d t o leave h i s own home and perhaps some of h i s own f a m i l y to en ter a b o a r d i n g home where p r i -vacy i s perhaps a t a premium, and o r d i n a r y c o n t a c t s are m i s s i n g , needs to be accorded the d i g n i t y o f b e i n g t r e a t e d as a worthwhi le and r e s p o n s i b l e a d u l t by the s t a f f o f the home where he has come t o l i v e . I t has been p o i n t e d out e a r l i e r t h a t the a t t i -tude t h a t the o l d person i s h a r d l y a r e s p o n s i b l e a d u l t i f i o f t e n u n c o n s c i o u s . Where i t i s d e l i b e r a t e , i t i s . o f t e n so w i t h the b e s t of m o t i v e s . A g a i n , a worker who was a b l e t o spend a l o t o f time w i t h the matrons or opera tors o f homes on other then the more s t r a i g h t forward i s s u e s , might be able t o h e l p them r e a d j u s t t h e i r t h i n k i n g a l i t -t l e . Wi th the r i g h t k i n d o f h e l p they c o u l d r e c o g n i z e a t t i t u d e s on t h e i r own p a r t o f which they are p r o b a b l y not aware. The o l d people who found the opera tors meet-i n g them a s e q u a l s and hot as b e l o v e d but i r r e s p o n s i b l e c h i l d r e n , or as irksome c h i l d r e n , would l o g i c a l l y r e -spond by f e e l i n g h a p p i e r and more a t home and t h e r e f o r e "more eager to a d j u s t t o everyone i n the home. A New InmateNe The matter of adjustment to such a new and t o -t a l l y d i f f e r e n t environment would be d i f f i c u l t f o r the most p l i a b l e n a t u r e . Old people a r e n o t o r i o u s f o r ' b e i n g " s e t i n t h e i r ways" . I t would be a w o n d e r f u l t h i n g i f -122 placement o f an aged peraon i n a home c o u l d be c a r e f u l l y planned and c o n s i d e r e d . I d e a l l y he would have time t o c o n s i d e r the reasons f o r placement and be g i v e n support w h i l e he accepted them. He. s h o u l d be able t o v i s i t one o r more homes more than once so t h a t he c o u l d make a c o n -s i d e r e d c h o i c e . I t . would be h e l p f u l a l s o i f a worker were a v a i l a b l e to g e t a s o c i a l h i s t o r y so t h a t r e a l thought c o u l d be g i v e n to s e l e c t i o n o f a home, and the s t a f f of the home g i v e n an unders tanding of the p e r s o n . N a t u r a l l y , where shortage o f accommodation i s so acute t h a t placements are u s u a l l y made on an emergency b a s i s , such i d e a l i s t i c p l a n s are r i d i c u l o u s . N e v e r t h e l e s s there are some t h i n g s which can ease the new inmate i n t o h i s new home. M. f r i e n d l y matron who t r e a t s him as an i n t e l l i g e n t person whom she expects i s g o i n g t o make every e f f o r t to f i t i n , can do a l o t i n the i n i t i a l meet ing . The o l d person has the r i g h t to know j u s t what the house r u l e s a r e and why they e x i s t . As w i t h everyone e l s e , w i t h the o l d person the r u l e s should be. enumerated and e x p l a i n e d i n terms of the t o t a l b e n e f i t to a l l members of the h o u s e h o l d . T h i s i n i t s e l f does two t h i n g s . I t h e l p s the person t o accept r e g u l a -t i o n s as necessary and reasonable i n s t e a d of s e e i n g them a s measures d e l i b e r a t e l y aimed a t c u r b i n g h i s l i b e r t y . I t a l s o i n v i t e s h i s p a r t i c i p a t i o n i n the program of a house-h o l d o f which h e , i n t h a t p a r t i c i p a t i o n , becomes a member. The a c t u a l p r a c t i s e a t the entrance o f a new -123 inmate may i n some i n s t a n c e s be something l i k e the above o u t l i n e . However, i n q u i r y r e v e a l e d t h a t there i s no r e a l s c r e e n i n g o f a p p l i c a n t s and study before placement , due, as h a s , a l r e a d y been p o i n t e d out , t o the f a c t t h a t accom-modation i s so l i m i t e d t h a t no attempt i s made even to fists. keep w a i t i n g / The concensus o f o p i n i o n seemed to be t h a t t h e matrons take whoever comes a t the time a vacancy oc -c u r s and takes a chance on t h e i r f i t t i n g i n t o the home. D i s s e n t e r s who are troublesome and s imply w o n ' t a d j u s t have to g o . U s u a l l y t h i s i s not done w i t h o u t some e f f o r t b e i n g made t o h e l p the d i s s e n t e r s t o f i n d t h e i r p l a c e s . - . One operator d i s c u s s e d an e l d e r l y man who quar-• r e l e d b i t t e r l y w i t h every roommate he h a d . N e v e r t h e l e s s , he was moved s e v e r a l t imes i n an e f f o r t to f i n d someone c o n g e n i a l t o h i m . F i n a l l y a s m a l l s i n g l e room was a v a i l -ab le f o r him and i t was found t h a t h i s r e l a t i o n s w i t h ev-eryone improved when he was ab le t o be alone when he w i s h e d . E v i d e n t l y t h i s same technique of s h i f t i n g people about u n t i l they appear to have found roommate's w i t h whom they, can ge t a l o n g s a t i s f a c t o r i l y i s used by more t h a n one o p e r a t o r . I t i s a h i t and miss method, of c o u r s e , but the o n l y one a v a i l a b l e to date and t h e r e f o r e a g r e a t d e a l b e t -t e r than no method a t a l l . A worker who c o u l d devote h e r -s e l f to i n t a k e and p e r s o n a l r e l a t i o n s h i p s w i t h i n the home should be ab le t o e f fec t /much more harmonious atmosphere. I t may not be p r a c t i c a l or p o s s i b l e f o r some time t o come t o a c t u a l l y suggest t h a t a worker might be ass igned t o -124-working w i t h the s t a f f and inmates o f b o a r d i n g homes, q u i t e apar t from any workers g o i n g i n a l r e a d y t o do a s p e c i f i c j ob - the l i c e n s e i n s p e c t i o n or the d e l i v e r y of r e l i e f cheques f o r i n s t a n c e . There, are. a. g r e a t v a r i e t y of t a s k s such a worker might undertake i n h e l p i n g inmates t o a d -j u s t to one another and the s t a f f and t h e i r f a m i l i e s , I n h e l p i n g s t a f f t o a p p r e c i a t e the s p e c i a l problems, and the s p e c i a l assets ' o f the aged, i n h e l p i n g o l d people use t h e i r t ime c o n s t r u c t i v e l y , and i n . many other ways. S p e c i f i c Problems i n . Adjustment Problems of p e r s o n a l i t i e s c l a s h i n g and of unhap-py people l a s h i n g out a t a u t h o r i t y or a t o ther inmates n a -t u r a l l y o c c u r . Some o l d people compla in about e v e r y t h i n g , • are very demanding, or h o s t i l e to everyone. Arguments a r i s e ; about almost every i t em or event o f d a i l y l i f e . One matron s a i d she never had r e a l t r o u b l e s because the o l d people have, l e a r n e d t h a t i f they come to her w i t h t a l e s of woe, they can ge t them o f f t h e i r c h e s t . She o f -f e r s sympathy and a d v i c e b u t she never i n t e r f e r e s and n e -v e r passes any compla int on t o o t h e r s . They b r i n g t h e i r compla in ts and a i r them, and a p p a r e n t l y leave w i t h t h e i r anger or d i s t r e s s d i s s i p a t e d . A second matron s a i d b i t t e r l y t h a t the o l d peo-p l e were never s a t i s f i e d w i t h a n y t h i n g and she r e f u s e s to l i s t e n to t h e i r compla ints as she d i d when she f i r s t went to the b o a r d i n g home. The r e s i d e n t s however were able --i25-and even encouraged - t o go s t r a i g h t to the board r u n n i n g the home to a i r g r i e v