NATIONAL CENTER Series 12 

For HEALTH STATISTICS I Number 11 

VITAL and HEALTH STATISTICS 

DATA FROM THE NATIONAL HEALTH SURVEY 

Useof SpecialAids 

in Homes 

for the aged 

and chronically ill 

United States - May- June 1964 

Statistics on the use of wheelchairs, eyeglasses, hearing aids, braces, crutches, artificial I.imbs, and walkers 

according to age, sex, mobility status, type of service, 

type of disease or impairment, and length of stay. Based 

on data collected during the period May-June 1964. 

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

Public Health Service 

Health Services and Mental Health Administration 

Washington, D.C. December 1968 

NATIONAL CENTER FOR HEALTH STATISTICS 

THEODORE D. WOOLSEY, Director 

PHILIP S. LAWRENCE, Sc.D., Associate Director 

OSWALD K. SAGEN, PH.D.,, A ssistant Director for Health Statistics Development 

WALT R. SIMMONS, M.A., Assistant Director /07 Research and Scientific Development 

ALICE M. WATERHOUSE, M.D., MedicaZ Consultant 

JAMES E. KELLY, D.D.S., Derital Advisor 

EDWARD E. MINTY, Executive Officer 

MARGERY R. CUNNINGHAM, Information Office7 

DIVISION OF HEALTH RESOURCES STATISTICS 

SIEGFRIED A. HOERMANN, Director 

PETER L. HURLEY, Chief, Health Facilities Statistics B7anch 

JACQUELINE GLEASON, M.A., Chief, Health Manpower Statistics Branch 

EDYTHE GRAY, M.A., Chief, Hospital Disc$atge Survey B7anch 

COOPERATION OF THE BUREAU OF THE CENSUS 

Under the legislation establishing the National Health 

Survey, the PublicHealth Service is authorized to use, insofar 

as possible, the services or facilities of other Federal, State, 

or private agencies. 

In accordance with specifications established by the 

National Center for Health Statistics, the Bureau of the Ccnsus, under a contractual arrangement, participated in planning 

the survey and collecting the data. 

Public Health Service Publication No. lOOO-Series 12-No. 11 

Library of Congress Catalog Card Number 68-62242 
CONTENTS 

Page 

Introduction _______-________________________________------------------ 1 

Highlights __________-____---__------------------------------------- 1 

Description of Survey----------------------------------------------- 1 

Distribution of Special Ai& ________________________________________----

Type of Service----------------------------------------------------

Age, Sex, andMobility-----------------------------------------------

Selected Chronic Diseases and Impairments---------------------------

Type ofAid----------------------------------------------------------- 6 

Wheelchairs ________________________________________--------------- 6 

Eyeglasses ________________________________________---------------- 8 

HearingAids------------------------------------------------------- 10 

Braces------------------------------------------------------------ 10 

Crutches ________________________________________------------------ 10 

Artificial Limbs---------------------------------------------------- 11 

Walkers----------------------------------------------------------- 11 

Comparison ofAids------------------------------------------------- 11 

12 

Detailed Tables- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ 13 

Appendix I. 

A, Technical Notes on Methods______________________________________ 22 

B, General Qualifications------------------------------------------- 24 

Appendix II. 

A. Definitions of Certain Terms Used in This Report------------------ 27 

B. Classification of Homes by Type of Service------------------------ 28 

Append& 111. Forms and Questionnaire,+- __c-----_ - --____ - _____ - --_____ 29 

iii 
--- 

IN THIS REPORT residents of nursing and personal cave homes ave 

described in tevms of the special aids they use. These aids-wheelchairs, eyeglasses, hearing aids, braces, crmtches, artificial limbs, and 

walkers-are discussed with such chavactevistics as age, sex, mobility 

status, type of service provided in the home, chronic diseases and impaivments, and length of stay. 

An estimated 554,000 persons resided in nursing and personal caye 

homes at the time of this survey. Excludinghearing aids and eyeglasses, 

about 71 pe-rcentof the Ye&dents used no special aids; howevw, with the 

inclusion of these, about 29 percent used no aids. A higher pyopovtion of 

women than men used special aids (76 percent of the womenand 63 percent 

of the men.. The useof heaving aids, eyeglasses, and walkers increased . 

with age, whereas the use of wheelchuivs Y&mined fairly cons&?. The 

use of crutches, byaces, and artificial limbs, on the other hand, decreased in the older age groups. 

Most of the residents (96 percent) were Yeported as having a chronic 

disease OY impairment. Chronic diseases appeaaved to be the main cause 

reading to the use of walkers, cmctches, and wlzeelchaivs. Byaces were 

just US likely to be used by Yesidents with impairments as by Yesidents 

with chronic diseases. 

Of the Yesidents who used special aids of any kind, about 14 percent 

wwe Yestvicted to their beds, 21 percentwere Yestvicted to theiylrooms, 

and about 65 percent we-re unrestricted. Of those Yesidents who used 

none of the special aids, approximately 23 percent were Yestricted to 

the& beds, 20 percent to the@ rooms, and almost 57 percent we+re 

unves tvicted. 

