Commission delivered final report to Congress on June 28, 2002
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Testimony to
The Commission on Affordable Housing and Health Facility
Needs for Seniors in the 21st Century
November 7, 2001
Susan Mack

Thank you for allowing me to speak. Okay, so you've already assumed some awareness of the needs of the seniors, and that has already been incorporated in the buildings in which you have been servicing the seniors.

Unfortunately, many builders have not been in the senior building industry and have totally been unaware of the structural needs of seniors, as you and the people you've worked with have been for all of these years. So a lot of those fundamental needs of seniors are not being met by the general building contracting industry.

I am an occupational therapist. I've been a therapist since 1971. As a registered therapist providing services in a clinical setting, I was very frustrated by sending people home to traditionally constructed and designed homes which had numbers of barriers and hazards throughout the home which prohibited people from functioning at their highest level in safety and in dignity.

So what happened is that I initially started out -- and it's explained in the document that I handed to you -- in advising families on how to make the best out of a bad situation, which was a house with many stairs, narrow doors, narrow hallways, low toilets. So I was working on recommending home modifications. After many years, the light came on for me and I realized I really need to be contract -- concentrating on working with builders to build houses more appropriately for people so that they didn't have to go back in and spend tens of thousands of dollars in retrofitting ill-designed homes to accommodate their changing abilities and needs.

As has been mentioned in the past, many seniors do not complain. They withdraw. They withdraw from the community. They withdraw from their neighbors. They withdraw from major parts of their homes. They live in smaller and smaller portions of their homes. They bathe at the kitchen sink. They toilet in a commode next to the sofa.

So we don't know that there is a hidden number of people in this country who are living at a much lower level of quality than they should be, but they will not bring it up. They are also people who are children of the Depression and the war who've learned to make do. I put that in my summary.

My reason for coming to you now, besides -- I mean, you can read what I've already given you, but I also want to say that there is the need -- there is a need -- Mr. Weinstein did elaborate on it -- so he took most of the wind out of my sail -- in that we do need to encourage the general -- the public construction industry with whatever incentives you see appropriate through whether it be the federal, the state -- maybe comes through the state from the federal government.

You've got to get out there. You've got to motivate these people to be more conscientious about what you're building for our public. Bathrooms are getting smaller. Doors are getting smaller. There are people besides seniors who are living in substandard levels of housing. I just think that we need to be more of a moral society and provide housing that's, quote, "inclusive", that is allowing people to function at their highest level.

So whatever means you see -- it can be done to achieve this would be very much to the benefit of this whole society.

When you can allow people to function at a higher level, you reduce the burden of care-giving. If you can allow people to live independently and get out and work -- we did the ADA so people with disabilities can go out and work. We did the ADA so people with disabilities can go out and spend the money they can earn when they work. What about -- where are they going to sleep at night?

So I think we have a third step we need to think about. Where are they going to live and how are they going to function? What can we do to provide environments, transportation, housing, to allow them to live better lives?

So building incentives -- now, I have to say, being that I've been doing these houses in the general building industry with people who have not been involved with medical care, there is a void of knowledge, a total void of knowledge of how to do it. It sounds simple. You just give them wide doors and you take out the stairs. I want you to know that that sounds like rocket science to these construction people. To get a no-step entry is like building a rocket to the moon.

So I think we need to increase the education, beginning in colleges. We need to get it into technical schools for the plumbers on how to install grab bars. We need it to be -- education has got to be a prime element, in addition to incentives, to get people to be motivated to do it in the first place. Thank you very much for your time.

The page was last modified on November 29, 2001