a n c e s . R e l a t i o n s appeared to be s t r a i n e d to the b r e a k i n g p o i n t , and wo.uld appear to have needed a. very s t r o n g and wise person to take over and c l e a r up the r e l a t i v e p o s i t i o n s and r o l e s of s t a f f , board and r e s i d e n t s . Probably the matron had r e a l reason t o f e e l her job was an i m p o s s i b l e one. P o s s i b l y her own f e e l i n g s , about' o l d people needed c l a r i f y i n g t o o , so t h a t she c o u l d understand hero own r a t h e r v i o l e n t r e a c -t i o n s t o the s i t u a t i o n . O b v i o u s l y there i s need here f o r an o b j e c t i v e , s k i l l e d person to h e l p w i t h r e a d j u s t -ments i n r e l a t i o n s h i p s . There were, numerous s m a l l elements which a p -peared t o cause f r i c t i o n i n the homes. I n one home where e v e r y t h i n g appeared t o f u n c t i o n f a i r l y smoothly , the ma-t r o n n e v e r t h e l e s s remarked t h a t the l a d i e s i r k e d her t e r -r i b l y because they so resented every request she made t h a t they do something f o r themselves or the home. They even re fuse t o make t h e i r own beds , a l though the m a j o r i -t y had been homemakers or had worked a t o ther c a r e e r s . This; seemed r a t h e r a s e r i o u s i n d i c a t i o n o f maladjustment s i n c e a number of other homes r e p o r t e d the eagerness i n -mates showed t o do some k i n d s of t a s k s . One home uses i t s inmates f o r the major p a r t o f the l i g h t work, w i t h e x c e l l e n t r e s u l t s i n what might be c a l l e d the s p i r i t of the home. I n the f i r s t i n s t a n c e i t may be t h a t the ma-t r o n ' s own b a s i c h o s t i l i t y to the aged arouses o p p o s i t i o n -126-t o a. request t h a t might be i n t e r p r e t e d as a. command. P r o -b a b l y no c l e a r statement o f what was expected of the women by the s t a f f was made a t the time, of a d m i s s i o n . J u s t p o s -s i b l y some a t l e a s t f e l t t h a t they had earned a p e r i o d of f u l l l e i s u r e a f t e r a l i f e t i m e of work. I t should h a r d l y have been the i n s u p e r a b l e problem t h a t i t e v i d e n t l y was: i t c e r t a i n l y appeared t o be' a. c h r o n i c source o f i r r i t a t i o n f o r everyone i n t h a t p a r t i c u l a r home. A t the r i s k o f b e -i n g r e p e t i t i o u s , a worker g o i n g i n t o t h a t home might be ab le t o r e s o l v e the matter o f making or not making beds t o someone's s a t i s f a c t i o n . R u l e s , R e g u l a t i o n s and P a r t i c i p a t i o n No home occupied by a number of persons can be operated e f f i c i e n t l y u n l e s s there are some r u l e s and r e g -u l a t i o n s which are observed by everyone. I t goes w i t h o u t s a y i n g t h a t these r e g u l a t i o n s should be as few as i s com-mensurate w i t h smooth o p e r a t i o n o f the home. They should be observed, o f course., but they should a l s o be f l e x i b l e enough to a l low, f o r s p e c i a l c i r c u m s t a n c e s . Sample r u l e s might be t h a t anyone p l a n n i n g t o be away f o r a meal should n o t i f y the s t a f f o f h i s i n t e n t i o n s . , and a l s o o f any p l a n s t o be out l a t e o f an e v e n i n g , or t h a t v i s i t o r s should be-gone by a c e r t a i n hour a t n i g h t . Some homes r e q u i r e the inmate to do c e r t a i n t a s k s such as making h i s own bed and t i d y i n g and d u s t i n g h i s own room. Such r u l e s should be e x p l a i n e d f u l l y t o e v e r y -one on e n t e r i n g the home, i the reason f o r t h e i r e x i s --127-tence b e i n g g i v e n . A r a l e t h a t has a r e a l reason f o r be-i n g made i s much e a s i e r t o f o l l o w w i t h o u t f r i c t i o n or d i s -content r e s u l t i n g . Indeed, i t i s p o s s i b l e to invoke a ±' f e e l i n g o f p a r t i c i p a t i o n i n a program des igned to g i v e the maximum of comfort to a l l r e s i d e n t s . On the other hand, r e g u l a t i o n s which are merely l i s t e d a r b i t r a r i l y are apt t o awaken a f e e l i n g of r e b e l l i o n . C e r t a i n r u l e s which are enforced i n some of the homes appear t o be both a r b i t r a r y and unnecessary . One home i n s i s t s t h a t l i g h t s must be out a t t e n o ' c l o c k a t n i g h t . Such a r u l e over looks the i n d i v i d u a l l i k e s and needs of d i f f e r e n t p e o p l e . P o s s i b l y t h i s i s necessary i n a room where the on ly l i g h t i n g i s overhead l i g h t i n g . I n e v i t a b l y a l l persons i n the room submit to a common l i g h t s - o u t t i m e , but i t should be l e f t to themselves to t u r n i t out when they are r e a d y . Of c o u r s e , they should i n s t e a d secure i n d i v i d u a l bed-lamps i f i t i s a t a l l p o s -s i b l e to do s o . However, even the two or three people i n s i n g l e rooms were a p p a r e n t l y f o r c e d to observe, t h i s r u l e even though they d i s t u r b e d no one by not d o i n g s o . I t i s d i f f i c u l t to j u s t i f y such a r u l e b e i n g a p p l i e d to r e -s p o n s i b l e a d u l t persons , e s p e c i a l l y as they were n e i t h e r r e q u i r e d nor expected to r i s e a t an e a r l y h o u r . A r u l e r e g a r d i n g b a t h t i m e s , based on water sup-p l y and bathroom schedules , i s reasonable enough. Such a r u l e , l i m i t i n g each person to one bath a. week r e g a r d l e s s o f h i s p e r s o n a l i n c l i n a t i o n s , based as f a r as c o u l d be - 1 2 8 -d i s c o v e r e d on the matron ' s f e e l i n g t h a t b a t h i n g c r e a t e d e x t r a work by u p s e t t i n g bathrooms, i s i n e x c u s a b l e . Ma-t r o n s and o p e r a t o r s should be encouraged to c o n s i d e r the r e g u l a t i o n s they are. e n f o r c i n g , examining them c a r e f u l l y t o see how necessary they a r e , and how r e s t r i c t i v e they a r e . I t might be i n t e r e s t i n g and have r a t h e r amazing r e -s u l t s , i f the r e s i d e n t s of a home were t o study such r u l e s anri comment on them and make s u g g e s t i o n s f o r changes and omiss ions - and even a d d i t i o n s . R e s i d e n t s o f o l d p e o p l e ' s homes are too o f t e n k e p t i n t h e i r r o l e of p a y i n g guest w i t h no r e s p o n s i b i l i -t i e s and c e r t a i n set p r i v i l e g e s . I t would p robab l y be c o n s i d e r e d a p r i v i l e g e by many to be a l l o w e d to take c e r -t a i n r e s p o n s i b i l i t i e s i n the home. These should not be r e s t r i c t e d to s h a r i n g i n some of the r o u t i n e t a s k s , but i n p l a n n i n g and a d m i n i s t r a t i o n . They might examine the r u l e s and . r e g u l a t i o n s , as has been suggested. They might r o t a t e some of the l i g h t e r household t a s k s . I t might a l -so be. p o s s i b l e t o make them r e s p o n s i b l e f o r some k i n d o f o r g a n i z a t i o n , of l e i s u r e t ime a c t i v i t i e s , p ro bab l y on a v e r y modest s c a l e . The matron might even be ab le to take them i n t o her conf idence r e g a r d i n g the problems met i n h e r a d m i n i s t r a t i o n and the measures taken to s o l v e them. Very few matrons would be able to i n s t i t u t e even such a modif ied" and modest program suggested above; I t would c a l l f o r an o r g a n i z i n g a b i l i t y coupled w i t h a -129-s