America's elderly - not as well off as the public thinks

Advocates for older Americans are trying to get the pendulum of the public's perception of the elderly back on center. In the 1960s and '70s it was skewed way over to one side. The elderly were then widely viewed as nearly all poor and ailing. Some were - but many were not.

Now public perception has swung and is inaccurate from the opposite perspective. ``There's been a switch in mythology,'' Ronald Pollack says. Americans, he says, generally think that all of the elderly are ``doing very well'' financially - but many are not. Mr. Pollack is executive director of the Villers Foundation, which concentrates on problems of the elderly.

The accurate picture, Pollack and others say, is that the condition of older Americans has improved immensely in the past two dozen years, due in large part to increases in social security and establishment of the medicare program to ease health costs. Many are vigorous and financially comfortable, but others require more assistance from American society than they receive.

Two studies just released support this view. One, by the Villers Foundation, concludes that, in Pollack's words, ``a very large number, and percentage, of the elderly are either poor or economically vulnerable.'' The official poverty line for a single elderly person is $5,156 a year. The study finds that 3.5 million elderly Americans have less income than that. Another 8 million take in less than twice that amount; the study defines them as economically vulnerable. These 11.5 million make up more than 40 percent of all elderly Americans, he says.

Some of the worst problems are among the 8 million older Americans who live alone, says a second study, by the Commonwealth Fund. ``Some inexcusable conditions ... confront large numbers'' of solitary seniors, problems primarily of finances and loneliness, says Dr. Robert Butler, a renowned gerontologist. He chaired the commission that studied the problem for the fund.

Most who live alone do so stoically and without complaint, whatever their need, Dr. Butler says. Most, he adds, are women who have been widowed.

``The majority of women over 75 in the United States are widows living alone,'' says Thomas W. Moloney, senior vice-president of the Commonwealth Fund. ``Elderly poverty in America is now widow's poverty.'' Most widows ``were not in poverty until their husbands died.''

In many cases their poverty, experts say, arises when a woman's husband, over 65, is adjudged to require long-term care, and the couple is not wealthy. Long-term nursing-home care costs between $20,000 and $60,000 a year, depending on the required medical assistance; these costs are not covered by medicare, the government-financed health program for the elderly.

To obtain financial assistance, the couple first must spend virtually all their money and assets. Once they are destitute then medicaid, the government program to pay health-care bills for the impoverished, will take over paying the costs of the husband's care.

But this procedure results in the wife living in poverty from the time she is widowed; widows who are elderly rarely then are able to pull themselves out of poverty.

The solution, Dr. Butler says, is to provide assistance to the couple at an early financial point, when one requires long-term health care, which he calls ``certainly a critical issue.'' Dr. Otis Bowen, secretary of Health and Human Services, has a plan that eventually could be of assistance to older Americans facing long-term care.

Several proposals will be introduced in Congress that would provide financial help from Uncle Sam to people requiring extended stays in nursing homes or hospitals. In this time of major national deficit, however, no one is certain where the government would find the funds to finance such a major expansion of the medicaid program.