" STANDARDS OF CARE IN HOMES FOR.THE A? ED -
A STUDY OF THE STANDARDS OF ST. FRANCIS

HOME OF SAGINAN, MICHIGAN "

BY

PEUGENE T. PLEWKA

A PROJECT REPORT

Submitted to the Department of Social Work
Michigan State College
in Partial Fulfillment of the
Requirements for the Degree
of
MASTER OF SOCIAL WORK

May 1954

Approved :

     

ORead of Department.

Wm...
Chairman, Research Co ttee

THESIS

ACKNOWLEDGMENTS

The author wishes to express his sincere thanks to Dr. Ernest B. Harper,
Head of the Social Work Department of Michigan State College, for his inspiration
and guidance, and to Miss Frances Hetznecker, Assistant Professor of Social werk
at Michigan State College and to Mr. Manfred Lilliefors,for their valuable
direction and assistance in the preparation of this study.

Grateful acknowledgment is due to the Reverend Ralph M. Richards, Director
of Catholic Family Service in Saginaw, Michigan, to Mr. Alfred J. Ciaffone,
Administrative Assistant, to the entire staff of Catholic Family Service for their
generous assistance and wholehearted sceperation during the period of the writer's
field work and during the course of this study.

Deep appreciation is due to the Most Reverend Stephen S. Woznicki, D.D.,
Bishop of Saginaw, for the Opportunity afforded this writer to pursue graduate
study at Michigan State College.

Finally, sincere thanks to my wife and children for their patience and

understanding while the writer pursued his studies at Michigan State Cdllege.

TABLE OF CONTENTS

ACMOLflEDGIANTD ..... . ....... .. ..... .........
LIST OFTABLES...... ......
INPRCM'JUCTION .........
HISTORY OF ST. FRANCIS HOr-IE
SCOPS AND METHODOLOGY

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CHAPTER
I. CON EFT OF TIE AGING? PHOBIAEJ'I o...oeeeeoeeeeeeeeeeeeeeeeeoeeeeeeeeeoe

.II. STANDARDS OF CARE FOR OLDER PEOPLE IN INSTITUTIONS .................
III. STANDARDS FOR HOMES FOR THE AGED IN MICHIGAN .......................
Iv. POLICIES AND FRACTISES OF BOARDING HOMES FOR THE AGED IN MICHIGAN ..
v. POLICIES AND SERVICES OF ST. FRANCIS HOME ..........................
VI. SUMMARY AND EVALUATION OF THE PROGRAM OF ST. FRANCIS HOME ..........
APPENDIX A-BY-LANS OF ST. FRANCIS HOME ...................................
IAFPENDIX B.ARTICLES OF INCORPORATION OF ST. FRANCIS HOME .................
.APPENDIX C.QUESTIONNAIRE .................................................
APPENDIX D.CONVALESCENT HOME LICJNSE .....................................
.APPENDIX E.STANDARDS OF CARE FOR OLDER PEOPLE IN INSTITUTIONS ............
IIPFENDIX F.8TANDARDS FOR HOMES FOR THE AGED IN HICHIGA ..................
.APTENDIX G.APPLICATION BLANK .............................................
TAPPENDIX H.MEDICAL REPORT ................................................
APRENDIX I.HOUSE RULES OF ST. FRHNCIS ROI-CE.

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LIST OF TABLES

Table Page
1. Population of the United States by Age, 1950 and 1850 ............ 12

2. Annual Rate of Mortality Per 1000 Living at Age Indicated,
by Sex, 1939-Z‘lt01949 .0.OO.O.OOOOOOOOOOCOOOOOOOOOOO.0.0.OOOOOOO 13

3. Average Future Life Term in Years at Age Indicated, by Sex,
1939-h1 to 191.9 0.00.00.00.000................0.0C.......00....OCO 13

4. Responses to Questionnaires Sent to Boarding Homes for the
Aged with a Capacity for More than 10 Persons,in Michigan ........ 25

5. Legal Ownership of Homes and Admission Policy Towards
P'eligion Of AI)E)liCant .‘.......O................O..O.CD.0‘95.99.., 26

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INTRODUCTION

In our society today, there is a steadily growing recognition that the health
and life of society are best protected when the individuals of that society have the
fullest Opportunity for a meaningful and satisflying life. This is especially true
in the past ten years with the concern for the problem of the older, aging group of
people in their attempts to remain active members of society.

From statistical tables we are aware of the fact that our population is not
only older but that life expectancy of the population is also increasing. We may
vmll assume from these tables that our aging population will continue to increase.
A.detailed analysis of the American pOpulation is contained in Tables 1, 2 and 3 of
Chapter I.

Jith this increase in the aging population, there exists the needs of these older
gmople in their search for the security of a home as well as the needs to associate
vdth other older peOple. These needs differ as widely as people themselves differ.
In this search for a security of a home, these needs can be divided into four cate-
gories.

The first group are those who are old chronologically, but are still very vig-
orous and able to produce. Industry and business no longer accept them.because
they have reached the age of sixty-five. These people are obliged to retire on an
income which is not equal to the standard they enjoyed as wage earners. These per-
sonsxnust make new arrangenents for living.

The next group comprises the segment of the aging, which has passed the stage
of good health without actually becoming ill. They too, are faced with a limited
budget and must adjust to declining physical and mental faculties. They are sensi-

tive to the noise of youngsters, must avoid stairs, and must be within easy walking

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\

distance to services. Their housing needs.must be devised so that they can care for
themselves as long as health permits. These people are self sufficient within the
limitations of health and finances.

The third group of the aged are those who cannot care for themselves completely.
These may have a disability which hampers them in their self sufficiency, as the ar-
thritic woman who cannot do her own cleaning. Such individuals can maintain their
own privacy and independence with some provision of household help without the limits
of group care living.

The fourth group, with which this paper is concerned, is that which comprises
those of the aged who can best be served by a group care facility. In this group
care service, we consider the boarding home, convalescent home, nursing home or home
for the aged. Service in these group care facilities is directed to those aged people
who need the personal, medical or nursing care and comradeship of fellow aged that
they are unable to receive in their om home.

Group care services should not ignore the balance between security and independ-
ence. Institutional placement should not be considered as a last step to the grave
but rather should strive to rehabilitate all who have a potential for living more in-
dependently and be concerned with the individual!s adjustment to the community. It is
a hopeful goal that the individual be permitted to maintain independence as he might
have in his own ho.e under more favorable circumstances. The individual should not
deteriorate into the condition of helplessness and degeneration as sometimes does occur
within this setting.

It is hoped that this paper will provide a means of evaluating the program of
St. Francis Home for the Aged in Saginaw,iMichigan within the fourth category.

A.study of practices in the various boarding homes for the aged in the State of Michi-

gan, rules and regulations for licensing as Standards in the State onMichigan.

-3-

for the care of the aged 1 and the "Standards of Care for Older People in Institu—
tions" as prepared by the National Committee on the Aging of the National Social
Welfare Assembly 2are used as a basis to study and to evaluate the practice of St.
Francis Home for the Aged in Saginaw, Michigan. Possibly, if indicated, the program

of St. Francis Home might well be modified or expanded.

1 State of Michigan, Department of Social Welfare, Rules and Regulations for Inspec-
tion and Licensing of Convalescent Honesnanduliome‘s‘fifprnthe Aged, Lansing, mohigm,
March 1954.. opp; ” - _ ---,. ”

 

2 National Committee on the Aging of the National Social Welfare Assembly, Standards

 

 

Inn---“—

for the Aged andyursing Homes, ll2pp. Section II, Methods offistablghing and
Maintainfiig Standards in Homes for the Aged and Nprging‘lipmeg, National Social welfare '
Assembly, New York, 1953, llpr. '

 

 

 

 

   

 

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HISTORY OF ST. FRANCIS HOME

An increasing number of requests,on the part of the aged population of the
Diocese of Saginaw,Michigan, has been received during the past decade for a home
‘where these aged persons might live their lives to the fullest extent. While it is
'true that there are a large number of homes for the aged in the State oijichigan,
'these homes apparently did not seem.to satisfy the need as it was expressed from
frequent requests.

The requests of these people expressed the wish to be able to live in a Catholic
atmosphere. Embodied in this Catholic atmosphere is the ability to enjoy religious
services and devotions, companionship of other Catholic people and the kindness
and charity of the religious sisters. The welfare of their souls for eternal sal-
vation can be better protected in a Catholic atmosphere.

Most Reverend stephen S. Woznicki D.D., Bishop of Saginaw, a man who is very
conscious of social welfare and aware of these requests, enjoined upon Father Ralph
M. Richards, Diocesan Director of Catholic Charities to make a preliminary study of
the extent of these requests. Father Richards contacted various pastors within the
Diocese of Saginaw and reported that the need was sufficiently great and services
inadequate to warrant the consideration of establishing a home for the aged.

Suitable quarters were found in the Fall of 1951, in a building which formerly
housed St. Luke's Hospital. It is this building, located at 1407 Janes Street in
Saginaw, Michigan, that is presently known as St. Francis Home . The Diocese of
Saginaw purchased this building as well as two other buildings, to house the Sisters

who were to care for the residents and to house the domestic help in the Home.1

 

“Hm-“Ma—w‘AO 0' I. I»... .0.— s-..*~.l~ t—M-’ ‘ ' I ”'1' O

1
Father Ralph.M. Richards, Director of Catholic Charities, Saginaw, Michigan, personal
interview.

 

"

 

_ 5 _

Extensive remodling was done in the newly acquired building to meet the needs
of the aged and to meet the highest standards for care of these people. Ramps re-
placed steps, handrails were installed, decorations were made and equipment was
purchased with the needs and the comfort of the aged of primary consideration. The
total cost involvei in obtaining and renovating the structure was over $320,000.2

The Diocesan League of Catholic WomenBundertook as their major project, to

e1uip and maintain the equipment of the new Home as well as to offer volunteer

services to the residents and Sisters.

hwith Sister

The services of the Bernardine Sisters of Reading, PennSbrania,
Victoria as superior, were obtained to care for the residents. The Home has been
fortunate in obtaining among the Sisters, a trained social worker, a registered
lnurse and registered physio—therapists. During the Fall of 1953, five Sisters of
the Bernardine Order arrived in Saginaw, Michigan to undertake their new duties.

A board of directors was appointed by His Excellency Stephen S. weanicki, to
establish procedures and policies for the Home. There were seventeen members ap-
pointed to the board. The Most Reverend Bishop serves ex-officio as chairman. This
board is represented by members from the four branch agency areas of the Catholic
Charities of the Dioces of Saginaw, namely, Saginaw, Bay City, Bad Axe, Alpena.

Two physicians, two business men, an attorney, a representative of the local public

Social welfare Board and representatives of the League of Catholic Hemen complete

AA~~A--J—'.-‘-aa'snfi.3i4on:

2M1nutes of Beard of Directors of St. Francis Homes, Saginaw, Michigan.

3League of Catholic Women is a volunteer group of Catholic Women, which has as its
purpose, the uniting of Catholic women for the promotion of religious, intellectual
and charitable work.

#Bernardine Sisters of Reading, Pennsylvania are primarily a teaching order of
Sisters. They Operate general hospitals in the Eastern part of the United States.

~6-

the roster of the Board of Directors. The Board of Directors meets quarterly during
the year and may be called for meetings of an emergent nature.5

As soon as the site for the present Home was acquired, applications were ac—
cepted by the four branch areas of Catholic Charities of Saginaw, namely, Saginaw,
Bay City, Bad Axe and Alpena. These applications were processed through Catholic
Family Service of Saginaw, Michigan with the assistance of the Admissions Committee
of the Board of Directors. Presently, applications are still processed in the same
manner. The Admissions Committee is composed of the Medical staff, Administrator of
the Home and Catholic Family Service representatives.