i n c e r e b e l i e f i n the a b i l i t i e s o f the o l d . Most d i f f i -c u l t of a l l , she would have t o surrender some of her a u -t h o r i t y , and meet the o l d people as e q u a l s . Here a g a i n i n a l l l i k e l i h o o d the o u t s i d e worker , t h i s time one w i t h some group work s k i l l s , would be needed to do the j o b . I t would be aimed i n p a r t a t r e s t o r i n g to the o l d people some of t h e i r f e e l i n g s of independence and i n t e r e s t , and i n f o s t e r i n g a group f e e l i n g among them. I d e a l l y they would i n t ime be able t o c a r r y on under t h e i r own i n i t i -a t i v e . The most d i f f i c u l t person i n many homes w i t h whom to work would i n a l l p r o b a b i l i t y be the o p e r a t o r . The Problem, o f the Fami l v Where an o l d person l i v i n g i n a b o a r d i n g home has a f a m i l y new and d i v e r s e problems can a r i s e . The home should of course encourage contac t w i t h the f a m i l y , b u t i n many cases the f a m i l y i s to the matron and s t a f f a source o f t r o u b l e and i r r i t a t i o n . I f the. aged man or woman and h i s or her f a m i l y are on a f f e c t i o n a t e and f r i e n d -l y terms, and the-placement i n the home has not meant r e -j e c t i o n of the o l d p e r s o n , the f a m i l y would not be a p r o b -lem to the home. V i s i t s between f a m i l y and inmate are a source o f p l e a s u r e and s a t i s f a c t i o n t o b o t h . However, where the f a m i l y has pushed the o l d person out o f t h e i r home they may f e e l g u i l t y and r e l i e v e t h e i r f e e l i n g s by demanding s p e c i a l c o n s i d e r a t i o n s f o r t h e i r aged r e l a t i v e f rom the home. One matron d e s c r i b e d i n some d e t a i l such a -130-s i t u a t i o n . A woman of about s i x t y - f i v e had been p l a c e d w i t h her by the f a m i l y . A l l the sons and daughters had r e f u s e d to keep her i n t h e i r homes, g i v i n g i n each case r a t i o n a l excuses which were d o u b t l e s s . l a r g e l y t r u e . However they e v i d e n t l y a l l f e l t some g u i l t and demanded s e v e r a l concess ions f o r the mother on the p a r t of the home. The mother r e a l i z e d she c o u l d g a i n a t t e n t i o n and an e x p r e s s i o n o f concern f rom her c h i l d r e n by making com-p l a i n t s t o them, and she d i d so f r e e l y . E v e r y v i s i t by her c h i l d r e n - who were a d u l t s , i t should be remembered,-r e s u l t e d i n . some degree o f c l a s h between s t a f f and v i s i -t o r s . The o l d l a d y was p l e a s a n t and c o o p e r a t i v e i n the home and e v i d e n t l y enjoyed the a s s o c i a t i o n w i t h her f e l -l o w - i n m a t e s , but n a t u r a l l y enough there was always some i l l - f e e l i n g between she and the s t a f f because of the a t t i -t u d e s o f her f a m i l y . There a r e many v a r i a t i o n s o f the above s t o r y . Some o l d people are i r r i t a b l e and unhappy f o l l o w i n g c o n -t a c t s w i t h f a m i l y , o thers depressed . Some boast i n c e s -s a n t l y of the love t h e i r c h i l d r e n have f o r them, which i s irksome t o t h e i r a s s o c i a t e s even i f they are ab le to see the attempt a t reassurance t h a t i s b e i n g made. These are examples of poor f a m i l y r e l a t i o n s where some attempt a t camouflage i s b e i n g made. Other f a m i l i e s f r a n k l y widh t o she lve the o l d person and make no e f f o r t to c o n c e a l i t . The problems c r e a t e d by the f a m i l y r e l a t i o n -s h i p s of inmates are numerous and c o m p l i c a t e d . "They might fce -131-a l l e v i a t e d by some b r i e f c o u n s e l l i n g o f both the o l d p e r -son and h i s f a m i l y , but a c t u a l l y r e s o l v i n g the c o n f l i c t s would need a l o n g - t e r m s k i l l e d job and i t i s p ro bab l y i m -p r a c t i c a l to suggest i t . The worker to whom f r e q u e n t r e -ference has been made might w e l l f i n d the a r e a of r e l a -t i o n s between aged persons and t h e i r f a m i l i e s in one where she i s needed and u s e f u l . G e n e r a l Observat ions The whole problem of r e l a t i o n s h i p s i n a b o a r d i n g home c o u l d be d e a l t w i t h adequately on ly i n a very much l o n g e r and more comprehensive s t u d y . T h i s seems to the w r i t e r to be an area d e s e r v i n g of an exhaus t ive survey and might be suggested as the sub jec t o f a subsequent t h e s i s . B r i e f l y , the importance o f the s t a f f t o the smooth o p e r a t i o n o f a home has been i n d i c a t e d and i t was i n t i m a t e d t h a t operatore and s t a f f c o u l d be he lped t o a p p r e c i a t e the i n d i v i d u a l q u a l i t i e s o f aged p e r s o n s . They o f t e n need to be. a s s i s t e d so t h a t they can a t l e a s t r e c o g n i z e t h e i r unconscious c o n v i c t i o n o f the i n f e r i o r -i t y o f the aged. The o l d people themselves too o f t e n share t h i s c o n v i c t i o n and are t h e r e f o r e b l o c k e d from a d -j u s t i n g i n a h e a l t h y f a s h i o n . They need to l e a r n t h a t they can. p a r t i c i p a t e i n some k i n d o f group e f f o r t . •Fami l ies have a dec ided impact on the b o a r d i n g homes and of course on the happiness of the b i d p e o p l e . -132-Both t h e f a m i l i e s and the aged persons themselves need h e l p o f t e n i n . r e s o l v i n g t h e i r c o n f l i c t s about placement o f the o l d person i n the b o a r d i n g home, as w e l l as i n deeper r e l a t i o n s h i p s between one a n o t h e r . Whereas i t h a s been suggested i n e a l i e r c h a p t e r s t h a t a worker w i t h the o p p o r t u n i t y to spend t ime on b o a r d i n g homes c o u l d h e l p i n b r i n g i n g s e r v i c e groups i n t o homes t o e f f e c t c e r -t a i n p r a c t i c a l , ( i . e . , m a t e r i a l ) changes, and to make, i n the i d e a l s i t u a t i o n a t l e a s t , c a r e f u l l y c o n s i d e r e d p l a c e -ments, the a r e a i n which such a worker i s needed most a c u t e l y i s the a r e a o f p e r s o n a l r e l a t i o n s h i p s i n the home. A student who i n d i c a t e s i n t e r e s t i n s t u d y i n g some aspects, o f the problems of the aged m i g h t , a s an e x -ample , attempt an exper imenta l j o b i n one or two homes, and r e p o r t on the r e s u l t s o b t a i n e d . The present s tudy has been conducted on a c o m p a r a t i v e l y s u p e r f i c i a l l e v e l and t h e r e f o r e can only p o i n t t o some o f the a r e a s o f need and suggest p o s s i b l e p l a n s f o r f u t u r e s t u d y . -133 PARI I I I  SOME. IMPLICATIONS Chapter X ADVSCnCURES I H FLAMING D u r i n g the p a s t two or three decades a number o f i n t e r e s t i n g a t tempts have been made t o p r o v i d e s u i t a b l e a c -commodation f o r aged p e r s o n s , g e n e r a l l y w i t h the view o f g i v i n g them b o t h a s l i g h t l y p r o t e c t e d atmosphere and the companionship o f o thers o f t h e i r own age . Such schemes are r a r e l y conducted on a s c a l e which would make them a -„ v a i l a b l e to a l l persons who would need or w i s h t o make use o f them. There i s l i t t l e i n the present o u t l o o k , i n Cana-da a t l e a s t , t o i n d i c a t e t h a t the near f u t u r e w i l l o f f e r the aged s u i t a b