In 1965 Congress passed the Older Americans Act. This act has been amended and expanded several times during the past 35 years. Other national legislation has provided special services to individuals age 55 and older. Federal funding of the various programs for individuals nearing retirement age and older has increased slowly.
The net result of all this legislation, development of new programs, and increased funding appropriated is that there are in all communities special services for senior citizens. Meals On Wheels, congregate meals, recreational centers, special counseling, some special transportation, medical assistance, and legal assistance are services that are widely available throughout the country. The law requires each state to develop plans and systems for providing all these services and more. Furthermore, states are encouraged to take into consideration disabilities that are common among older Americans. Since more than half of all blind people in the country are 60 years of age or older, agencies providing services to senior citizens are expected to give special attention to those who are blind or have lost a substantial amount of vision.
Section 301(a) of the Older Americans Act as Amended states the purpose as follows:
It is the purpose of this title to encourage and assist State and local agencies to concentrate resources in order to develop greater capacity and foster the development of comprehensive and coordinated service systems to serve older individuals by entering into new cooperative arrangements in each State with State and local agencies, and with the providers of social services, including nutrition services and multi-purpose senior centers, for the planning for the provision of social services, nutrition services, and multi-purpose senior centers, in order to—
(1) secure and maintain maximum independence and dignity in a home environment for older individuals capable of self care with appropriate supportive services;
(2) remove individual and social barriers to economic and personal independence for older individuals; and
(3) provide a continuum of care for the vulnerable elderly.
Nutritional services, social services, and multi-purpose senior centers are general concepts—types of services and assistance that can make a great deal of difference in the quality of life for millions of older Americans. Nutritional services are perhaps understood best and easiest to find. In almost all communities it is possible to have at least one meal a day five days a week delivered to the homes of elderly persons who are sick or disabled (Meals on Wheels). In addition, at least one meal a day is served at centers for senior citizens in many communities. Sometimes these meals are served only on certain days of the week and sometimes this meal is combined with recreation and/or special programs for senior citizens. The cost of these meals is generally kept low as that lack of money will not prevent anyone from participating. Blind persons can and should take advantage of whichever of these services they wish. It should be emphasized here that a blind person ought to feel as comfortable going to the senior citizens center as staying home. Special transportation should be arranged if needed. The center can and should assist a blind person to get acquainted with the facilities and activities. All senior citizens centers should encourage blind individuals to participate in their group meals and other activities. Blind persons should be offered assistance if needed, but they should not be restricted or protected from activities they want and need.
MYTH: Individuals who lose their sight late in life are less able to adjust and become self-sufficient than younger persons.
FACT: Blindness is a common problem to be dealt with by senior Americans. It can be reduced to the level of a nuisance, if the individual receives encouragement to be self-sufficient and some practical advice about skills and methods that can be used for everyday activities and do not require sight.
EXAMPLE: Milton Galloway became blind at age 74, although his eyesight had been poor because of glaucoma for several years prior to that time. When Mr. Galloway became blind, he was afraid to go outside his home to shop, go to church, or to participate in his Lions Club although he had always enjoyed all of these things. His daughter arranged for him to be served lunch five days a week by Meal On Wheels and she brought him dinner or took him to her house several times a week. Mr. Galloway was very grateful for this but soon became lonely.
When Mr. Galloway's son from out-of-town came to visit, he encouraged his father to begin eating his mid-day meal at senior citizens center. Mr. Galloway was very much afraid to do this, but after some urging, he agreed to try it. He could find no one to teach him how to use a long, white cane properly, but he began to carry one to the center anyway and figured out on his own that he could use it to locate chairs, steps, walls, other people, etc. Although Mr. Galloway found these trips extremely exhausting at first, he continued to go to the senior citizens center for lunch and, after a few weeks, he found he thoroughly enjoyed it and knew his way around the center quite well. This experience made Mr. Galloway feel that he could begin to attend church again and take part in some other activities outside his home.
Section 321(a) of the Older Americans Act as Amended describes social services that can be provided. Subsections 2 (transportation), 5 (reader services and letter writing services), and 11 (services which are designed to meet the unique needs of older individuals who are disabled) deal with services of special importance to older blind persons. Blind persons can and should take advantage of any or all of the services provided under this law as needed, and all services must be equally available to the blind as to the sighted.
SEC. 321(a): The Commissioner shall carry out a program for making grants to States under State plans approved under Section 307 for any of the following social services:
(1) health, continuing education, welfare, informational, recreational, homemaker, counseling, or referral services;
(2) transportation services to facilitate access to social services or nutrition services, or both;
(3) services designed to encourage and assist older individuals to use the facilities and services available to them;
(4) services designed to assist older individuals to obtain adequate housing, including residential repair and renovation projects designed to enable older individuals to maintain their homes in conformity with minimum housing standards or to adapt homes to meet the needs of older individuals suffering from disabilities;
(5) services designed to assist older individuals in avoiding institutionalization, including pre institution evaluation and screening and home health services, homemaker services, shopping services, and other similar services designed to assist such individuals to continue living adequately in a home environment;
(6) services designed to provide legal services and other counseling services and assistance, including tax and counseling and assistance and financial counseling, to older individuals;
(7) services designed to enable older individuals to attain and maintain physical and mental well-being through programs of regular physical activity and exercise;
(8) services designed to provide health screening to detect or prevent illness, or both, that occur most frequently in older individuals;
(9) services designed to provide pre retirement and second career counseling for older individuals;
(10) services of an ombudsman at the State level to receive, investigate, and act on complaints by older individuals who are residents of long-term care facilities and to advocate the well-being of such individuals;
(11) services which are designed to meet the unique needs of older individuals who are disabled; or
(12) any other services;
if such services meet standards prescribed by the Commissioner and are necessary for the general welfare of older individuals.