St. Francis Home for the Aged was duly'licensed as a convalescent home to care
for 62 persons,having complied with the rules and regulations of the State of
Michigan Department of Social welfare? This type of license was secured in order
to insure the highest standards of care as well as for a long range plan to provide
convalescent care in the future.

There were 168 applicants for admission, of which 28 were men and 1&0 were
wmnen. Of this number, 24 were rejected because of medical reasons, A8‘made no
response to repeated efforts to contact them after their applications had been
placed, death claimed 13 of the applicants before their applications could be pro-
cessed, withdrawals accounted for 19, 12 applicants were placed on the waiting list.

On September 8, 1953, the first resident was admitted to St. Francis Home. At
present 11 men and 37 women are residents of the Home.

St. Francis Home was duly incorporated as a non-profit corporation and ByéLaws

of St. Francis Home were duly stated? The purpOSes of incorporation are stated in

A -- -Ja-fi."M-‘--fi F

it: '—~v -w‘v _

5Minutes of Board of Directors, op.cit.

6State of Michigan Department of Social Welfare, A Directgryfigfmiicensed Home for the
Aged . Lansing, Michigan, April l95h, p.35.

7Appendix A. mam. .01? SP; Fransisfieesifigépavihi chi-ass

 

_ 7 -

the Articles of Incorporation as follows:

To establish, provide, equip, furnish, manage and maintain, for benevolent
and charitable purposes, a home for the care and support of aged persons.
To receive gifts, donations, bequests and devices of real and personal
property of whatever nature or kind from any person or from any source, and
receipts, gifts, donations, bequests, and devices from persons taken care
of in said home or elsewhere and any other source of revenue for the main—
tenance and support of said home.

Imbued with the positive philOSOphy that Catholic social welfare programs can
best be served by a Catholic agency and because of the influence of religion in the
lives of people and in the philosophy that charity and service are the responsibility

of the Catholic Church, the Diocesan program for the aged was instituted.

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8Appendix B. Articles of_;ncgrporation of St. Francis fipme, Saginawleichiggn.

I.

SCOPE AND METHODOLOGY

This study has been encouraged by the Catholic Family Service of Saginaw,
Michigan to evaluate the progrmn of St. Francis Home for the Aged in Saginaw,
Michigan. Although the institution has been in operation since September of
1953, the director of Catholic Family Service is interested in the evaluation of
its program of service to the aged. The services of St. Francis Home for the
Aged have been added to the services which Catholic Family Service of Saginaw,
Michigan, an established social work agency, now perfonns.

For the purposes of this study, the term "aged" will be confined to persons
who have reached their sixty-fifth birthday. The terms "Convalescent Home" and
“Home for the Aged" are those defined by the Michigan Social Welfare Act, Act 280,
P.A. 1939 as amended:

A Convalescent Home is defined as a home or institution operated by an indivi-
dual, partnership, corporation, or other group, which for a valuable consideration,
provides planned continuing nursing care and treatment for A or more aged persons,
in addition to maintenance and personal services and which.possesses equipment, faci-
lities and staff consistent with the requirements of such nursing care and treatment.

A Home for the Aged persons is defined as a home or institution Operated by an in—
dividual, partnership, corporation, or other group which for a valuable consideration
provides maintenance and persml service on a planned and continuing basis to 4 or more
aged persons. Such maintenance and personal service does not include.nursing care and
treatment except in the case of minor temporary illness.1

In the attempts to evaluate the program of St. Francis Home for the Aged, the pro-

gram was compared with the programs offered by various boarding homes for the aged in

the State of .Michigan. Further evaluation was made with the "Standards of Care for

1
Michigan Public Act 280, 1939 as amended, "Michigan Social Welfare Act".

V2)

Older People in Institutions" as prepared by the National Commidnae on the Aging
of the National Social Welfare Assembly.2
Evaluating the program of St. Francis Home for the Aged with "Standards of
Care for Older People in Institutions"3was encouraged by Mrs. Mary Guiney of the
United Cannunity Services of Detroit, Michigan. A regional.meeting was held in
New Orleans, Louisiana,in 1953 to discuss and evaluate these proposed standards and
to evaluate the standards of care of older people in institutions in the southern part
of the United states. Another regional meeting was scheduled to take place in April
of l95h at St. Louis, Missouri for the same purpose. It was suggested that these
standards have considerable approval of many in the field of the aging, as embody-
ing sound philOSOphy of the aging, as well as of institutional care for the aging.
In seeking information of practises of the various boarding homes for the aged
in Michigan, a questionnaire 5 was devised with the assistance of one prepared by
the Wisconsin State Board of Health, Division of Hospitals and Nursing Hones.
Data was sought by means of this questionnaire in regard to admission policy,phy-
sical arrangements, cost of service,ages of residents, professional and recreational ser-
vices.Ear1y attempts were made to seek financial information, as to institutional sal-

aries, cost of operation, pe r capita costs.These attempts were not succes ful, probab~

-----

2National Committee on theAging of the National Social Welfare Assembly, Standards of
Care for Older :eople in Ins+11u zine, Section 1, Suggested Standards for Homes for the

 

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W953, 112p). I. .
BEEEEP

QMrs. Mary Guiney, personal interview, March 29, 195h.
5Appendit C. Questionnaire.

6Wisconsin State 806 rd of Health, Division of Hospitals and Nursing Homes, Preliminary
:Surver, Nursing, Boarding, Convalescent and Rest Homes _for the Aged, Infirm or Chronic-

............... 1m-—

ally 3%. Madison, Wisconsin, 1952.

 

 

- 10 -

1y because of the confidentiality of sucn information.

Although St. Francis Home for the Aged in Saginaw, Michigan is classified as
a Convalescent Home for the Aged by the State of Michigan Department of Social
Welfare,7 questionnaires were sent to homes listed as Boarding Homes for the Aged
because of the present admission policy of St. Francis Home for boarding care
only. St. Francis Home does meet the requirements for a Convalescent Home. The
classification was sought by the Board of Directors, with a view to future expans-
ion of the program after evaluation of the present progrmn.

In the April 1953 directory of licensed homes for the aged in the State of
Michigan, 108 homes are classified as boarding homes for the aged with a capacity
for 1,730 beds. Questionnaires were sent to boarding homes, whose capacity was for
more than 10 persons, in order that a comparison might be more equitable. The capacity
for St. Francis Homes is listed for 62 persons. Homes listed with a capacity for
more than 10 persons number 58 with a total bed capacity for 1,338 beds.8

Case records and pertinent data in regard to St. Francis Home were made avail-
able. Personal interviews were heLd with various people, who were associated with
st. Francis Home, in order to gather background information and historical data.
Minutes of the Board of Directors were utilized to provide information in regard
to the planning involved and.setting policies of the Home.

Census figures have been used to analyze the national population. Death rates
and longevity trends were used as a means of evaluating the extent to which services

for the aged might be needed.

This study comprises six chapters. Chapter 1, Concept of the Aging Problem.

Chapter II,"Standards of Care for Older People in Institutionsn as proposed by

...___ .- -"-___.__. -‘——M_‘_M--

 

 

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8State of Michigan, Department of Social Welfare, A DirectpgyhogkLicensed Homes
for the Aged . Lansing, Michigan, April 1953.

 

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the National Committee on the Aging of the National Social welfare Assembly? Chapter
III, Standards of the State of Michigan for the care of the agedlo. Chapter IV,A
Policies and practises of various Boarding Homes for the Aged in the State of
Michigan as they relate to "Standards of Care for Older People in Institutionsfl}1
Chapter V, Policies and services of st. Francis Home in Saginaw, Michigan. Chapter
VI, Summary and evaluation of the program of st. Francis Home in Saginaw, Michigan.
It is hoped that this study will serve as a means of evaluating the services of
st. Francis Home in Saginaw, Michigan, with suggestions to modify or to expand its
services, if indicated. It is expected that this study will be of assistance to
Catholic Family Service and to the Board of Directors of St. Francis Home in providing
progressive service to the aged. This study will also be of use to the writer in his
interest in the problems of the aging and as a basis for a more comprehensive study

at a later date.

 

W; k A-A‘L h‘.. Dina—W‘m “=‘-mr-mflcu‘t-‘QO . 4". - O-I-‘H 1"- .. O ‘ .4-

9National Committee on the Aging of the National Social Welfare Assembly, Standardsfof
Care for _0_lder Feople in _In.stitutions, Section I , Sggested Standards for Homes for-”the

.‘u‘...,~

Aged andfiNursing'ypmeg3'llQpp::§ection II, Methods of EstafiiféfiifiE“shaffi31fitaihihg

v. *0 e 0

Standards in Homes for'thegAgdea d Nursing_Homes, National Social Welfare Assembly,
New York, 1953,'112pp.

 

loState of Michigan ,Department of Social Welfare, Rules and_§egulations for Inspection
and Licensing‘of Convalescent Homes and Homes for the#Age§. Lansing, Michigan,March 1954.

 

 

11National Committee on the Aging of the National Social Welfare Assembly, 02. cit.

 

CHAPTER I
CONCEPT OF THE AGING PROBLEM

In our American culture, emphasis is placed on youth, which appears to be very
little in keeping with our.mounting aging population. Table 1, "Population of the
United States 1950 and 1850", reveals the fact that the median age increase from
18.9 years to 30.1 years. For the ages 30 years and over, the proportion of persons
in the total population at each ten year level was greater in 1950 than in 1850.

This gain increased progressively with each age group. In the older age group, 50 to
59 years, the preportion of increase was more than twice as great as in 1850. The
greatest gain occurs in the group of persons 70 years or over, where the portion is

' more than three times as great.

TABLE 1

POPULRTION OF THE UNITED SffiTflS BY AGE 1950 AND 1850

 

 

 

 

 

 

 

 

 

 

 

0" Number ifigrcent

go 1950 1070 1950 1855——

Total 150,697}000 23,191,376 100.0 100.0
Under 10 years 29,565,000 6,7h3,185 19.6 29.1
10 to 19 years 22,091+1m0 Sail-23571410. M07 2301+
20 to 29 years 23,b20,000 4,279,958 15.5 18.5
30 to 39 years 22,791+,OOO 2,827,577 15.1 12.2
#0 to #9 years 19,0h8,000 1,8h7,806 12.6 8.0
50 to 59 years 15,504,000 1,110,226 10.3 the
60 to 69 years 11,010,000 610,301 7.3 2.6
70 years and over 7,262,000 349,079 h.8 1.5

’ L f
Source: C. Tibbits andgfiifi. Sheldon, "A ihilosophy of Aging! Annals of thqumgg-

 

ican Academymgf PoliticaljmmijyggegLSpienpe, CCLXXIX, January, 1252’VP3°

- 12 -

ev—'

 

_ 13 _

Along with this preportional increase in population :vi'tf-lin a cent-11y, it is pos-
sible to see a decreasing mortality rate as well as an increase in the life term ex~
pectancy of the population. Table 2 indicates that within a ten year period the mor-
tality rate of the pepulation has decreased rather significantly for both sexes. Table
3 shows that the future life term expectancy within this ten year period for both sexes
has also increasei. Although the change is not so dramatically indicated,yet the in-

crease is sufficient to realize that the population is expected to live longer.

 

 

 

 

 

 

 

 

 

 

 

 

TABLE 2
ANNUAL (UT; 3F MORTALITY PER lCOO LIVING AT AGE -VDlCALflD BY SEX
1939-hl to lEHt
At 3:01}; Age}: Age t3. Age 65
Period M F M LF M I F M 1W F
. "' a 37.89 2012 ICES 7066 5023 36.85 260A3
19L9 32.5 25.0 1.6 .8 6.h 3.8 35.9 21.9
Source: "SelectedLiTE Tables Values 909-11 to 1949". Statistical'Abstracfy-

 

U.S. Department of Commerce, U.S. Government Printing Office} 1953 No. 66 p.70.