l e hous ing i n a n y t h i n g approaching an ade-quate amount. However, i t i s i n s t r u c t i v e t o c o n s i d e r some of the v a r i e t i e s o f accommodation t h a t have been t r i e d i n a number o f d i f f e r e n t l o c a l i t i e s and to b r i e f l y c o n s i d e r the advantages or disadvantages they may o f f e r . L o c a l l y we have, o f c o u r s e , a number o f b o a r d -i n g homes which o f f e r good care on a p h y s i c a l l e v e l , , amd i n some cases a r e a l f e e l i n g of companionship and b e l o n g -i n g i s a l s o a c h i e v e d . There are a t l e a s t two other types o f accommodation o f i n t e r e s t . A Church group operates a row o f a t t a c h e d two room c a b i n s . These are i n a poor d i s -t r i c t , and have l i t t l e to recommend them i n beauty or com-p l e t e n e s s o f appointments . However they are l e t a t a v e r y low r e n t a l , and the o l d p e o p l e , mainly men, who l i v e -134-there are ab le to achieve both a reasonably comfortable l i f e and a f e e l i n g o f independence on 'low incomes. Each man c l e a n s h i s own c a b i n , f i n d s h i s own f u e l and prepares h i s own meals . They are w i t h i n easy reach o f the down-town area., and the r e s i d e n t s have p r i v a c y p l u s the oppor-t u n i t y to enjoy companionship wi th , o ther men. A r e s i d e n t s u p e r v i s o r I s there when she i s needed by the men, but they are not i n any way regimented or r e s t r i c t e d . T h i s type o f accommodation has much to recommend i t . I t i s . p o s s i b l e f o r a pens ioner to m a i n t a i n h i m s e l f c o m f o r t a b l y i n such a d w e l l i n g w i t h o u t s u r r e n d e r i n g h i s independence, but w i t h o u t exposing h i m s e l f t o the i s o l a -t i o n and l o n e l i n e s s of a room or c a b i n where perhaps no one i s i n t e r e s t e d i n h i s w e l f a r e . R e c e n t l y the f i r s t work was begun on what w i l l be a group of s m a l l c a b i n s f o r aged p e o p l e . These w i l l have the advantages mentioned above w i t h the added a t t r a c -t i o n of b e i n g newer and. more modern, and h a v i n g p l o t s o f ground f o r the use o f the r e s i d e n t s . Such developments do tend t o i s o l a t e the o l d people from the r e s t of the community but w i l l probably r e p r e s e n t the h e a l t h i e s t and f i n e s t e f f o r t p o s s i b l e u n t i l such t ime a s hous ing i s p lanned f o r the p o p u l a t i o n as a w h o l e . E n g l i s h housing schemes have f e a t u r e d s e v e r a l t y p e s o f group accommodation f o r aged p e o p l e . Some have been b o a r d i n g homes, o t h e r s b l o c k s of s m a l l s u i t e s , s t i l l 135-o t h e r s groups o f i n d i v i d u a l c o t t a g e s . The most r e c e n t development has been a r e c o g n i t i o n by the h o u s i n g p l a n -ners t h a t the aged have a p l a c e i n the community, w i t h the r e s u l t t h a t hous ing u n i t s have been planned which i n c l u d e the young couples w i t h t h e i r f a m i l i e s , the aged, and other g r o u p s . T h i s would seem t o be the n a t u r a l scheme of t h i n g s and i t I s t o be. hoped t h a t when Canada comes t o p l a n the b u i l d i n g of communit ies , the aged w i l l be i n c l u d e d w i t h the r e s t o f the p o p u l a t i o n . Denmark's m u n i c i p a l homes f o r the aged are worthy of comment here as they o f f e r a degree o f i n d e -pendence p l u s p r o t e c t i o n t o the aged, a l t h o u g h o f course they do serve to se t the aged a p a r t from the community. F o r the a b l e - b o d i e d there a r e s m a l l apartments c o n s i s t -i n g o f l i v i n g room, bedroom and k i t c h e n , "where they 1 cook t h e i r own food from raw m a t e r i a l s u p p l i e d " . The m u n i c i p a l i t y pays a l l expenses f o r the home, and I n t u r n c o l l e c t s the o l d p e o p l e s ' p e n s i o n cheques, l e a v i n g them a s m a l l amount f o r p e r s o n a l spending money. One of the f i n e s t o f such m u n i c i p a l homes, l o c a t e d a t E l s i n o r e i n Denmark, has one. hundred and n i n e t y f o u r apartments i n f i v e t h r e e - s t o r y b l o c k s s e t i n a g r o u p . Such homes f o r the aged o f f e r a f u l l e r and more secure l i f e to o l d people than they are o f t e n ab le t o f i n d i n many other c o u n t r i e s . Here too couples are 1 Manniche, P e t e r Denmark, A S o c i a l L a b o r a t o r y , Oxford U n i v e r s i t y P r e s s , New Xork , 1939. p . 165 -136-a b l e t o remain together i n s t e a d of h a v i n g t o separate when they g i v e up the home they have made f o r themselves i n t h e i r e a r l i e r y e a r s . A p l a n t h a t would appear to o f f e r almost e v e r y -t h i n g t h a t o l d people might want was o u t l i n e d by K a t h r y n 1 C l o s e i n her a r t i c l e " O l d F o l k s a t Home". I t was s u g -g e s t e d t h a t s m a l l v i l l a g e s might be b u i l t i n the m i l d southern c l i m a t e s . They would be planned s p e c i f i c a l l y t o meet the s o c i a l , p h y s i c a l and economic needs o f the aged. They would have the o p p o r t u n i t y t o c a r r y on a c -t i v e and i n t e r e s t i n g l i v e s i n s i n g l e or m u l t i p l e - d w e l l -i n g u n i t s w i t h o u t the curse, of l o n e l i n e s s or f e a r i n t h e i r o l d age. The community i d e a l l y would o f f e r f u l l r e c r e a t i o n a l r e s o u r c e s , gardening and other hobby oppor-t u n i t i e s and h e a l t h s e r v i c e s . Probably a cooked-food serv ice , f o r d e l i v e r y of meals to those homes where the w i f e a l s o had chosen to r e t i r e , would be a d v i s a b l e . T h i s would ensure proper meals f o r the aged w i t h o u t the disadvantage of common d i n i n g rooms. Such v i l l a g e s were p i c t u r e d as o f f e r i n g a g r e a t d e a l to the aged p e r s o n s , e s p e c i a l l y i f f u l l med-i c a l , n u t r i t i o n a l , , group work and other s e r v i c e s were s u p p l i e d . They might a l s o be wonder fu l cent res f o r t the study of g e r i a t r i c s and the s o c i a l i m p l i c a t i o n s of a g i n g . F i n a n c i n g of course was seen as a f o r m i d a b l e 1 I n Survey Midmonthly , Survey A s s o c i a t e s I n c . , E a s t S t roudsburg , P a . , Aug . 1941 -137-o b s t a c l e , and a l s o the s e l e c t i o n of r e s i d e n t s . I t was r e c o g n i z e d t h a t here a g a i n there i s s e g r e g a t i o n o f the aged, e x c l u d i n g them from the community as a. whole . A f u r t h e r d i f f i c u l t y might w e l l l i e i n the o l d e r p e r s o n ' s r e l u c t a n c e t o t e a r up h i s r o o t s and leave b e h i n d him a l l t h a t i s f a m i l i a r and l o v e d , even f o r the advantages such a se t t l ement would have . A l l such p l a n s i n v o l v e e x t e n s i v e p l a n n i n g and f i n a n c i n g , but are i n t e r e s t i n g t o c o n s i d e r a t l e a s t . There i s l i t t l e to be ga ined by comparing l o c a l p r o -v i s i o n s f o r the aged w i t h these few b r i e f l y d e s c r i b e d schemes. There a r e , however, o ther k i n d s of care f o r aged people t h a t i t should be p o s s i b l e t o p u t i n t o p r a c t i s e h e r e , i f only on an e x p e r i m e n t a l b a s i s f o r the p r e s e n t . One o f these i s v i s i t i n g housekeeper s e r v i c e f o r the aged. T h i s s e r v i c e was experimented w i t h by a 1 New York Agency by a s s i g n i n g a. c e r t a i n p r o p o r t i o n o f t h e i r housekeepers ' time t o aged c l i e n t s . The terms o f e l i g i b i l i t y were the. same as f o r a l l o ther c l i e n t s . T h e i r p o l i c y was to g i v e t h i s s e r v i c e t o " f a m i l i e s and i n d i v i d u a l s who c a n , w i t h i n a l i m i t e d amount of t i m e , make c o n s t r u c t i v e use o f (the v i s i t i n g housekeeper) , e i t h e r to work out e x i s t i n g problems nr t o work outaan-1 D a v i s , Gertrude R . , " V i s i t i n g Housekeeper S e r v i c e f o r A g e d " , ffournal o f S o c i a l Case V/ork, Fami ly S e r v i c e A s s o c i a t i o n of A m e r i c a , A l b a n y , N . Y . , J a n . 