Many other laws have been passed which provide benefits to senior citizens, and some of them provide special services and funding for services for older Americans who are blind. Most notable of these laws are Title 20 of the Social Security Act and the 1978 Amendments to the Rehabilitation Act. These laws state specifically that special services can be provided to older persons who are blind.
Special services that should be available to blind persons include: training to travel independently, assistance with transportation, assistance to find and maintain appropriate housing, assistance to find appropriate low-vision aids, and assistance to get printed materials read. Although some of these services may be available from the agency on aging, they may be available from the rehabilitation agency for the blind instead. This will vary from one state to the next. Unfortunately, some States are not making these services available to the blind as well and a broadly as they could and should.
Some special services to older Americans are available to any person past the age of 55, 60, 62, or 65, regardless of other resources or the income of these persons. For example, a certain theater may have special admission prices for senior citizens. The fact that an individual has reached a certain age makes him or her eligible for these special prices. However, some special services may be available without cost to senior citizens on a limited income. Legal services and certain types of health care are examples of this. The next chapter will discuss general financial assistance provided by the federal and state governments. But many programs for senior citizens are subsidized, and special prices are offered regardless of the income of the older individuals who take advantage of these benefits.
Most medium-sized and large cities in this country provide public transit—city buses, trains, or subways. The Urban Mass Transportation Act of 1964 as Amended provides that such public transit systems shall offer reduced rates to senior citizens during non-peak or non-rush hours in order to qualify for federal financial assistance. Therefore, cities do offer these reduced rates during the middle of the day. This has nothing to do with how much money an individual gets for other sources. This is not unique; only an example. It is the kind of thing that is generally publicized locally, and it is something about which you should be able to get information from the agency on aging in your state.
You, as a blind person, are entitled to all of the services administered by the agency on aging in your state, and you are also entitled to services administered by rehabilitation agencies for the blind in your state. (See Chapter 8) Knowledge of services that can and should be available will help you to get the services you need. Of course you cannot be expected to be an expert on all the laws that have ever been passed that affect older Americans—very few people are—but the information contained in the book should help to make it possible for you to find and take advantage of services that are being offered to you and other people like you.
If you income is not too high, you can get assistance with transportation to and from doctors' appointments, and other business you need to conduct. This service may be provided by the agency on aging as a general service to many senior citizens in you city under the Older Americans Act; it may be provided by the agency on aging under Title 20 of the Social Security Act; it may be provided by the rehabilitation agency for the blind under Title 20 of the Social Security Act; or it may be provided by a private agency with funds from more than one source. It may be necessary for you to contact several offices to find out about one service. In theory, this should not be the case, but in fact, your persistence in working to learn about services that are available is essential for you to be able to make use of services that are offered and that you need.
MYTH: Senior citizens centers cannot accommodate blind persons.
FACT: Blind persons do not require any special accommodations in the building or facilities. Until the layout of a building becomes familiar, a blind person would generally find it helpful if he or she could take the arm of another person to move about from room-to-room. Some blind persons will need more help than others in becoming accustomed to a new area.
EXAMPLE: Minnie Smith and Jack Robinson have come to a model city's senior citizens lunchroom and program for the first time. Both are blind, but they have never met one another before. Each was greeted at the door upon arrival and asked if he or she needed assistance. Miss Smith said: "Yes, could you show me around a little bit." Another lady who had attended this center for several weeks did show Miss Smith around. Miss Smith carried a long, straight, white cane and used it to locate furniture and get acquainted with her surroundings. Then she needed no more assistance.
When Mr. Robinson was asked if he needed assistance, he said: "Well, I guess you'll have to show me where there's a chair." This was done, and Mr. Robinson was left alone. Later, the lady who had helped Miss Smith asked him if he would like to meet some of the other people. He said he would and she introduced him to a few.
When it was time to eat, someone showed Mr. Robinson a place at the table and brought him a plate of food. He was grateful for the assistance. On the other hand, Miss Smith went to get her own food and felt perfectly comfortable carrying it to the table to eat.
At a later meeting when Miss Smith and Mr. Robinson got to know each other, Miss Smith learned that Mr. Robinson had only recently become blind and was not sure what he could do for himself and what he could not do. Since Miss Smith had been blind for almost 20 years, had had some rehabilitation training, and had been employed before her retirement as a social worker, she had much more confidence in herself as a blind person. She helped Mr. Robinson learn his way around the seniors citizens center and shared with him some of her experiences and methods for doing some things around the home. That was the day that Mr. Robinson really began to enjoy himself at the senior citizens center.
By law, it is the responsibility of the agency on aging in each state to serve as a referral agency. If the state agency on aging has contracted with a local agency or a private organization to provide special services to older Americans, or if some other agencies provide some of these services statewide (such as a rehabilitation agency for the blind), the head office of the state agency on aging is supposed to know about it and is supposed to tell persons who telephone or write for information about the services that are available to senior citizens throughout the state. Nevertheless, when a person who writes or telephones an agency on aging to learn about legal service, medical assistance, rehabilitation services, etcetera, he or she may be told that answers to his or her questions are not available or are not known. Then it is necessary to ask to speak with a supervisor or to ask for the telephone number or a name of another office or person who would know the answer. The fact that one person or one office cannot answer a question should not be interpreted to mean that the question raised is unreasonable or difficult to answer. It simply means that more effort will be required on your part to get the information needed.