TABLE 3

AVEEAGE FUTURE LIFE TERM IN YEARS AT AGE IIJDICATED BY SEX
1939-hl to 1949

 

 

 

 

 

 

 

 

 

 

 

 

At Birth Age 125 ”— Age 45F 11 ;;e 65
eriod M M. F I M
-51 62? 67.29 h7o76 51. 33' .- --°' .'-
4.3.949 65.9 71.5 19.3 511.2 30.8 14.6
v Source- "Selected Life Tao es Va ues '€'- ' '". S a 18 ical Abstractflt'

U. S. Department of Commerce, U. S. Government Printing Office, 1953 No. 66 p.70.

-11...

From these tables we are aware of the fact that our pepulation is older. Fur-
ther, mortality rates have decreased and life expectancy has increased. There is the
indication that we may eXpect our population to continue to grow older. Further im—
plication from these tables, is that we need to examine the aging population in the
role that is ascribed to it and the problems associated with this role.

National economy and value is geared to speed and efficiency. Growing old in this
culture is something that is, at times, denied, or even apologized for. Along with
this thought, many of our statements tend to increase the feeling that youth is to be
sought and aging denied. Statements as the following, "you are only as old as you may
think", and "someone is sixty years young", tend to place emphasis on youth.

The process of aging involves numerous interrelated elements of biological, psycho—
logicelfi. and sociological nature. Aging in itself is complicated on the one hand by
disease processes and restriction and on the other hand by culture so that it is diffi-
cult to describe or measure it.

As aging is a part of living, it can never be arrested without ending life. This
does not imply that changes which are consequent to the passage of time in the living
organism are not amenable to change. we are all aware of physiological changes concom-
itant with the passage of time, the debility to the human body and deterioration of fac-
ulties.

While we consider the needs of older people, it is well to remember that older
people have the needs that are common to all people and also that they have special
needs due to the fact that they are older people.

We find these needs common to all of us;emotional security and affection which is
met by receiving love and by living in a world where things are predictable and usually

in a
come out in a favorable or at leastktolerant way; Secondly, social recognition and status

met by receiving respect from people who count in one's world; Thirdly, a sense of worth

- 15 -

and self respect met by living up to one's ideals; Fourthly, adequate food, clothing,
shelter and health. 1

Along with these needs common to all of us, the older person has a problem created
for him because the physical body and society itself make it difficult for him to meet
the needs common to all of us.

I The aged person best by physiological changes is in conflict between what he would
like to do and what he is able to do. In our society, the aged person must sell his
talents in open competition with all age groups. This is brought about by premium
placed on speed and efficiency required in our industrial society. The devaluation of
the qualities of experience and wisdom in favor of speed and efficiency hardly promote»
for recognition and status.

In our industrial society, new employment after the age of AS is increasingly dif-
ficult to obtain. Usually compulsory retirement begins at the age of 65. The tremen-
dous task of earning a livelihood and rearing a family leaves little time for the de-
velopment of skills that may facilitate engaging in other useful and satisfying activi-
ties upon reaching retirement age. The older person then finds himself in retirement,
usually without a job, without the social relationships that he enjoyed in his laboring
capacity and eSpecially without the substitute activity.

Social roles of persons in family units change with age. The increase in prestige,
security and respect are not always assured in our society for the aging person. In
many situations, the parent after completing his role as family protector and provider
may now assume a dependent role upon his family. This seems to bring out an inconsis-
tency in the ideals of our society for independence and success. There is no defini-
tion of the role of the aged person which.may and frequently does cause stress within

the family unit.

-‘ ‘ hnh-fl A-~-m.&.-” -_-_.v - v—v v mo“

-..”.5.

can Academy of Political and social Science, Philadelphia, January, 1952. p.11.

_ 15 -

..16-

Another phenomenon that exists in our society is the fact that family members
.may be widely separated. With the promotion of education and degrees of speciali-
zation, family'members scatter to different regions so that they leave the familial
area entirely. The aged person, faced with a situation described, maintains a home
alone and without assistance.

There develOps a kinship among older people for association with persons of their
own age groupings or with those who may be undergoing similar difficulties. This kin-
ship and the wish to be with other aged persons is demonstrated in a study made of
residents in a trailer park in Florida. These residents were asked to cite their
reasons for preference for living in a retired community. Association, same status
and interests were reasons most frequently cited. Loneliness and "Don't feel out of
place" were reasons mentioned next in frequency.2

Society in promoting the compulsory retirement age at 65 years has not taken into
consideration the fact that the person is faced with the problem of maintaining
himself on an income,less than he received while in the labor force. The retired person
usually has the same financial obligations as he had when steadily employed. Census
figures report that 43 percent of families in the United States with a head of 65
years of age and older had a cash income of less than $1,500 in 1950; and for the
same year, 39 percent of those 65 years old and older and living alone or with
non-relatives had a cash income of less than 3550.3 .

The process of aging seems to be a process brought about by physiological changes
and sociological concomitants. While it is true, that progress has been made in
geriatrics to decrease and to alleviate the confining effects of physiological

change, the needs of the aging person have not been satisfied by our society. steps

h-

 

5.....- m up.“ a»... A -.- :- .m—l- a—l" “4..-:.— 0 t A e—I I . u.—

2G.C. Hoyt, "The Life of the Retired in a Trailer Park", American Journal;ef
Sociolo , Vol. LIX No.4, January ,L95h, p.367. ' ‘

 

3U.S. Bureau of the Census. Current Populatign Reports, ansumer Income, Ser. P—6C,
No.9. Government Printing Office, Washington., 1952, p.25.

 

 

-15..

_ 17 _

have been taken in industry to reconsider the compulsory retirement changes in
favor of a more flexible plan. Society still needs to plan for the aging population
in tenms of adequate, low cost housing and financial security. Society today, is
steadily recognizing the fact that the health and welfare of its members are best
protected when the individuals of that society have the fullest opportunity for a
meaningful and satisfying life. Community planning in regard to providing this op—

portunity for our older population would perhaps, be the logical place to begin.

- 17 -

CHAPTER II
STANDARDS OF CARE FOR OLDER PEOPLE IN INSTITUTIONS

Protection against exploitation of the sick and helpless in our society has
been a long established principle, especially when the care of these people is en-
trusted to others. Through programs of state and local agencies of accreditation,
protection has been established and developed in institutions for children, medical
facilities and mental hospitals. Rules have been set up whereby, administrators,
staffs and boards of directors may be governed in the care of those entrusted to them.

Although there is increasing activity throughout the country in regard to the
aged pepulation, the amount of protection offered these people in institutions is
a long way from the progress and protection that is offered to others.

The impact of the mounting aged population offers a challenge to incorporate
this group into our cultural and social life. The scope and meaning of this challenge
is making its impression on our society. Awareness of the needs of these people and
lack of satisfaction of them.have brought about efforts from many parts to alleviate
and correct injustices toward the aged.

Shocking reports of inhumane treatment of aged persons in institutions, deaths
as a result of condemned buildings, have brought about a rec0gnition of the aging
problem. With this awareness, national and local bodies have concerned themselves
with the improvement of standards in homes for the aged. National religious groups
and welfare groups have proposed standards which they felt were desirable. Among
these groups interested in institutional care for the aged is the National Committee
on the Aging of the National Social welfare Assembly.

The National Committee on the lging of the National Social Welfare Assembly,

- 13 -

_ 19 -

organized in l950,i eludes many individuals representing national agencies who have
had a long time interest in the development of a definitive set of standards as a
nationwide goal for institut.jons caring for older people.

A project committee was formed in 1951, and was called the Committee on
Standards for Sheltered Care. This was a two year project. Membership in the com-
mittee was composed of representatives of national voluntary organisations, federal
and state governmental agencies, business and medical, legal and social work pro-
fessions and executives and board members of homes for the aged and nursing homes.

The result of this project is found in the publication of "Standards of Care
for Older PeOple in Institutions", comprising two sections. Section 1, "Suggested
standards for Homes for the Aged and Nursing Homes". Section II, "Methods of
Establishing and r’aintainnr stanoaids in Homes for the Lged and Nursing Homes".

The underlying philosophy of this committee was that congregate living should
provide for all the residents an environment that is consistent, hopeful and
affirmative. The needs of each resident should be given equal consideration without
discrimination or partiality. ApprOpriate services should be available to residents
who are ill and disabled to insure responsible diagnosis, prompt and competent
treatment to aid in the achievement of recovery and under all circumstances, sympathe-
tic and continuous care.

standards are goals toward which institutional programs should be directed.
They represent the community group opinion of desirable care for older people.

'Jhen institutional practises have been able to meet mdnimum requirements,

desirable standards come to be accepted over a period of time as minimal. The goals

 

A D-Q--A._.~._a._v 1...: I I-‘—O.A—Q ‘-J - -....o~ ‘ e i 0-1-J.J..A O "D". '—

lNational Connittee on the Aging of the National Social'welfare Assembly, Standards
of Care for QlderoPeople in Institutions, Section I, Suggested Standards for Homes

4“...

for the Aged and _Qursing Homes, 112 pp.,Section II, Methods 6r establishing and

‘4‘.

Maintaining standards for the Homes of the Aged and Qursigg Homes, National Social

.JS‘QEOQI'Q‘

welfare Assembly, New York, 1953, 112 pp.

 

 

 

- 19 _

   

 

_ 20 _

themselves are gradually raised as community understanding and institutional
services develOp. Improvement of institutianel practises thus become a dynamic
process.

For the purposes of this study the standards of care have been condensed.
Details of the various recommendations were deleted but the principle ideas were

retained. The proposed standards in this form are included in Appendix E.2

 

wW'

 

Ol~l- ...... A..‘<O..."¢‘!fi“

2Appendix E. Standards of Caregfior OldenggeggleJynwlnstitqgions.

i-‘J

I
CHAI’FER III

STANDARDS FOR HG-IES FOR THE AGED IN MICHIGAN

The impetus of federal legislation within recent years because of the accept-
ance of public assistance recipients in nursing homes and homes for the aged, has
led to visitations of these homes by welfare groups. The Hill-Burton Act, Public
Law'725 placed many of these institutions under the jurisdiction of the state
agencies concerned with the needs of the chronically ill, and focused attention
on medical needs of older people. Particular emphasis was placed on those persons
in county homes and county hospitals.

Amendments to the federal Social Security Act of 1950, embodied in Public Law
734, made provisions that a state plan for Old Age Assistance, Aid to the Blind
and Aid to the Permanently or Totally Disabled provide, if the plan includes pay-
ment to individuals in private or public institutions, for the establishment or
designation of a State authority or authorities to be responsible for establishing
and maintaining standards for such institutidn.l

The‘Michigan Social'welfare Act, Act 280 P.A. 1939 as amended imposes upon
the State Department of Social welfare statutory provisions in its regulations for
homes for the aged.

The act provides that the Michigan Social welfare Commission shall inspect

and license convalescent homes and homes for the aged which are privately operated

A‘AA ‘

'3‘"- u"fl-"o§““4~~..r-‘o....--"‘"‘-.1"‘ wvfi

1U.S. Slat Congress, 2nd sess. Public Law 73h, Titles I,X and XIV of the Social
Security Act. ‘

-21-

- 22 -

for a valuable consideration for four or more aged persons not including members
of the householder's immediate family.2

The purpose of these rules is for the maintainence and enforcement of
standards for the care, treatment, health, safety, welfare and comfort of the
individuals in convalescent homes and homes for the aged and for the maintenance
and operation of such homes in such a manner as to promote safe and adequate
accomodation, care and treatment.