1948, p .22 -138-1 o t h e r , more a p p r o p r i a t e p l a n f o r f u t u r e l i v i n g " . Such-a s e r v i c e i s f o r p r e v e n t i v e work o f c o u r s e , and might im many i n s t a n c e s , i f s u p p l i e d a t the t i g h t t i m e , enable aged couples or s i n g l e o l d p e r s o n s , t o cont inue i n t h e i r accustomed homes f o r much l o n g e r , i n s t e a d of h a v i n g to e n t e r board ing or other homes a t a t imes of c r i s i s and perhaps never be ab le t o r e e s t a b l i s h themselves . The. agency u s i n g t h i s s e r v i c e found three types o f cases where i t was p a r t i c u l a r l y u s e f u l . Old couples or i n d i v i d u a l s who had been w e l l ab le t o care f o r them-s e l v e s u n t i l they s u f f e r e d a c c i d e n t s or acute i l l n e s s e s , were t i d e d over the bad time and were then able to c a r r y on as b e f o r e . O l d people l i v i n g w i t h c h i l d r e n or o ther r e l a t i v e s may become an I n s u p p o r t a b l e burden t o a w i f e and mother i f they become i l l . I n a number o f cases the housekeeper he lped out over the c r i s e s , when otherwise i t might have been necessary to move the o l d person out o f the home. I n a. few cases the v i s i t i n g housekeeper was used t o a s s i s t the younger f a m i l y , when an o l d person had become d i s t u r b e d or s e n i l e , care f o r such a p a t i e n t u n t i l a bed was a v a i l a b l e i n an i n s t i t u t i o n . Many o l d people c o u l d be he lped immeasurably by such a s e r v i c e on a p a r t t ime b a s i s . One or two hours o f h e l p a day w i t h the h e a v i e r work and chores might enable many t o c a r r y on i n d e p e n d e n t l y , who otherwise might have 1 . I b i d . , p . 23 -139-had to enter homes o f some k i n d , and to i n c r e a s e comfort and l i v i n g c o n d i t i o n s of many others who s a c r i f i c e h e a l t h and comfort f o r the sake o f remain ing i n t h e i r own homes. F o r many even a few hours a week to d i spose of the h e a v i -er work such as f l o o r s and laundry might make, a v a s t d i f -f e r e n c e . Housekeepers f o r aged people would o f course have t o be used w i t h d i s c r i m i n a t i o n and the housekeepers themselves should be g i v e n some s p e c i a l t r a i n i n g , and be supervised, by a case worker . A. s e r v i c e such as the one j u s t o u t l i n e d c o u l d c o n c e i v a b l y be p a r t of the " s e r v i c e s " p r o v i d e d t o those on O l d Age Pensions i n a d d i t i o n t o b e -i n g a v a i l a b l e t o o thers not on p e n s i o n through a p r i v a t e agency. F u l l t ime housekeeping s e r v i c e , would o f course be s u p p l i e d f o r s h o r t - t e r m cases o f acute need, b u t the: p a r t - t i m e type o f care would be j u s t i f i e d f o r l o n g term c a s e s . Dependency due t o l a c k o f s t r e n g t h t o c a r r y on a l l the t a s k s o f a home, alone., or t o becoming i l l because o f l a c k of proper food or s u f f i c i e n t warmth because o f p e r s i s t i n g i n l i v i n g alone d e s p i t e f a i l i n g s t r e n g t h might b e avo ided or a t l e a s t c o n s i d e r a b l y de layed f o r many. What i t might mean t o many couples and i n d i v i d u a l s i n terms of contentment and happiness to be ab le t o remain i n t h e i r own accustomed homes, cannot be measured. F i n a l l y f o s t e r homes f o r the aged might be d e -v e l o p e d on. a s m a l l s c a l e to e x p l o r e t h e i r advantages . Not -140-a l l o l d people can accept the i m p e r s o n a l atmosphere o f an i n s t i t u t i o n or even of a s m a l l i s h b o a r d i n g home, but might f i t i n t o a c a r e f u l l y s e l e c t e d f o s t e r home, F o s -t e r homes would have t o be chosen a f t e r c a r e f u l i n v e s -t i g a t i o n , and would be des igned t o o f f e r f a m i l i e s , not p a r e n t s , to o l d p e o p l e . An agency I n Ohio has done some work on t h i s p r o j e c t w i t h r e s u l t i n g comfort and 1 happiness f o r the. persons, s e r v e d . They have aimed a t f i n d i n g f a m i l i e s who w i l l accept the aged p e o p l e as members o f the f a m i l y r a t h e r than as b o a r d e r s . The most s u c c e s s f u l f o s t e r homes, they f o u n d , have been those i n which the f a m i l i e s , p a r t i c u l a r l y the mothers , have been e a s y - g o i n g , warm-hearted pei -ople , who are not too f a s t i d i o u s housekeepers . They must o f course have respec t f o r the aged, and need to have r a t h e r gay temperaments, and a. good d e a l o f p a t i e n c e . They have been encouraged t o i n c l u d e the o l d people i n the f a m i l y group , to g i v e them a. share i n l i g h t t a s k s i n the home as w e l l as i n the f a m i l y g a t h e r i n g s and c e l e b r a t i o n s . Even s l i g h t l y s e n i l e o l d people have been s u c c e s s f u l l y p l a c e d w i t h the r e s u l t t h a t t h e i r d e c l i n e has been r e -t a r d e d i n the f r i e n d l y home atmosphere. P h y s i c a l comforts are important t o o , and the o l d person should have h i s own comfortable room w i t h 1 . Wagner, Margaret W . , " F o s t e r Home Care f o r the A g e d " , J o u r n a l o f S o c i a l Case Work, V o l . XXV11, p . 238. -141-easy access t o the bathroom. Good food i s very i m p o r t a n t , homes where r a t h e r heavy "meat and p o t a t o " meals are s e r v e d b e i n g the: most s a t i s f a c t o r y f rom t h i s s t a n d p o i n t . The o l d p e r s o n ' s c l o t h i n g should be looked a f t e r i n most i n s t a n c e s . Such homes were found by the o l d people them-s e l v e s i n some cases., or l o c a t e d and developed by the w o r k e r s , but the bes t source o f homes was found t o be a d v e r t i s i n g , f o l l o w e d by c a r e f u l I n v e s t i g a t i o n . The w o r k e r ' s r o l e i n placement i s t o g i v e the f a m i l y a sym-p a t h e t i c and i n t e r e s t i n g p i c t u r e o f the c l i e n t , and to prepare the o l d person s i m i l a r l y f o r the f a m i l y . V i s i t s s h o u l d be made before placement so t h a t the persons i n -v o l v e d can become a c q u a i n t e d / b e g i n n i n g to l i v e t o g e t h e r . The worker assumes r e s p o n s i b i l i t y f o r the f i n a n c i a l a r -rangements w h i c h are c l e a r and b u s i n e s s l i k e , i d e a l l y , o f c o u r s e , the f a m i l y should be p a i d promptly and ade-q u a t e l y . The worker then should stand ready t o i n t e r -p r e t the f a m i l y t o the o l d p e r s o n , and v i c e v e r s a , where t h i s i s needed. While