Regulations of Michigan include certain basic requirements; that the premises
be safe; that the institution maintain a healthful environment; and that the
services provided be adequate to meet the needs of the residents served.

The law designates without limiting, the areas to be covered by the standards
including:

1. Location and construction of the home and all conditions within the home
necessary to insure healthful, safe, sanitary and comfortable environment for all
residents.

2. Number and qualifications of all personnel, including management and nursing
personnel.

3. Medical and nutritional services.

A. Administration of the home.

These standards imply the basic minimum.requirements for homes for'the aged.
In contrast to standards proposed by the National Committee on the Aging of the

Social welfare Assembly, the Michigan requirements are basic but do not limit

the extent to which these standards might be improved.

Standards established by the State of Michigan are made a part of and are

A‘ —“War\—vvv-oimmgaa.a -t.--- I-‘ 9 ‘ Ino-J—~D ‘—-—l ‘ 8 i... I

2State of Michigan Department of Social Welfare, Rules and R339%§E193§,£9§p39§2§9§¥29
and Licensing of Convalescent homes and fiemes;fion;§he_gged, Lan31ng, Michigan ,

March 19%. ‘ ”fl“.

- 23 _

included in Appendix F.3

General features of the regulations were retained . Embodied
in the original standards are those for convalescent homes. Detailed analysis of
these regulations is not made nor are the reasons for them.explained. Segments of
the regulations as they pertained to boarding homes were included. It is the pur-
pose of these regulations to set minimum standards for homes for the aged. Embodied

in these regulations is the philosoghy'that group care services should provide

opportunities for the aged person to enjoy his life to the fullest extent.

 

-u--‘.I.&—-".. . -.-—‘—i ll-“ - u "'1. -' 1 ‘ ’V ‘__J A- y—J—d- 4..“ . “a . 'I a 7. J .‘ -J I a _- I

3

Appendix F . St andardsijHsassisafle. Assaiafiishiasa-

CHAPTER IV
POLICIES AND 9RACTISES 0F BOARDING HOMES FOR‘THE AGED IN MICHIGAN

dithin the State of Michigan, many group care services for the aged have been
organized and licensed. According to the Directory of Licensed Homes for the Aged,
in April 1953, there were a total of 51A house for the aged. A further breakdown
of these homes reveals the fact that #06 homes were licensed for convalescent care
with a capacity for 8,420 beds, 108 homes were licensed for boarding care with a
capacity for 1,730 beds.1

Attempts were made to study the programs of various boarding homes for the aged
in the State of Michigan. No attempts were made to consider the programs of the
various convalescent care thes. As was pointed out earlier, this study is concerened
with the programs of boarding homes for the aged in the State of Michigan in order to
evaluate the program offered by St. Francis Home in Saginaw, Michigan.

Boarding homes with a bed capacity of more than ten beds were contacted by means
of a prepared questionnaire.2This was done so that a more equitable comparison
might be made with the pregram.offered by St. Francis Home, which has a bed capacity
for 62 persons. A total of 59 boarding homes with a capacity for more than ten
persons was listed in the Directory of Licensed Homes for the Aged.3

Information was sought in regard to type of legal ownership, classification

 

u-‘ “-¢W~~-J—‘a~oa~u—M.hu. .u. r.’-.I.l_t . . . nrn ‘ a I n e. n I - u. ‘ ‘, r ———"__"-

1State of Michigan Department of Social Nelfare. A Directory of Licensed Homes for the
’Jed, Lansing, Michigan , April 1953. '

2Appendix C. Questionnaire.

3A Directory of Licensed Homes. op.cit.

- 24 -

of the.hane, admission policy, age of residents, number and type of bedroom

facilities, financial responsibility for care, monthly rates, professional services

and recreation.

A total of 59 questionnaires was sent to the boarding homes. Responses to these

questionnaires were made by 26 homes. Follow up letters and personal contacts were

made in instances where it was possible. Approximately AO percent of the homes

responded to the questionnaires.

Table A indicates the groupings of the various homes in terms of capacity,

number of questionnaires and responses

in each grouping. The capacity of these

homes ranged from ll persons to 96 persons. One home had a capacity for 96 persons.

More homes were within the capacity range of ll to 19 persons and 20 to 28 persons.

The number of responses were centered within this capacity range.

TABLE A

RESPONSES TO QUESTIONNAIRES SENT TO BOARDING HOMES FOR'THE
AGED anH A CAPACITY FOR.MORE THAN 10 PERSONS IN MICHIGAN

 

. - A . 3 . A _

 

 

Capacity Questionnaires Responses
Total 59 26
ll to 19 persons 30 13
20 to 28 persons 15 6
29 to 37 Persons 8 5
38 to A6 persons 5 2
47 persons or more 1 a 0

 

 

 

aOne home had a capacity for 96 persons.

Several items on the questionnaire proved somewhat confusing and for that reason

replies were somewhat meaningless. Residence of applicants were therefore, tabulated

on a local or statewide basis. Lack of clarity for information requested in type of

care and rate for each was left unanswered in all but two responses.

-26-

Type of legal ownership of the responding homes were as follows:

Non-profit Corporations 12
Church Affiliation 9
Individual Ownership 5

Total 26

In describing the type of service, that the individual home provided, all re—
sponses classified the service as a Boarding Home for the Aged and Boarding Home.

Admission policies produced the following responses:

.§E§ ‘Male only A
Female only 15

Male and Female 7
Total 26

Ag: Under 65 years 3
65 years or older 23
Total 26
Religion Protestant 8
Catholic 3

Jewish 0
Non-sectarian 1h

No response 1

Total 26

A further analysis is made in Table 5 where a comparison is made on the basis
of legal ownership of the homes and admission policy towards the religion of the
applicants to the home.

TABLE 5

LEGAL Ov‘JNEJRSHIP OF HQVHLIS AND ADMISSION POLICY TOWARD
RELIGION OF APPLICANTS

 

 

. . Non-profit Church 7 Individual

3311310“ Corporation Affiliation ownership
Total 13 9 5
Protestant l 6 1
Catholic 0 2 l
Non-Sectarian 10 l 3
No Response 1 O O

 

 

 

 

- 26 -

EEZE£SE£ Illlbgglimbulatory 2:
Senile but ambulatory l
The admission policy in regard to the physical condition of the applicants
all responses accepted "well only" applicants, 8 homes stated that applicants
who were ill but ambulatory could be accepted and 1 home accepted senile but

ambulatory applicants as well.

Color White 26
Negro 1

In this classification one home did not restrict its applicants on the base of

color.
Residence Local 12
Statewide ll
No response 3
Total 26

Admission policies in regard to the various categories listed, showed that
Inore home limited their intake to women alone. Only 3 homes accepted applicants
'who were under 65 years of age.The physical condition of applicants is probably
realistic in view of the medical restrictions of the licensing law. All responses
considered the acceptance of "well only" applicants. The color of the applicant
‘was restricted almost entirely to the white person. One home did not restrict
‘the acceptance of appliCants on a racial basis.

The actual number of residents in the various homes numbered 232 men and 598
‘women. The responses to the breakdown of the capacity of the homes by sex was in-
qsomplete and no attempt was made to classifly them. It probably would have served a
Ioetter purpose if the information were available to determine the extent to which

the capacity for these homes is being utilized.

The youngest male resident was 50 years old and the oldest male was 95 years.
. listed
1116 average age of male residents was incomplete but did range from 75 years to

92 years.
The youngest female resident was 66 years old and the oldest female was 95 yearso

- 27- o

-23..

The average age of the female residents was listed incomplete but did range from
7h years to 85 years.

Room accomodations for residents indicated that these home had available #51
one-bed rooms, 62 two-bed rooms, 20 three-bed rooms, 6 four-bed rooms. There were
20 over four-bed rOJms. One home responded that its facilities were entirely over
four-bed rooms. There were no indications as to the number of bed facilities in the
over four-bed room accomodations. Only one-bed room facilities were provided in 9
homes; only two—bed room facilities were provided in 6 homes.

The majority of the homes were in agreement in accepting cases receiving Old
Age Assistance, Federal Old Age and Survivors Insurance, private payments. Three
homes limited acceptance of applicants to those who were able to pay privately. Nine
homes accepted applicants who were church or private agency placements in addition
to those described above.

The monthly rates for care ranged from no charge to a maximum .charge of 3125.
Most of the monthly rates as charged by the various homes were within the range of
$50 to $75.

Nineteen of the homes had a regular house physician on call while the remaining
7 homes had no regular physician on call. In 17 homes, visits of the doctor were
scheduled only when needed. A doctor's visit was scheduled on a monthly basis in
9 of the homes.

Meals were scheduled at regular periods. Breakfast was served from.7:30 A.M.
to 9:00 A.M. Lunch was served between 11:30 A.M. and 1:00 P.M. Dinner was served
from 5:00 P.M. to 6:30 P;M. All but 2 homes permitted the residents to have snacks
outside of the regularly scheduled meal times. One of these home permitted snacks
only at times and the other only when needed.

Recreational facilities and activities provided for the residents were numerous

and varied. Most of the activities listed on the questionnaire were checked. The least

-28—

_ 29 -

mentioned activities were wood carving and rug weaving. Library facilities were
not provided in about half of the homes.

Professional personnel employed in these homes indicated a very large use of
attendants. Responses to this section of the questionnaire were not complete. In
many instances, number of professional personnel employed and the extent to which
they were employed on a full or part time basis was not disclosed. Four registered
nurses were employed on a full time basis. Practical nurses were employed on a full
time basis in 9 homes. Attendants were utilized in 15 homes on a full time basis.
Social workers were employed in 6 homes, 2 on a full time basis and the others on
a part time basis. Chaplains or the services of the chaplain were available in homes
that responded to this section of the questionnaire. Six of thehomes that made
responses did not list the employment of professional personnel.

In the attempts to analyze the information gathered from these boarding homes,
we must presume that these homes have met the minimum standards of licensing regulat-
ions of the.State of Michigan. This presumption is based on the fact that the licenses
might be revoked or may not be issued if these homes failed to meet, substantially
the provisions of the law.

In the questionnaire that was sent to these homes, no attempts were made to
consider the extent to which they complied with the provisions of the Michigan
licensing provisions.

The extent to which the privacy of the individual resident was maintained
might well be judged from the living accomodations provided in the various homes.
Only in one instance, were facilities provided entirely for more than four-bed rooms.
The number of single room accomodatioas and two-bed rooms would appear to indicate a
trend away from the old dormitory style arrangements of the early part of the
century to a more individualized plan.

Although medical services in many of the homes were not on an established basis,

the services of a physician were made availamle as the needs of the residents required.

- 29 _

Recreational facilities provided a variety of activities frmn which the residents
could make a choice. These facilities were available but the extent to which they were
utilized is not known.

The cost of care seems to within reasonable limitations of the income of the
aged persons. While cost of care ranged from no charge to $125 per month, the average
range was within the ability to pay of public assistance recipients.

The information concerning the use of professional personnel was incomplete.

From the available information, it would appear that the use of professional people
13.; not used to any great extent except in a few homes.

Data sought and received does not lend itself to a thorough evaluation with
the standards as proposed by the National Social Welfare Assembly. This is a re-
cognized weakness of the questionnaire. More suitable data.may have been obtained

had the opportunity been available to revise the questionnaire.

_ 30 -

CHAPTER V

ADMISSION POLICIES AND SfiRVICES
ST. FRAggIS HOME

St. Francis Home for the Aged exists to provide care and service for aged persons
who reside, or have resided, within the Northeastern section of the state of Michigan.

St. Francis Home is a brick, three story, fireproof building. It contains
two separate wings, one for male residents and the other for female residents. It
contains identical equipment for both.vdngs. Sun parlors or recreation rooms are
located on each floor as well as two large common rooms for joint recreational
purposes.

A chapel for religious servicegigbusiness offices are located on the main floor.
Parlors for receiving and entertaining guests are also situated on this floor.

A dining room which is shared by both sexes is located in the basement along
with kitchen and food service facilities. Seating arrangements in the dining room
are made so that four residents are seated to a table.

Handrails and ramps have been installed to reduce hazards of falling and to
provide ease of locomotion for the residents. Stairways are located in both wings
for the protection against fire hazards. A fire alarm system.and an automatic
sprinkler system_ are installed.

Separate infirmaries under the supervision of a registered nurse are located
in each wing of the home. The infirmaries are equiped to provide care for minor
medical needs and to comply with medical directions for the care of residents.

House telephones are located strategically on each floor to facilitate com-

munication and for the purposes of an emergency.

—31-

- 32 -

Toilet facilities of stool, lavatory bath and shower are provided on the
basis of one complete facility for every three rooms. Some of the private rooms
already have these facilities.

Although monthly rates of care have been established, adjustments are made
to accomodate recipients of Old Age Assistance grants. At the present time, 20
residents are able to pay privately while 2a are recipients of Old Aged Assistance
grants.

I
ADMISSION POLICIES

Application Progess.

Applicants for admission to the Home may apply to any of the four branch
agencies of the Catholic Charities of the Diocese of Saginaw, namely, Saginaw,
Bay City, Bad Axe and Alpena. They are required to fill out an application blank.1
Applicants are responsible for making available information about themselves,
marital status, work history, relatives, medical status, means of support, insurance
and burial arrangements. The applicant is further required to state his reasons for
requesting admission to the Home.
Needs of Applicants.

Admission to the Home is based on the needs of the particular applicant. Each
request is considered on the basis of how the individual's needs may best be met.

The person, who finds it difficult to live by himself because of loneliness,

absence of family to take interest in him, self protection because of physical

weakness, possibility of neglect, may be considered for admission.
The person , who may not be able to live with his children or family, because
of £1DEDCial burdens or the possibility of jeopardizing the existing family unit,

may likewise be considered.

lunefllllll‘hi’yilb
ALA .1.

1AppendixG. Application for Admission t9 §E:.§?§P915 Home.

- 32”,.

- 33 -

Religion.
Although by its very sponsorship, the Home is Catholic, consideration for ad-

mission is given regardless of religious affiliation. The needs of the applicant
and the date of application are the basis of acceptance.

COlOr.

There are no restrictions as to the color of the applicants in the consideration

for admission.
§E§p

Both males and females may be accepted. Married couples may be considered
although facilities are not arranged to permit the sharing of the same facilities.
A53.

A person may be admitted who has reached his sixty fifth birthday. Certain
conditions may prove the exception, where there is a proximity to the age of sixty
five and hardship of the applicant.

Health.

Although st. Francis Home is licensed as a Convalescent Home , the board of
directors has limited admission to the "well aged". An applicant must be in satis—
factory health or if an impairment does exist, it must not be such that would in-
capacitate the applicant or require total bed care or constant assistance on the
part of the personnel.

The extent to which an applicant meets the health requirements of the Home is
determined by two staff physicians who conduct the examinations. This is done to
insure uniformity in ascertaining the physical condition of the applicants.2

Medical examinations of applicants are conducted at the Home on each Thursday

of the week. This procedure is carried out for a threefold purpose; to enable the

applicant to examine the facilities of the Home, to enable the medical staff to

 

—- ‘ 4-..... C In” ‘—

W

2Appendix H . Medical Hisaary 3.0.r..§,t:_.F.r's92.i-ahss£-

-33—

- 34,-

determine the health condition of the applicant, to enable the administrator of the
Home as well as the social werker from Catholic Family Service to interview the
applicant and to determine the extent of need of the applicant.

Residence of App}; cent 5.

Applications are considered from persons who are residents of the area known
as Saginaw Diocese. This comprises the sixteen counties of Northeastern Michigan.
Applicants who had formerly lived in this area and wish to return to it are also
given consideration.

Financial.

Applicants are accepted who are recipients of County relief, Old Assistance
grants, Federal Old Age and Survivors Insurance and those who are able to pay from
private sources.

When applicants are unable to meet financial requirements, efforts are made
to obtain assistance through Social welfare supplementation. Applicants who may
not meet requirements under this provision may be accepted on a free basis.

Persons possesing property are required to dispose of the same prior to ad-
mission to the Home. This amount realized from.the disposition of property is
deposited in their own bank account and is drawn upon to provide for their care.
Should this amount be depleted, proper referral is made within legal requirements,
to the Social welfare Board o€:;ld Age Assistance grants.

Should a resident be deceased before the amount of money is his account is
depleted, the balance reverts to his estate or is disposed of in accordance with
any wills that may have been drawn up by the resident.

On admission to the Home, the new resident is required to prepare a statement
as to the disposition of personal property and possesions in the Business Office
of the Home. This is required so that the Home may dispose of these effects in

accordance with the requests of the individual.

I”

_35-

Rates for Care.
Rates for care are computed on a weekly basis for the type of roan accomodations.
$35.00 weekly for one-bed room.
$30.00 weekly for two-bed room.
$27.50 weekly for three-bed room.
$25.00 weekly for four-bed room.

There are no additional costs for medical attention in the case of public assist-
ance recipients. Recipients of Old Age Assistance grants,who may be in need of
hospitalization or extensive medical treatment, may receive supplementation through
the Social Welfare Board. Private paying residents are expected toaassume costs
for their own medical care.

Old Age Assistance recipients receive $70 monthly, of which they retain nine
dollars for their own personal use and contribute $61 towards their board and care.

The fact that Old Age Assistance recipients and Public Welfare recipients do
not receive sufficient grants to pay for roan accomodations, does not automatically
imply that they will be placed in four—bed rooms. Room placements are determined on
the basis of available accomodations and on the basis of how the individual's needs
may best be met.

Residents are permitted to retain their health and life insurance policies. They
are also permitted to make their own plans in regard to burial arrangements.

Life—term contracts are not accepted as a financial requirement for admission.

Premiered. Dh .

 

The first three months of residence is considered to be a probationary period.
If the resident fails to make a satisfactory adjustment during this period, the
resident may be discharged.

A resident may be discharged if he fails to meet the standards of the Home in
regard to health.

A resident who requires extensive hospitalization or medical treatment that is

not provided in the Home or who is transfered to the County Infirmary for the same

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-36-

reasons may be discharged. The individual may be readmitted to the Home after
treatment only if the health requirements are met.
A resident may be discharged from the Home at any time who may flagrantly

f,

violate the rules of the Home.3
II
SERVICES FOR RESIDENTS

Periodic physical examinations are performed by staff physicians. Two physicians,
on a rotating basis are on call for any emergency.

weekly'visits to the Home are made by staff physicians on Thursday of each week.
An intern from St. Mary's Hospital, Saginaw, Michigan, makes his services available
to the Home on.Monday of each week.

Emergency service is performed at St. Mary's Hospital and ambulance service is
provided by two ambulance services on a free basis.

A registered nurse is maintained on a full time basis . Services of a registered
practical nurse is available. Five physio-therapists are also available on a full

time basis.

Religion.

A chapel is maintained in the Home. Catholic devotions and services as well as
daily Mass are provided. A resident Catholic chaplain is available.

Residents of religious faiths other than Catholic are permitted to receive visits
and mdnistrations of the clergy of their own faith.

well balanced meals are provided under the direction of a full time dietician.
Meals are served in the dining room on an individual basis because of special diets

required by the residents.

-*- kA— ‘ e .-......l' u h! e..-_I I ‘l I. . u—f -—-. --L_l |_J .& .fileJ I I. . A p I

3Appendix 1. House Rules forgfigsidentshofh§t,.francis Home, Saginaw, Michigan.

-36-

Breakfast is served at 8:30 A,M., Lunch at 11:30 A,M., Dinner at 4:45 P.M.
Snacks and lunches are permitted outside of the regularly scheduled meal time.
Kitchenettes are provided for this purpose on each floor.

Social Needs.

 

Visitors are permitted anyday of the week until 8:30 P.M. Residents are per-
mitted to leave the Home to visit relatives, friends or for business purposes.

Letter writting is encouraged and no censorship of incoming or outgoing mail
is permitted.

Participation in social affairs of the Home and in the community is encouraged.

Recreation.

 

Two large sun parlor recreation rooms are available to the residents of each
wing as well as two community recreation rooms. The following activities are made

available and are promoted for use by the residents;

Cards and chess Library Seasonal parties
Gardening Movies in the Home Supervised walks

Group reading Movies in town Television

Group singing Needlework Entertainment from groups
Knitting Piano

Sewing Radio

Beauty and barber shop facilities are provided at the Home on a free basis
through the courtesy of volunteer groups.

Social Work.

 

A Social worker from the Catholic Family Service is assigned to the Home and
visits the residents on a weekly basis to provide casework and counseling services.
The services of the Social Worker are available to the residents in helping to meet
exigencies as they arise.

Clothing 0

Residents are required to provide their own clothing. In cases where residents
them

are unehle to provide them, the St. Vincent De Paul Society makes ‘ available.

- 37—

,fi

- 38-

Every effort is made at St. Francis Home to provide a home like atmosphere
within the limitations of a group care setting. Attempts are made to insure privacy
for each resident. The needs of the individual resident are of primary importance.
indeperdence and security of the resident is fostered . st. Francis Home strives
to provide every opportunity for a meaningful and satisfying life to the aged

residents.

CHAPTER‘VI
SUMMARY AND EVALUATION OF THE PROGRAM
ST. FRAggIS HOME

The aged population is rapidly becoming a new generation, of which the
community has only recently begun to be aware. Traditionally, America has re-
garded itself as a young country full of young people. Probably a greater share
of the population believes that this is still true. Our communities therefore,
must understand the nature of the aging process and the situation of the older
people in the community. The needs and problems of older people not only affect
the older people themselves, but also the other members of the community.

It has been discussed in another part of this study that older people have
needs that are common to all people. The satisfaction of basic needs is more
difficult for the older person because of health, finances and living quarters.
Needs of older people are not independent nor can they be isolated. All needs
are interrelated and are brought on by other needs.

Interest in the problems of the older people is increasing and so is the
experience in ways and means of solving them. Action at various levels of society
has been taken toward improvement of the situation of the people in the community.
In some communities, programs for the aging have resulted frdm the impetus supplied
by an agency which has already provided a service to the aging, but which recognized
the need for additional services. Specifically constituted committees for the aging
with representatives from many communities have been formed.

This study has been concerned with only a segment of the aging problem.as it

relates to institutional services. Emphasis was placed on that group of older people

_ 19 _

I9

1‘

who need personal, hello l aha protectiVe care wnioh they were unable to aotain

in their own homes. Particular concern of this study was directed to the evaluation
of St. Francis Home and the extent to which it compares with state and national
standards and with other institutions for the aged in Michigan.

Laws concerning care of older people, even though they may be soundly con-
ceived and prOperly administered, can establish requirements of only a minimum
nature. They provide a level, below which no institution should Operate. There
are many elements, tangible and intangible, above this level which should be a
part of the facilities and services for the older people. Laws can protect the
individual but they cannot assure the happiness of the individual.