the worker should encourage the • homemaker t o use h e r , she remains p r i m a r i l y i n t e r e s t e d i n her aged c l i e n t . For many o l d people the f o s t e r homes are the f i r s t r e a l homes they have had . For others i t means b e -i n g able t o go on l i v i n g much a s they have always done, w i t h o u t h a v i n g to face both s e p a r a t i o n from t h e i r own people and l e a r n i n g to l i v e i n an e n t i r e l y new k i n d of -142-s e t t i n g a t the same t i m e . The f e e l i n g of b e l o n g i n g i n a c l o s e , warm group, of h a v i n g s e c u r i t y and comfor t , i s v e r y b e n e f i c i a l to them. There should be a d i v e r s i t y o f resources i n the community f o r the o l d p e o p l e ; . i n s t i t u t i o n s , b o a r d -i n g homes, f o s t e r homes and apartments , t o name a. few. I t would be r a t h e r wonder fu l t o be able t o o f f e r them a choice of accommodation, and to be able t o g i v e them time t o explore and choose the k i n d which w i l l be most p l e a s i n g to them. There i s l i t t l e to be g a i n e d , o f c o u r s e , by s p e c u l a t i n g on how f i n e i t might be t o o f f e r a. choice o f b o a r d i n g home, or s e l f - c o n t a i n e d apartment p l u s such t h i n g s as c l e a n i n g s e r v i c e s , 6t a f o s t e r home. I t i s c o n c e i v a b l e however t h a t i n . a l i m i t e d way f o s t e r homes and v i s i t i n g housekeepers. c o u l d be p r o v i d e d f o r a few, e i t h e r through an e s t a b l i s h e d agency, or w i t h the h e l p o f some s e r v i c e group i n t e r e s t e d i n t h e w e l f a r e o f the aged. 143-Chapter XI CONCLUSIONS I t i s on ly r e c e n t l y t h a t the problems o f t h e aged have been r e c e i v i n g c a r e f u l study and a t t e n t i o n . There a re v a l i d reasons f o r the n e g l e c t o f t h i s p o r t i o n I o f the p o p u l a t i o n i n the p a s t . U n t i l m e d i c a l sc ience and improved l i v i n g c o n d i t i o n s i n c r e a s e d the average l i f e - e x -pectancy so g r e a t l y , the aged d i d not make up so l a r g e or i m p o r t a n t a p a r t of ' the p o p u l a t i o n as they do now. The p o s i t i o n o f those who reached o l d age was not so p r e c a r i o u s as i t I s i n the modern age o f s m a l l homes, mobi le p o p u l a -t i o n s and i n d u s t r i a l ! z e d c i v i l i z a t i o n . A f a c t o r d e l a y i n g awareness of the aged may a l s o have been the p r e s s i n g needs f o r s e r v i c e s f o r c h i l d r e n and f a m i l i e s . The f i r s t p r o v i s i o n s made on a l a r g e s c a l e were f i n a n c i a l , but we are becoming aware t h a t p r o v i d i n g main-tenance f o r o l d people does not s o l v e a l l , or even most, o f t h e i r problems.. • One o f the g r e a t e s t of. t h e s e , a s has been s t r e s s e d throughout t h i s s t u d y , i s s u i t a b l e h o u s i n g . W h i l e many k i n d s of accommodation are needed i n g r e a t quan-t i t y , t h e r e are. numerous ways i n which the e x i s t i n g f a c i l i -t i e s can be a d j u s t e d and improved so t h a t they w i l l b e t t e r meet the p h y s i c a l and other needs o f those u s i n g them. The p r e s e n t study has focussed on such adjustments w i t h i n b o a r d -i n g homes f o r ambulatory or s e m i - a c t i v e o l d p e o p l e . -144-Some of these adjustments c o u l d be made r e l a t i v e -l y e a s i l y - For i n s t a n c e , s e r v i c e groups anx ious to make some c o n t r i b u t i o n toward the i n c r e a s e d comfor t o f aged r e -s i d e n t s o f b o a r d i n g homes c o u l d p r o v i d e bed lamps and p e r -haps e x t r a e l e c t r i c w i r i n g i f necessary , to homes where these are l a c k i n g . L i g h t movable screens might be s u p p l i e d through the same medium. Such suggest ions have been made throughout the body of t h i s s t u d y . The Committee on the Care o f the Aged would be t h e a p p r o p r i a t e group through which such needs i n b o a r d i n g homes might be c l e a r e d and r e f e r r e d t o i n t e r e s t e d s e r v i c e g r o u p s . The Committee, through a r e p r e s e n t a t i v e , or through a f u l l - t i m e worker , s h o u l d seek t o b r i n g the persons who are t o be the r e c i p i -e n t s o f any such h e l p i n t o the p l a n n i n g f o r i t , and t o h e l p the donors t o a p p r e c i a t e the need f o r u s i n g a c a r e -f u l approach t o the peopler they w i s h t o h e l p . Much has been s a i d i n e a r l i e r pages about the p r e v a i l i n g a t t i t u d e s to o l d p e o p l e . . They are too o f t e n regarded as a group apar t from the r e s t o f the human r a c e , and even the matron who says she l i k e s o l d people i s by t h a t v e r y statement b e t r a y i n g her own f e e l i n g t h a t they are i n f e r i o r . I f one h o n e s t l y sees them as i n d i v i d u a l s r a t h e r than as an i n f e r i o r group, one would l i k e and a p -p r e c i a t e them, or not l i k e them, on the same b a s i s as one l i k e s , or does not l i k e , the people who are seen as equals or contemporar ies . The o l d need r e c o g n i t i o n as p e o p l e . However i t i s expressed , whether by an o v e r p r o t e c t i v e a t t i t u d e , or a p a t r o n i z i n g k indness or even by f r a n k c o n -tempt, the aged sense t h i s f e e l i n g t h a t they are i n f e r i o r , and r e a c t to i t i n some degree . T h e i r u n c e r t a i n t i e s about t h e i r own va lue as persons are i n c r e a s e d by the s u b t l e ex -p r e s s i o n o f t h i s f e e l i n g by the people, w i t h whom they have most f requent c o n t a c t s . The g r e a t importance o f p h y s i c a l comfor ts i s g r a n t e d and should be g i v e n f u l l c o n s i d e r a t i o n . Boarding home opera tors can. be g i v e n h e l p i n r e c o g n i z i n g what can be done t o improve t h e i r i n s t i t u t i o n s so t h a t o l d p e o p l e l i v i n g i n them have a g r e a t e r measure o f p r i v a c y and oppor-t u n i t y f o r r e c r e a t i o n . The w r i t e r has t r i e d to make p r a c -t i c a l sugges t ions w h i c h c o u l d be p u t i n t o o p e r a t i o n w i t h -out i n c u r r i n g undue expense or caus ing ex tens ive a l t e r a -t i o n s i n p l a n t . The most imperat ive , need seems to the w r i t e r to be f o r development of a program aimed toward creating•• a h e a l t h i e r and more normal atmosphere i n b o a r d i n g homes. A case worker w i t h enough time a t h e r d i s p o s a l c o u l d h e l p the more r e c e p t i v e of the opera tors to see the o l d people as i n d i v i d u a l s r a t h e r than as a g r o u p . T h i s i s not meant t o deprecate the v e r y warm, f r i e n d l y f e e l i n g most o f the matrons have f o r t h e i r r e s i d e n t s . The r e s p e c t f o r them as p e r s o n s , a f t e r the case work has been done, should show i t -s e l f i n s m a l l ways, p r o b a b l y , i n an i n c r e a s e d awareness of the i n d i v i d u a l ' s r i g h t t o p r i v a c y shown b y , f o r i n s t a n c e , never e n t e r i n g h i s room u n t i l he has i n v i t e d the knocker -146-i n ; i n abandonment o f r u l e s r e g a r d i n g t imes f o r l i g h t s t o be out a t n i g h t ; i n emcouraging r e s i d e n t s t o b r i n g p e r s o n -a l be longings i n t o the home.. I t might appear more v i v i d l y i n a. w i l