The rules and regulations of Micnigan for the licensing of institutions for
the aged stipulate the minimum requirements. Implied in these regulations is the
awareness of the needs of the older person which are cannon to all; adequate
food, health, housing and protection. Privacy of the individual is recognized
in the stipulations for living arrangements and restrictions of passage through
sleeping rooms.

These regulations protect the welfare of the individual in that failure to
provide adequate and humane treatment and failure to meet the minimum requirements
may result in revoking of the license or the refusal to grant a license.

Standards of care as prOposed by the National Social welfare Assembly establish
not only the minimum requirements but also suggest elements to insure the happiness
of the individual. The implication of these standards involves a community
responsibility toward the aging problem. It is an important responsibility of
communities, especially public assistance agencies, to know thoroughly the
community resources they use and pay for. It is only through knowledge of these
needs and potentiality of older people , that individuals and agencies can

appraise the adequacy of institutional care. Support of poor institutional

-40..

,Q

- 41 -

practises through payments by public welfare sources or voluntary agencies retard
the development of community responsibility in.this field.

Material obtained from questionnaires directed to boarding homes for the aged
in Michigan, yielded information about physical facilities, services and policy.
Scope and quality of service can only be inferred because of deficiencies in the
questionnaire. An assumption is made, that these homes maintain at least the
minimum standards for care. This assumption is based on the fact that these homes
have been licensed by the State of Michigan as having substantially met the pro-
visions of the statute.

Changes in attitude toward institutional care for the aged can be seen in
these homes. In the majority of them, the use of dormitory living has given way
tommore individualized accomodations. Recreational facilities were made available
to the residents which is a further indication of progress away from the concept
of the institution as a terminal facility.These homes, generally, provided care
at a cost which was within the financial limitations of the residents. This in
turn maintains the self respect and independence of the older person.

The services and policies of St. Francis Home have been described in another
chapter of this studszhe Home not only meets the standards for boarding care for
the aged but has met the requirements to improve these standards in that it has
been licensed for convalescent care .

Substantially, St. Francis Home standards compare favorably with the pro-
posed national standards. Policies and services are directed toward the satis-
faction of the needs of the residents within the limitations of group care
facilities.

The Home attempts to meet the basic needs of the residents. Admission and
accomodations are made on the basis of how the needs of the individual may best

be met. The ability to pay is not a measure by which services are provided.

_ 41 -

_ 42 -

Social needs are met by providing and encouraging participation in group
activities of the Home and community. Freedom to visit friends and to write
to them. and to remain in contact with the community are esential features
of the rules of the Home.

The program is geared to provide, as far as possible, an atmosphere which
these people may have enjoyed in their own homes. Eating facilities and living
accomodations are arranged on a small group basis. Dining tables are shared by
four residents, There are no more than four residents assigned to room.accomodations.
Freedom to select friends and to receive visitors, have pocket money help to
maintain independence and self respect.

The staff of the Home have experience and training to qualify them for the
particular duties assigned to»them. The use of professional staff on a full time
basis is greater than deScribed in the boarding homes of Michigan, and those
suggested in state and national standards.

Health facilities are also provided to a much greater degree than has been
found in other homes and in suggested standards. Weekly visits of physicians,
registered nurse on duty at all times, emergency facilities are made available
to the residents.

Like any new project, growth is dependent upon the willingness for self
evaluation and plans to improve. The extent to which a program accepts these, to
that extent will it become an asset to the community.

Residents of a home for the aged can be made to feel that this is their home,
if they are permitted to have something to say about how things might be run. A
step in this direction, is the appointment of a representative of the residents,
who may carry suggestions to the staff and in turn may be consulted in regard
to matters of the home.

Establishment of a house news organ can serve many purposes. Individuals

- AZ -

- 43 -

recognition through this medium and are also brought up to date about any new
develOpments in the home.

Operation of a home for the aged can be facilitated, when classifications
of duties have been established. Functions of staff members and responsibilities
of the personnel insures frictionless Operation at the various levels . A written
personnel policy, containing classification of duties and responsibilities, salaries
and benefits, is a means whereby the staff is more content and services to the
residents more adequate.

Staff relationships have more value, when members of it, can feel that they
are participating in the setting of standards and policies. Staff conferences
can further staff development and the improvement of services.

Attendance at conferences and participation in educational Opportunities
are of real value to members of the staff in their attempts to grow profession-
ally and to provide progressive service to residents.

As the needs of older people become better identified and as forward ~ look-
ing programs develop, institutions for the care of the aged will be called upon
to provide more and more specialized services. The mounting incidence of chronic
illness of the older people will make demands on institutions for services that
are related to their specific needs.

Regardless of the type of institution, the well being of the residents is
determined by the services provided. Older people must be thought of as individuals
who wish to live and act like other people. They need interests, friendship and
activity. When these are provided, when the residents are given something to live

for, the institution becomes a happier place for all.

- 43 _

 

.Ct A\N an! n\ .I N‘M :1 S f d I

APPENDIX A

BY-LAWS
OF
ST. FRANCIS HOME OF SAGINAW

ARTICLE I.

The Board of Trustees of said corporation may at any time provide for memberh
ship in said corporation.

ARTICLE II.

Sec. 1. The affairs of the corporation shall be managed by a board of five
trustees, any three of whom shall constitute a quorum. The board shall con-
sist of five members; the Roman Catholic Bishop or Administrator, Vicar Gen-
eral, and Chancellor of the Roman Catholic Diocese of Saginaw, who shall be
members of the board by virtue of their respective offices, and two elective
members. The trustees set forth in the Articles of Incorporation shall con-
stitute the first BDard of Trustees and the two elective trustees shall hold
office until the next annual meeting of the corporation. At the first annu-
al meeting of the corporation thereafter, the two elective trustees shall be
elected by the said members of the board who are members thereof by virtue
of their offices for a term of one year.

Sec. 2. Vacancies in the elective members of the Board of Trustees shall be
filled by the remaining trustees and such appointee shall hold office until
the next annual.meeting.

ARTICLE III.

Sec. 1. The officers shall consist of a President, a'Vice President and a
Secretarydrreasurer.

Sec. 2. The duties of the officers shall be such as usually attach to such
offices, and in addition thereto, such further duties as shall be designated
from time to time by the Board of Trustees.

ARTICLE IV.

Sec. 1. Gifts, donations, bequests and receipts from persons taken care of
in said home for the purposes specified in the Articles of Incorporation
shall be given ornmade direct to St. Francis Home or to a designated trustee
for the payment of the principal or income therefrom to the corporation. All
disbursement of corporate funds shall be under the control of the Board of
Trustees. '

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-45..

Sec. 2. Unless some designated special purpose accompanies a gift, donation
or bequest the Board of Trustees may disburse the principal or income for any
of the purposes specified in the Articles of Incorporation.

ARTICLE V.

The annual meeting of the Board of Trustees for the election of trustees and
the transaction of such other business as may cane before the meeting shall
be held on the second Monday in January.

ARTICLE VI.
The books of account shall be audited annually.

ARTICLE VII.
These By-Laws may be amended by a majority vote of the Board of Trustees at

any meeting, provided notice of intention to amend and the terms of the pro-
posed amendment have been delivered to each trustee prior to the meeting.

-45-

-45-

APPENDIX B

ARTICLES OF INCORPORATION
OF
ST. FRANCIS HOME OF THE DIOCESE OF SAGINAN

These Articles of Incorporation are signed and acknowledged by the incor-
porators for the purpose of forming a noneprofit corporation under the previ-
sions of Act No. 327 of the Public Acts of 1931, as amended, as follows:

I.
The name of the corporation is "St. Francis Home of Saginaw”.
II..

The purpose or purposes for which the corporation is formed are as fol-
lows:
To establish, provide, equip, furnish, manage and maintain, for benev-
olent and charitable purposes, a home for the care and support of aged per-
sons. To receive gifts, donations, bequests and devises of real and personal
property of whatever nature or kind from.any person or from.any source, and

receipts, gifts, donations, bequests and devises from.persons taken care of
in said home or elsewhere and any other source of revenue for the maintenance

and support of saii home.
III.

The location of the registered office is: 1407 Janos Street, Saginaw,
Michigan.

IV.
The name of the resident agent is: Eugene A. Forbes.
V.
Said corporation is organized on a non-stock basis.
Said Corporation is to be financed under the following general plan:
Gifts, donations, bequests and devises omeoney or any other preperty of
whatever nature or kind and receipts, gifts, donations, bequests and devises

from persons taken care of in said home, as set forth in Article II hereof.

VI.

The names and places of residence, or business, of each of the incorpo-
rators are as follows:

7 _ 46 -

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Stephen S. Noznicki 121. North Hamilton Street Saginaw, Michigan

John J. Sonefeld 12!. North Hamilton Street Saginaw, Michigan
Eugene A. Forbes 121. North Hamilton Street Saginaw, Michigan
VII.

The names and addresses of the first board of directors (or trustees) are
as follows:

Stephen S. Woznicki 124. North Hamilton Street Saginaw, Michigan

John J. Sonefeld 12!. North Hamilton Street Saginaw, Michigan
Eugene A. Forbes 121. North Hamilton Street Saginaw, Michigan
Marjorie A. Chesher 2175 Shattuck Road Saginaw, Michigan

Vincent A. Scorsone 1017 North Fayette street Saginaw, Michigan
VIII.

The term of the corporate existence is: "perpetual"’.
IX.

The affairs of the corporation shall be managed by a board of five trus- ‘
tees whose names have heretofore been affixed. Two trustees shall hereafter
be elected as provided in the By-Laws of the corporation, and the BishOp or
Administrator, Vicar General and chancellor of the Roman catholic Diocese of
Saginaw shall be members of the board by virtue of their respective offices.

X.

No incorporator, trustee, member or shareholder shall personally have
any proprietary interest in any of the assets of the corporation. In case of
dissolution the assets of the corporation shall not be distributed to the in—
corporators, trustees, members or shareholders thereof, but instead, after the
payment of all obligations, the then remaining assets of the corporation, real
or personal, shall be conveyed to the Roman catholic BishOp of the Diocese of
Saginaw, or Administrator of Saginaw, or his successors.

XI.

Neither the officers nor the trustee of this corporation shall ever re-
ceive any compensation for services rendered to the corporation in their of-
ficial capacity. The foregoing provision, however, shall not prevent the pay-
ment for necessary clerical and administrative work of the corporation to be
carried on by secretary, treasurer or by the agents or employees of the corpo-
ration.

We, the incorporators, sign our names this 29th day of February, A.D., 1952.
1. Stephen S. Woznicki '

2. John J. Sonefeld
1. Eugene A. Forbes

-47-

 

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-h8-

STATE OF MICHIGAN
COUNTY OF SAGINAW

33
On this 29th day of February, 1952, before me personally appeared Stephen

S. Woznicki, John J. Sonefeld and Eugene A. Forbes to me known to be the persons

described in and who executed the foregoing instnunent, and achemledgedthat they

executed the same as their free act and deed.

James A. Hickey
Notary Public

.53..

-49..

APPENDIX C

 

 

 

 

 

 

 

 

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_ 5o _

APPENDIX D

Michigan
Social welfare Commission

Lansing, Michigan
A LICENSE IS HEREBY GRANTED TO
ROMAN CXTHOLIC DIOCESE 0F SAGINAW

To conduct a Convalescent Home For the Aged Persons under the provision of Act 280,
Public Acts of 1939, as amended, to be known as,

ST. FRANCIS HQME OF SAGINAW
Located at lh07 Janos Avenue, Saginaw, Michigan, County of Saginaw, state of Michigan.

Approved Maximum capacity..
62

This license will expire by operation of law on December 31, l95h subject, however,
to revocation by the Michigan Social welfare CommiSsion for the violation of any of
the provisions of the statute under which it is issued, or for the violation of any
of the respective rules and regulations adopted by the Commission.

ISSUED THIS 30 day of December 1953
MICHIGAN SOCIAL WELFARE COMMISSION
BY W. J. Maxey

Secretary

LICENSE NO. 371

_ 5o -

- 51 _

APPENDIX E
STANDARDS OF CARE FOR OLDER PEOPLE IN INSTITUTIONS

I
NEEDS AND SERVICES

Personal and _S_ 0.9.1.3}...I‘ie. e ds of: .Q‘l‘de‘r. __P_e_op_le in In st it ut_i ons .

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The older individual has a universal need to be regarded as an individual.
(3roup care always results in some loss of autonomy and privacy. Within this
framework, attempts must be made to find some balance between the group welfare
and the desires of the individual. Every individual resident should have in-
dependence in the degree that it is possible.

Residents should be permitted to choose their own friends, write and re-
ceive mail uncensored and promptly. The person should be able also to choose
his own clothing.

Efforts should be expended to preserve, if possible, the feeling of security
and independence to the individual, such as he might have in his own home. Use
of the telephone, reception of visitors in privacy and the freedom to visit
should be afforded. The human being is a social animal and it is a natural
reaction to strive to remain in contact with society.

Personal accomodations and personal possessions can help the resident to
maintain individuality. Rooms that are bright and cheery may very well make the
spirits a little brighter. where facilities are not available for private
accomodations, screens should be provided to insure privacy to the individual.

The self respect of the individual is promoted and.maintained by cleanliness
and good appearance. The factor of good healthe enters into the matter of
cleanliness and appearance. The home should be responsible for the cleanliness
of the person by making bathing facilities accessible and such that meet the
particular needs of the resident.

Some homes are new developing self government and activity programs. These
programs are somewhat slow in gaining participation until such time as the
resident is able to understand that the security of the home is not jeopardized
by participation. Residents are still members of the community whether in the
institution or outside of it. If they have enjoyed this right and priviledge
within their own homes, this program.might well be promoted to further the
concept of the resident being an individual human being.

Older people are also social beings. Many of the aged seek group care
because of loneliness. Even group care will not prevent loneliness if there is
nothing to do or nowhere to go. There is no need to "push" the individual into
constant activity. What is necessary, is the fact that activities are available
and that the resident.may participate freely and actively without losing the
security of the home.

- ,1 -

- 52 -

The ability to do something about the home encourages and maintains the
feeling of respect, esteem and personal accomplishment. In many homes, residents
are given tasks, no matter how small with responsibility placed upon them to
see to it that they are done. Many times there is conflict should someone else
take over or the suggestion made that someone else do it. To the individual,
there exists the tremendous need to be assured that they are still individuals
capable of doing something.

Many of the aged persons, as they grow older, find more comfort and con—
solation in religious services than they did when they were younger. Adequate
provision for the fullfillment of these wishes should be provided according to the
religious belief of the resident.

Admission Policies

 

The aged person seeking group care does so for various reasons. Health
factors, physical weakness which make it difficult to carry on alone. The
loneliness of the individual and absence of families and friends, brings the
aged person to seek shelter. Financial security or the lack of it, creates
tremendous fear in the older person that he may not be able to satisfy his
minimum.needs. Family tension and inability live with his family because of
the presence of children and lack of understanding of his role, tends to
isolate the older person. Self protection brings the older person to seek
group care because of the lack of safety and health factors.

With the population growing older and the inevitable incidence of chronic
illness, group care services are very badly needed by this aging group.

Limitations enjoined because of licensing procedures will determine the
extent of care and service to the aged person. It would appear that residents
seem happier and are able to adjust in homes where both men and women are accepted
even though the proportion of one is greater than the other.

Financial arrangements of care should be reasonable and within the aged
person's ability to pay and still maintain some semblance of independence.
Admission should be arranged with the understanding that the resident may leave
if he so desires. The trend is towards the pay as you go plan rather than to
life-care contracts.

Admission of an aged person should be done with the individual's under-
standing of the facilities provided. .Consideration must be given to the indivi—
dual request as to how the individual's need may be met. Facilities in the
community should be explored in order to determine the extent to which the
individual may be able to maintain himself without group care services.

The transition in taking up a new residence can be a trying situation for
the aged person. His routine is upset, the need to conform with some form of
regimentation, strangeness of new people and scenes are all factors in the
period of adjustment. Casework services should be provided for the residents.
The fact that a person is elderly does not indicate that he is not beset with

 

 

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lLife-Care Contract is a specified sum of money required of the applicant for
board and care as a prerequisite for admission.

_ 52 _

 

- 53 -

personal problems that require some assistance in adjusting to them.

Residents in the home should have pocket money available to them. This
provides the individual with the sense of personal responsibility and helps
to avoid the feeling of dependency upon the home in not being able to care
for himself. Should residents be unable to provide this for themselves, some
fund should be made available in order to provide this. Along with this, a
plan of work by residents and remuneration for the sane is to be considered.
within limitations of the condition of the individual, jobs might be provided.
ray'for these services can help in providing pocket honey without the danger
of the feeling that this is charity but rather something the resident has earned.

Food Service

 

Nutrition, probably is one of the great factors affecting health. As the
person grows older, he is less active and hence the metabolism rate is low.
The need for high caloric food is not great.

The dietician is an important member of the staff. It is this person
who arranges and sometimes helps prepare the meals for the residents. Since
most of the aged require special diets, the service is on an individual basis.
Menus should be varied and attractive.

Dining facilities should be such that would promote a friendly atmosphere.
Blacenent of four or six residents prompts congeniality. It has been found that
residents eat more of the needed food and have fewer eating problems when meals
are eaten together and enjoyed.

Health Care

 

Every home should make arrangenents with a doctor, if one is not assigned
to the staff, to give advice and to accept emergency calls.

It is also highly recommended that a registered nurse be a member of the
staff. This is made to assure competency in following medical directions for
the residents.

A room.should be made available for residents who have become seriously
ill. This protects the other residents and also insures the comfort for the
ailing individual.

A well equiped infirmary is also required. The infirnary in the boarding hone
should not be set up to render hospital care. It is to deal with minor or
temporary illness that may occur in any group setting.

Recreational activities should be providid because living in a group and
learning no group activities makes for inactivity. This reduces boredom and
the preoccupation of the resident with himself. Occupational and physical
therapy, in their aims to help the resident to retain and improve his normal
patterns of fUnctioning are essential. A group worker is another person who
may assist the directing and assembling of an activity grogram and work with
the therapists.

A resident requiring extreme supervision to prevent injury to himself and
others should not be cared for in the homes for the Find. locking of rooms

_ 53 _

- 54 -

at any period of the night is a hazard to the safety of the individuals.

It is important to realize that many of the homes are not sufficiently
endowed to provide all of the recommended services. The use of and the
awareness of existing facilities in the community should be made by the
facility offering care to the aged. Casework services can be provided by
contacts with social agencies as needs arise. Voluntary services from groups
may be encouraged for planning and participation in group activity. Local
library facilities should be explored for use by the residents. Consultation
with state and local health departments can be had in regard to food and
nutrition.

II
PERSONNEL

0.-....“-

 

Perhaps the greatest asset of a person, employed in a group care service
for the aged, is the genuine liking for this group. The older resident is
very quick to be aware of the employee who is not warm, friendly and interested.
The reactions of the residents to these employees will be in accordance with
the personality and attitude of the employee.

Professional staff as medical, therapy, social work, should be properly
trained within the standards of their profession.

The director of the home directs all functions of the home in keeping
with the policies established by the board of directors. This is done to
assure that the home is being directed to the best interests of the individual
resident and the residents as a group. It is the duty of the director to
interpret and administer the policies that were formulated; coordinate activities
of all departments; maintain high professional standards and to insure the
safety and protection of the residents. The director must assume leadership
and control of the home within the limitations of the policy.

The director is directly responsible to the board of directors. This
person is responsible to the entire board and not to individuals or committees
of the board.

The relationship of the director to the staff is important in promoting
harmony and coordination. Leadership and the assumption of responsibility for
the Operation of the home and decision making within the staff relationship is
important in providing service.

In the employment of personnel, it is important to select kind and
patient persons. Competency on the part of the personnel and their attitudes
have a decided effect of the happiness of the resident.

In general there should be one employee to five so called "well" residents
as are generally accepted in boarding homes.

Personnel Practises

 

The size of the staff should be sufficient to insure adequate service to

..SA-

 

-55...

the residents without requiring the help of the residents. A written code
should be prepared. This sets up specifications or requirements for staff,
salaries and benefits.

The salary scale should be appealing to attract adequate staff. The
description of Specific duties should be incorporated in written form in a
manual of personnel practises. This assures the employee of what is expected
in the particular classification. Job classifications can be used as a basis
for recruitment and also as a means of determining the need for further staff.

Problems that arise between the employee in regard to their position
should be resolved by means of a definite plan where these can be discussed.

It is particularly important in employment of staff, that opportunities
be given for staff development. Staff meeting, in service training, partici-
pation in educational Opportunities and conferences should be considered as a
part of the program for employees. It is in this way, that service can be ade-
quate and be improved. -

Living arrangements for personnel, who are obliged to live away from their ;
homes,should be apart from the quarters housing the residents. Surroundings should
be pleasant and relaxing to provide at least some semblance of the comforts of
their own homes.

III
SPONSORSHIP AND ADMINISTRATION

Governinggfigggg.

Authority for every non—profit group care facility should be clearly defined
and responsibility specifically placed. For this reason, the institution should be
incorporated as a non-profit organization. Responsibility and obligations of the
corporation are fixed and the right to acquire property is defined.

The setting up of a constitution and.by-laws states the broad purpose of the
institution and establishes a responsible governing body, and the intent to develop
a service program in the public interest.

The role of the governing board is that of determining policy and the administ-
rator of the institution is delegated authority and responsibility for developing
and carrying through the program in accord with the policies.

Board membership should be broadly representative of the community served by
the home. These shohld men and women of varying ages, professions and occupations.
The board should consist of not less than fifteen members nor more than twenty.
Members should be selected on a continuing as well as on a rotating basis. There
should be no compensation for membership.

The board should meet at least quarterly and preferably monthly. The director
of the facility should be a participant at these meetings. Minutes should be
recorded. Members should attend meetings regularly and be in touch with the facility
and be aware of the program.

- 55 -

-56-

Functions and Responsibilities.

 

The board is responsible for formulating general policies governing the
function of the institution, admission, discharge, medical care and personnel. The
board has a responsibility for relating the service program to the work of other
agencies in order to coordinate community programs for older people.

Records.

When an aged person enters the home, pertinent records for each one should be
maintained and kept up to date, including admission, medical, nursing and social
data. This material should be confidential information and residents should not be
permitted to see their own records.

Suggested material for records:

1. Application form.

2. Admission agreement.

3. Information obtained at time of admission, as a social study, medical history,
names and addresses of relatives or persons responsible for the resident.

A. Detailed inventory of personal possesions.

5. Individualls own financial records, expenditures and income.

6. Legal papers concerning agreement with the home, transferal of property,
insurance papers, will, correspondence.

7. Chronological record of welfare of the resident.

8. ChronolOgical medical history.

9. Accidents and injuries with dates, causes and extent.

10. Burial plans. '

IV
PHYSICAL ENVIRONMENT

Most people, particularly those with restricted income or energy are better off
when they are within access of community services. An urban location with pleasant
surroundings is most desirable for an institution caring»for older people.

The size of an institution should be related to its function. As yet, definitive
standards have not been formulated to evaluate size in relation to purpose.