l i n g n e s s and. even a d e s i r e to, have the r e s i d e n t p a r t i c i p a t e more a c t i v e l y i n the a c t u a l bus iness o f o p e r a t i n g the home.. S h a r i n g i n some of the l i g h t e r t a s k s i s on ly one form o f p a r t i c i p a t i o n but even t h i s , i f done i n the r i g h t way, c o u l d give, the r e s i d e n t s a f e e l i n g o f i d e n t i t y and i m p o r -t a n c e . B r i n g i n g them i n . on p l a n n i n g of house r e g u l a t i o n s , meals , d e c o r a t i n g and even f i n a n c i n g would be more d i f f i -c u l t t o a c c o m p l i s h , or even t o accept f o r any operator who needs, t o be i n a. p o s i t i o n o f importance and power. A worker g o i n g i n t o a. home w i t h such ends i n . view would need group work s k i l l s as w e l l as case w.ork s k i l l s . . A g r e a t d e a l c o u l d be done a l s o d i r e c t l y w i t h many of the o l d people i n h e l p i n g them to accept the f a c t o f o l d age and a l l t h a t goes w i t h i t , and perhaps more v i t a l f o r some, i n . h e l p i n g them r e s o l v e t h e i r c o n f l i c t s , w i t h . t h e i r f a m i l i e s . I t has a l r e a d y been suggested t h a t such tasks, as o u t l i n e d above might be attempted on an ex-p e r i m e n t a l b a s i s and be r e p o r t e d on . L i t t l e has been said r e g a r d i n g the work a. group worker might be able to do i n such a s e t t i n g . The w r i t e r knows too l i t t l e o f t h i s f i e l d to be ab le t o do more t h a n s p e c u l a t e , but i t seems reasonable t h a t a. group worker c o u l d , i n the course o f i n t r o d u c i n g l e i s u r e - t i m e a c t i v i t i e s - 1 4 7 -t o o l d people i n such a s e t t i n g , accompl i sh a g r e a t d e a l I n d e v e l o p i n g s o c i a l i z e d a t t i t u d e s . C e r & i n l y too many o l d people i n "boarding homes seem unable t o f i n d a s a t i s -f a c t o r y p l a c e f o r themselves i n the g r o u p . Group r e l a -t i o n s h i p s a re important to everyone f o r the enjoyment of the group , and a l s o f o r the development the i n d i v i d u a l p e r s o n a l i t y g a i n s from, a group e x p e r i e n c e . S u c c e s s f u l group experience i s many t imes more s i g n i f i c a n t f o r p e o -p l e who, l i k e , the aged i n b o a r d i n g homes, l i v e i n g r o u p s . Whatever the f u t u r e may h o l d i n development o f programs f o r the aged, i t i s to be hoped t h a t the essen-t i a l i n d i v i d u a l i t y of aged people w i l l not be l o s t s i g h t o f . There I s no s i n g l e answer t o t h e i r needs. There i s no model b o a r d i n g home which i s the p e r f e c t b o a r d i n g home f o r a l l persons r e q u i r i n g t h i s k i n d of c a r e . However, c e r -t a i n f a c t o r s should be present i n a l l homes.- S i n g l e rooms, adequate bathroom f a c i l i t i e s , m o d i f i e d to meet the f r a i l -t i e s of o l d age, comfortable bedroom f u r n i t u r e , w e l l p lanned common rooms, are some of the t h i n g s which should be a v a i l a b l e i n the i d e a l ( o r more n e a r l y i d e a l than we now enjoy) b o a r d i n g homes. The t ime may come when these t h i n g s w i l l be p r o v i d e d or l i c e n s e s w i l l not be granted f o r such homes. For the present such m o d i f i c a t i o n s as a re p r a c t i c a b l e should be made i n order t o g i v e the aged i n . board ing homes the maximum comfort p o s s i b l e under ex-i s t i n g c i r c u m s t a n c e s . -148-A major c o n c l u s i o n d e r i v e d by the w r i t e r from a l l the impressions and f a c t u a l m a t e r i a l gathered i n the course of t h i s survey has not been mentioned i n the d i s -c u s sion of boarding home care f o r the aged. There seemed l i t t l e t o be gained by o u t l i n i n g ambitious plans f o r a l -t e r i n g present homes or f o r c o n s t r u c t i n g new. ones to meet a l l the needs of t h e aged. The measures suggested f o r im-provements have been d e l i b e r a t e l y kept to a. p r a c t i c a l l e -v e l . However, as. the study proceeded and the assembled m a t e r i a l was examined, the c o n v i c t i o n grew that, private: endeavour cannot r e a l l y adequately meet the problem of p r o v i d i n g care f o r t h e aged. The k i n d e s t and best i n t e n -t i o n e d matron must charge her guests a high enough board r a t e to meet the f u l l expense of t h e i r care and to leave a l i t t l e over f o r her own use. i f she charges a r a t e low. enough to make i t p o s s i b l e f o r a s s i s t a n c e cases to use her home, she must, keep c o s t s down i n order to meet oper-a t i n g expenses p l u s a reasonable reward f o r her own labour and investment. Extras such as; the often-mentioned bed-lamps would l i t e r a l l y have, to be provided out of her own pocket. Homes operated e i t h e r by a s e r v i c e group or by the government are. not expected to show a p r o f i t or even to operate, without a "loss-. 1" Only a home s u b s i d i z e d e i -t h e r by a group or by the s t a t e can o f f e r a r e a l l y e x c e l -l e n t standard of care and s t i l l be a v a i l a b l e to anyone needing i t , whatever h i s resources may be.• No c r i t i c i s m - 1 4 9 -i s . be ing o f f e r e d here o f the r e a l l y f i n e homes and the o f -t e n s e l f l e s s people toho operate them. The f a c t remains ,how-ever the opera tors may w i s h to g i v e the best p o s s i b l e s e r -v i c e to t h e i r c l i e n t s , they must make t h e i r l i v i n g a t i t , and t h e r e f o r e there a re r e a l i s t i c l i m i t s to how. much they can o f f e r the c l i e n t s , and to how l i t t l e they can charge them f o r c a r e . As. the s tandards which homes must meet a re r a i s e d b i t by b i t , a p o i n t may w e l l , be reached a t which p r i v a t e , persons w i l l no longer be able to f u l f i l l the l i c e n s i n g requirements and s t i l l make a. l i v i n g . S e r v i c e c l u b s and n a t i o n a l groups who s u b s i d i z e b o a r d i n g homes w i l l be ab le to go oh p a s t t h i s p o i n t of c o u r s e , as w i l l the s t a t e - m a i n t a i n e d homes. I n the meantime p r i v a t e l y -r u n homes are do ing a s u r p r i z i n g l y good j o b , a l though they o f t e n l e a v e something t o be d e s i r e d . Future p l a n s f o r b o a r d i n g homes f o r the aged can draw q u i t e a b i t t h a t i s u s e f u l from such homes. -150-APPENDICES BIBLIOGRAPHY SPECIFIC REFERENCES C l o s e , K a t h r y n , " O l d F o l k s at. Home". Survey midmonthly. Survey A s s o c i a t e s I n c . , E a s t S t r o u d s b u r g , P a . , August , 1941, p . 237. - o u t l i n e s a p l a n f o r a. v i l l a g e i n Southern U . S . A . G r i f f i n , John J . , "Suggest ions f o r the. S u p e r v i s i o n o f P r i -vate Homes, f o r the A g e d " , P u b l i c w e l f a r e , the monthly j o u r n a l o f the. American P u b l i c Wel fare A s s o c i a t i o n , C h i c a g o , 1 1 1 . , Dec, 1943. - d e a l s w i t h the mushrooming of homes i n the l a s t few y e a r s , the f a c t t h a t l i c e n s i n g has not kept pace i n . most p l a c e s , d e a l s w i t h i d e a l l e g i s l a -t i o n , suggest ions f o r s e t t i n g up i n s p e c t i o n , e t c . Very u s e f u l i n t r y i n g t o eva luate the l o c a l l e g -i s l a t i o n and p r a c t i c e . G r i f f i n , John J . , " S h e l t e r e d Care f o r the A g e d " , Survey  midmonthly, D e c , 1945, p . 