Living arrangements should be such that rooms should be light and cheerful. Where
privacy of the individual is not possible, beds should be at least three feet apart.
Bedrooms should open on to a hall and it should not be necessary to reach the outside
of the room.through another. Quarters for sexes should be separate except for
married couples and passage to the hall should not be necessary through the rooms
of the opposite sex.

Bathroom facilities should be adjacent to each room or between adjoining rooms. It
is advisable to have at least one toilet for every six persons; one wash stand for
every eight persons and one tub or shower for every ten people.

There should be a large living room available to all residents and accessible to
them. Also, smaller rooms or sun parlors on each floor, if possible should be made
available.

,fi

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-57..

Stairs for the use of residents should be avoided as much as possible. Each
floor should have at least two well separated exits. Provisions for ramps and
elevators should also be made. Fire hazards as, open faced heaters and fireplaces
should be protected with a metal screen.

All rooms and every part of the building should be kept clean and orderly
and free of offensive odors. Regular cleaning should be done by the housekeeping
staff, leaving only the tidying of the rooms to the residents themselves.

-58--

APPENDIX F

STANDARDS FOR HOMES FOR THE AGED IN MICHIGAN

I
BUILDINGS AND EQUIPMENT

In the consideration of licensing of any home, plans and specifications for
the building or buildings must be submitted to the state Department of Social
Welfare and State Fire Marshal..

All buildings shall be in a safe, sanitary condition and suitably located.
Stairways must be equiped with handrails and stairways suitably lighted. Lighting
facilities are to be such to protect against possible hazards to the residents.

Living arrangements for staff and families of the staff are to be properly
segregated from the quarters of the residents. '

Sanitation facilities are'to comply with comm “ity standards as determined
by the state and local health departments.

Quarters are to be arranged so that passage through them is not through
sleeping rooms.

Individuality of the resident is encouraged by the provision for storage and
wardrobe space for each resident. Privacy of the seriously ill is guaranteed by
provision of rooms for this purpose.

Overcrowding of facilities which do not promote cheerful living is contained
in the regulation which permits no beds to be placed in hallways.

II
PdRSONNEL

The number of personnel required in boarding homes is not specifically
stipulated. Sufficient staff should be available for 2h hours of service according
to the needs of the residents and requirements of the State Fire Marshal.

Staff should be qualified and responsible people of suitable age, character
and temperament and ability to funtion in their duties and to provide adequate ani
proper care for the residents.

III
MEDICAL AND NUTRITIONAL SERVICE

- Residents are, at all times, to be treated humanely and suitably provided with
whatever may be necessary for their needs , safety, comfort and well being.

- 58 -

 

 

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- 59 -

Physical examinations before and after admission of residents by a physician
are prescribed to insure medical care and protection against contagion.

Seriously mentally disturbed residents may not be accepted. Should a resident
evidence a serious mental disturbance, he is to be removed from the home.

Food service to residents must be adequate both in preparation and in balance.
Supplementary food and diets must be provided as prescribed in writting by a
physician.

IV
ADMINISTHHTIUN

Life-care COHtPiCtB are frowned upon unless the home can furnish evidence of
fulfilling such contracts.

The administrator of the home must be free from.family'business or other
obligations which might interfere with the operation of the home and care of the
residents.

Records are to be maintained for each resident:

1. Name of resident.
2. Date of birth.
3. Last address of resident.
L. Date of admission.
5. Religion.
6. Church and pastor.
7. Name, address and telephone number, if available, of relatives or persons
responsible for his admission.
8. Amount of weekly or monthly fee.
9. Inventory and disposition of personal property, money or valuables possesed
by the resident at time of entrance, death and discharge.
10. Name, address and telephone number of resident's physician.
11. Date of discharge or death.
12. Cause of discharge or death.
13. Such additional information as may be prescribed or found necessary or desirable.

Application for a license shall be denied or a license may be revoked for

failure to meet substantially the provisions of the standards or for cruelty or
indifference to the welfare of residents.

-59-

 

 

 

 

-60-

APPENDIX G

APPLICATION FOR mmssxcu TO:
sr. rzuwcxs mm
1407 J4me an
enema, MICHIGAN

Telephone: 5-6111

 

 

 

 

 

 

 

 

Name Maiden Name

Address Telephone

Age_____Dcte of Birth Place of Birth _

Citizen? ==How long in U. 8.? In Diocese of Saginaw“
Parish Pastor's Home

 

 

-60...

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Dividends $ From Whommu'
Savings $
Property $
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Reasons why you with to live at St; T‘”101" Eome:
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Lot Owner of Lot

 

 

 

Cemetery Holder of Deed

 

andress

Date of Application:
“ Referred by:

 

 

 

APPLICATION FOR ADI-.JSSIOI: TO:
313. FIU‘INCIS sum
1407 Lil-3E8 ST.
8 6mm, MICE-IIGAN

Telephone: 5-5111

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Neme_m_ Maiden Esme
Address Telephone
309 Date of Birth Place of Birth
Citizen? 1=fiow long in U.S.? In Diocese of Saginaw
Parish Pastor's Neme_11
MARITAL S' ‘31“st
Single Merried1__m__uwmyidowed Divorceq~flmm_m_18eparated
Mann 1:; ge 3 ......w......... Ch 111‘ ch I

Spouse: If living where
If deceased when1“

 

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Cause of Death

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Kind of job (Kind of work done during most of working life, even if retired

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If presently employed for how longgv

 

 

 

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Social Security No. Union meanermiip
were you in U;S. Armed Forces _‘ .33 Which War or Dates of Service
Father's name Mother‘s fiaiuen name

RELATIVES
Children Address Occuyation of

Son or Daughter's Husband Tolephone

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Other Relatives __fiddress Relationship Telephone

 

WEED ICAL Sr‘ATUS

Present Medical Needs

Name and Address of Physician
Tel ephon e Numb er ‘ of Physi c i an.

 

 

 

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- 62 -

APPENDIX I
HOUSE REGULATIONS OF THE RESIDENTS
OF

ST. FRANCIS HOME

This is your home. These regulations are intended to make a peaceful, comfortable
home for you and others sharing it.

I
MEALS

Residents are expected to go to the dining room.unless illness or some valid reason

prevents them.Continuous tray service will be given on doctor's orders only. Should
a resident be absent from any meal, the Office is to be notified.

II
YOUR ROOM

No food (except fresh fruit) or dishes are to be taken from the dining room. Cookies,
candies, etc. are to be kept in a glass or tin container.

No candles or electrical appliances such as irons, electric plates, heating pads or
heaters are permitted. (Exception: Radio).

III
CARE OF YOUR ROOM

All physically able residents are to care for their rooms daily. Rooms and beds are
to be aired each day upon rising. Beds are to be made after breakfast.

No unnecessary articles such as boxes, packages are to be kept in rooms(nothing
under the bed). Surplus materials are to be placed in the storeroom. The top of the
dresser should be kept neat.

The supervisor of the floor or the sister Superior may inspect the rooms and closets
at any time.

Lights must be out by 10:00 P.M. Allowance will be made when needed.
No smoking is allowed in your room. Use smoking facilities available.

No alcoholic beverages are permitted in your room without the knowledge of the Sister
in charge.

-62-

-63-—

IV
LAUNDRY

,aundry must be done in the laundry room. No washing of any articles is permitted in
rour room.

. V
BATHING

Allresidents of the Home must take a tub bath at least once a week.

VI
VISITING HOURS

You may'have visitors any day to 8:30 P.M. out of courtesy to your roommate you are
asked not to use bedrooms for visiting purposes. On each floor there is a large social
room in which you.may visit.

Residents are expected to be in by 10:00 P.M. When necessary an extension of time will
be granted.

VII
LEAVE OF ABSENCE

If you are absent from the Home for any length of time, notify the Supervisor of the
floor and then register in the book found in the Office, giving the address, telephone
nwnber or instructions as to where and how you can be reached.

VIII
CHAPEL

Attendance at all services is recommended.

\ 1X
USE OF TELEPHONE

Residents use the Public Telephone to make calls. Incoming calls to the office will be
accepted and the residents will return the call at the Public Telephone.

‘f

A

DISMISSAL

A resident may be dismissed for:
1. Continued failure to cooperate with the authorities of the Home.

2% Inability to live in a group so as to interfere with the harmony of the Home.
3. Conduct unbecoming a lady or a gentleman.

h. Continued violation of the rules.

5. Excessive use of alcoholic beverages.

BOARD OF DIRECTORS

 

I.

1.

2.

A.

5.

6.

7.

9.

10.

ll.

13.

BIBLIOGRAPHY
"Aging And Retirement", American Journal Of Sociolggi, Vol. LIX, No. A,
January 1954.

A Home In Later Years, New York State Association of Councils and Chests,
New York, 1953. 9 pp.

 

 

Community Services For Older People - The Chicago Plan, welfare Council of

 

‘---H

Metropolitan Chicago, Chicago: Wilcox & Follett Co., 1952, 240 pp.

Donahue, Nilma, " Experiments In The Education Of Older Adults", Adult
Education, Vol. 2, December 1950.

Havinghurst, Robert J. and Ruth Albrecht, Older People, New York: Longmans
Green & 00., 1953, #15 pp.

Hunter, Noodrow and Helen Maurice, Other ngple Tell Their Story, Ann Arbor:
University of Michigan Press, 1953, 99“pp.

 

Individualized §EIYEEE§.ESE.Th9 Aged, Family Service Association of America,
NeW'York, 'IQEI.

Living ThrouL h Older Years, C. Tibbitt.s, Editor, Ann Arbor: University of

 

Michigan Press, 1949.

Prelininary Survey, Nurs1ng,_Board1ng, Convalescent And Rest Homes For The

oooooooooooo

flfl°dz Inf'irm Or Chronically Ill, Wisconsin State Board of Health, Division
of hospitals and Nursing Homes, Madison: 1951, 13 pp.

 

 

Problems Of The American Aging POpulation, T.L. Smith, Editor, Gainsville:

University of Florida Press,"l951.

"Social Contribution By The Aging", The Annals Of The American Apademy;pf
Political And Social Sciences, Volume CCLXXIX, January, I952.

 

standards Of Care For Older People In Institutions, Section I,"Sueg ested

 

Stindards For Homes For The Aged And Nursing Homes" National Committee
on the“ Aging of the National Social Welfaxe Assembly, New’York: 1953. 112 pp.

standards mOf Care For Older People In Institutions, Section II,"Methods

I—u—h..----—‘-R-

Of mStdbllohlnb And Maintaining Standards In_ Homes For The .eged And

-prr ‘..-rOr-”

Nursing Homes? National Committee on the Aging of the NatiOnal Social
Welfare Assembly, New York: 1953, 112 pp.

 

 

~61.-

h
n-r‘

[“I

 

1.

2.

h.

5.

~65-

WOOds, James H. , Helping Older 133091.91359X1111f9’ New York : Ehrper & Bros. ,

 

1953. 139 PP.

PUBLIC DOCUMENTS

State of Michigan Department of Social Welfare, A DirectoryfiOf, Licensedhflgge s

For The Aged ,Lansing

 

April 1953.

State of Michigan Department of Social HElfare, A Directory49thicens d Hbmeg

For The Aged, Lansing

 

 

 

April 1954.

State of Michigan Department of Social‘welfare, Rules And Regulations For
Inspection And Licensing Of Convalescent Homes And Homes For The Aged,

Lansing : March 195A.

 

U. 5. Bureau of the Census, Current Population Reports, Consumer Income,

Ser. P—éO, Washington

0
O

GovEEEEEfifhfirifitihgmfiffice}‘1952.

U. S. Department of Commerce, statistical Abstrgpts, Washington 3 Government

Printing Office, 1953.

 

-55..

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