3 2 3 . - E x h a u s t i v e o u t l i n e of s tandards f o r o l d p e o p l e 1 s b o a r d i n g homes, c o v e r i n g a l l a s p e c t s . Holmes, E d i t h , " In take P o l i c i e s i n P r i v a t e Homes f o r the A g e d " , I n d i v i d u a l i z e d s e r v i c e s f o r the a g e d " . Fami ly W e l f a r e A s s o c i a t i o n o f A m e r i c a , New Y o r k , N . Y . , 1941, p . 2 8 . - o u t l i n e s need f o r f i t t i n g the Inmates t o one a n -o t h e r , f o r h a p p i e r r e l a t i o n s f o r a l l . Deals w i t h s i g n i n g over p r o p e r t y v e r s u s p a y i n g by the month. Manniche, P e t e r , Denmark, a s o c i a l l a b o r a t o r y , Oxford U n i -v e r s i t y P r e s s , New Y o r k , N . Y . , 1939. - o u t l i n e s a community's b l o c k s or apartments f o r o l d p e o p l e . P o t t e r , E l l e n C , and o t h e r s , , " I n s p e c t i o n and the Power o f l i c e n s e as Tools i n the Care of the C h r o n i -c a l l y 111 A g e d " , P u b l i c w e l f a r e , A p r i l , 1944, p . 1 0 0 . - d i s c u s s i o n of the., way i n which a sound worker can educate and r a i s e standards w i t h o u t d i r e c t use o f a u t h o r i t y , and of some s t a n d a r d s . I s d i r e c t l y a p p l i c a b l e t o l i c e n s i n g p e r s o n n e l d e a l i n g w i t h ambulatory aged p e r s o n s . Rapp, Sahra S . , " B o a r d i n g Care f o r the A g e d " , J o u r n a l o f  s o c i a l case work, F a m i l y S e r v i c e A s s o c i a t i o n o f A m e r i c a , .New Y o r k , N . Y . , J u l y , 194.6, p . 192.. = o l d people need i n d i v i d u a l i z e d care., some are not ready t o use c h r o n i c care.; we need more f a c i -l i t i e s , and need t o coordinate , those we have . - H e o o r t of the. " W e l f a r e I n s t i t u t i o n s L i c e n s i n g A c t " f o r the year ended Dec. 31st .7 1946, V i c t o r i a , B . C . , 1947. - l o c a l s t a t i s t i c s , some e v a l u a t i o n o f homes. -S tudy of the s i t u a t i o n o f the: aged i n Vancouver , Report o f a. s p e c i a l sub-committee oh the Care o f the Aged, Wel fare C o u n c i l of G r e a t e r Vancouver, Dec. 3 1 s t . , 1945. - e x c e l l e n t p i c t u r e o f the g e n e r a l s i t u a t i o n of the aged i n t h i s c i t y . BIBLIOGRAPHY GKNKPAL REFERENCES Banning , Margaret C u l k i n , " P e r s o n a l I n s p e c t i o n " , Survey  midmonthly, S e p t . , 1941, pp.252-4 - d e s c r i p t i o n o f one o l d p e o p l e s ' home, g e n e r a l needs o f o l d p e o p l e . B r u n o t , H e l e n Hardy , "Case Work S e r v i c e s i n a Bureau f o r the A g e d " , I n d i v i d u a l i z e d s e r v i c e s f o r the aged. F a m i l y W e l f a r e A s s o c i a t i o n o f A m e r i c a , Hew Y o r k , N . Y . , 1941, p . 1 3 . - f e a r s o f the o l d age g r o u p , what i s needed i n a caseworker f o r the aged, study of r e f e r r a l s t o the bureau . E p s t e i n , Abraham, F a c i n g o l d age. A l f r e d A . Knopf , New Y o r k , N . Y . , 1922. - s o c i a l f a c t o r s a f f e c t i n g o l d p e o p l e , c o s t s of l a c k o f s e r v i c e s f o r aged, o l d age p e n s i o n s , causes o f dependency. Good. Farquhar , H . S . , " S e r v i c e s f o r the A g e d " , Ob. iect ives and c h a r a c t e r o f pos t war s o c i a l work. Proceed-i n g s , the Canadian Conference on S o c i a l Work, H a l i f a x , N . S . , June , 1946. -good g e n e r a l p i c t u r e o f needs and the p r e s e n t s e r v i c e s to meet t h e s e . Folsom, Joseph K . , " O l d Age as a S o c i o l o g i c a l P r o b l e m " , J o u r n a l o f O r t h o p s y c h i a t r y , George Banta P u b l i s h -i n g C o . , Mensaha, W i s . , J a n . , 1940. - p o p u l a t i o n t r e n d s , employment s i t u a t i o n , econo-mic burden o f the aged, a t t i t u d e s among the aged t o age , aged as i n d i v i d u a l s , needs f o r r e s e a r c h , f o r r e s o u r c e s , f o r e d u c a t i o n f o r o l d age. Good, J e a n M., " F u n a t S i x t y " , Canadian w e l f a r e , p u b l i s h -ed by the Canadian Wel fare C o u n c i l , Ottawa, O n t . , D e c , 1947. --what o l d people have t o o f f e r t o the community, i n p o l i t i c s , need f o r adequate p e n s i o n , some Cana-d i a n programs. G r a v e s , E r n e s t R_, S o c i a l problems of the f a m - f ^ j . p. L i p p i n c o t t C o . , C h i c a g o , 1 1 1 . , 1927, p p . 207-8 . -s tatement a s t o the p o s i t i o n o f the aged i s d i f -f i c u l t . No s i g n i f i c a n t d i f f e r e n c e s i n the s i t u -a t i o n a c c o r d i n g t o more r e c e n t w r i t e r s . G r i f f i n , John J . , " R e c r e a t i o n f o r the A g e d " , P u b l i c w e l -• f a r e , Dec . , . 1944. -need f o r study of f a c i l i t i e s , needs and a t t i -t u d e s . Should p u b l i c supply f a c i l i t i e s ? P e n -s i o n should i n c l u d e a l lowance f o r r e c r e a t i o n . J o r d a n , H . M . , Home and f a m i l y , MarMi 11 an C o . , New Y o r k , N . Y . , 1942. p . 4 9 . ( c o - a u t h o r s , Z i l l e r M . L . , and Brown, J . F . ) -causes o f economic i n s e c u r i t y , dependence on wages, methods o f g u a r d i n g economic s e c u r i t y . -Monthly labour r e v i e w , f i n d i n g s o f the survey of o l d p e o p l e s ' homes i n t h e U n i t e d States-, made by the U . S . Bureau of Labor S t a t i s t i c s , Super-i n t e n d e n t o f Documents, Washington, D . C . , May, 1940. - e v e r y v a r i e t y o f f i g u r e s on such homes., i n c l u d -i n g c o s t o f o p e r a t i o n and methods o f f i n a n c i n g . P o w e l l , Amy S . and Fox , F l o r a , "Growth i n O l d A g e " , The f a m i l y . V o l . XX, p . 119. - r o l e of a worker i n a i d i n g adjustment t o r e t i r e -ment, age, development o f i n t e r e s t s , see ing the needs o f the i n d i v i d u a l . -Report of the M i n i s t e r of P u b l i c W e l f a r e , P r o -v i n c e o f O n t a r i o f o r the. F i s c a l Year 1945-6, T o r o n t o , O n t . , 1947. - p a r t t h e p e n s i o n p l a y s , needs f o r k i n d s o f hous ing f o r the. aged, p l a c e of o c c u p a t i o n a l t h e r a p y . Rowntree, B . Seebohm, O l d p e o p l e , N u f f i e l d F o u n d a t i o n , Oxford U n i v e r s i t y P r e s s , London, J a n . , 1947. - p a r t i c u l a r l y the s e c t i o n on. recommended p l a n s f o r hous ing the o l d . -"The S o c i a l F r o n t " , Survey midmonthlv, S e p t . , 1940. - p r o p o r t i o n s o f the p o p u l a t i o n by ages , s u r v e y s o f where the aged l i v e and t h e i r a b i l i t y t o tend t o t h e i r own p h y s i c a l needs. Wagner, Margaret W . , " M e n t a l Hazards i n O l d A g e " , The  f a m i l y . V o l . XXV, p . 1 3 2 . - p e r s o n a l i t y o f the aged, person shaped by h i s c h i l d h o o d ; c h i l d r e n encourage dependence i n the o l d ; use o f homes t o g i v e independence as: w e l l as t o shed r e s p o n s i b i l i t i e s ; the " curse o f i d l e -ness , . , . Wagner, Margaret W., " F o s t e r Home Care f o r the A g e d " , The f a m i l y . V o l , XXV11, p .238 . -community should supply d i v e r s i t y o f r e -sources f o r the. aged, what i s needed i n a f o s t e r home, i n . the "mother" , what i t can g i v e t o the. o l d p e r s o n , the r o l e o f the s o c i a l worker i n the. f o s t e r home program. 

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