SYMBOLS 

Data not available -______-- - __--_____-_- -

Category not applicable------------------- . . . 

Quantity zero---------------------------- _ 

Quantity more than 0 but less than 0.05----- 0.0 

Figure does not meet standards of * reliability or precision------------------
USE OF SPECIAL AIDS IN HOMES 

FOR THE AGED AND CHRONlCALLY ILL 

Darrel L. Eklund and Alvin Sirrocco, Division of He&h Resources Statistics 

INTRODUCTION 

Highlights 

Over 1,724,OOO special aids (hearing aids, 

walkers, crutches, braces, wheelchairs, artificial limbs, and eyeglasses) were used by 395,000 

of the 554,000 residents of institutional facilities 

providing nursing and personal care, according 

to estimates from a survey conducted duringMay 

and June of 1964. By far the most prevalent types 

of aids used were eyeglasses and wheelchairs, with 

an estimated 330,900 residents using eyeglasses 

and 117,400 residents, wheelchairs. Escluding 

hearing aids and eyeglasses, the percent of residents using no special aids ranged from approximately 65 percent in homes providing primarily 

nursing care to 91 percent in homes providing 

only personal care. In general, it was apparent 

that the use of special aids by residents was 

more common among the older residents. One 

To be included in the universe (sampling frame), 

the facilities must have maintained at least three 

beds and routinely have provided some level of 

nursing or personal care. Thus homes providing 

only room and board to aged people were not 

within the scope of the survey. 

The estimates presented in this report are 

based on a two- stage probability design consisting 

of a sample of 1,073 facilities found to be in operation at the time of the survey and, within the 

sample facilities, a sample of 10,560 residents. 

Personal visits were made to each of the homes 

by Bureau of the Census interviewers to select 

samples of the residents and to conduct the 

interviews. 

Details about the sample design, survey 

procedures, and tables of approximate sampling 

errors are given in appendix I. Definitions of 

certain terms used in the report and an explanation of the procedure for classifying facilities may be found in appendix II. Questionnaires 

of the more interesting observations is that a and forms are provided in appendix III. 

higher percentage of both male and female residents using one aid (excluding hearing aids and 

eyeglasses) were restricted to their beds than DISTRIBUTION OF SPECIAL AIDS 

residents using two or more aids. 

Type of Service 

Description of Survey 

The homes as classified by the type of service 

This report is one of a series based on a provided in the home were either nursing care, 

survey titled Resident Places Survey-2 (RPS-2).t‘ 5 personal care with nursing, or personal care 

This survey included such institutional facilities homes. Definitions of these types of homes are 

as nursing homes, homes for the aged, and simi- provided in appendix II. 

lar types of places, as well as geriatric hospitals. 
Table A. Number and percent of residents using specified special aids, by type of 

service: United States, May-June 1964 

[Percents do not add to 100 because of duplication of aide] 

Aid 

Number 

of 

resi- Hear- Walk- Wheel- $~$& Eye- No dents ing ers Crutches Braces chairs 

limbs glasses aids aids 

Percent 

554,000 4.4 8.7 2.1 1.0 21.2 0.4 59.7 28.7 

373,300 4.1 10.3 2.0 1.1 26.1 0.5 58.1 28.1 

‘We 

of service 

All 

services -

Nursing care-­

Personal care 

with nursing- Personal care145,400 

35,300 

12.9 3r 64.2 28.3 

3.3 0.6 58.6 37.2 

Figure 2 and table 2 illustrate a relationship 

between a resident’s length of stay and the use of 

special aids (excluding hearing aids and eyeglasses). The use of special aids was moreprevalent among residents who had been in the homes 

PERCENT DISTRIBUTION 

Typo0 20 40 60 60 100 

-1 I 1 , I I 

All services 

Nursing core 

Figure I. Percent distribution of residents, by number of 

special aids used (excluding hearing aids and eyeglasses) according to type of service. 

In table A it is shown that the percent of 

residents using certain types of special aids 

varies according to the type of home. A higher 

percent of residents in nursing care homes used 

walkers, braces, and wheelchairs in comparison 

with residents of personal care homes. Also, a 

higher percent of residents innursing care homes 

used some type of special aid than did residents 

of personal care homes. It may be seen in tables 

A and 1 that about 28 percent of the residents in 

nursing care homes usedno special aids compared 

with 37 percent of the residents in personal care 

homes. However, a higher percent of residents 

in personal care homes used hearing aids and 

crutches. The percent of residents using eyeglasses showed little variation by type of service. 

If hearing aids and eyeglasses are excluded, 

approximately 65 percent of the residents of 

nursing care homes, 81 percent of the residents 

of homes providing personal care with nursing, and 

91 percent of the residents of personal care homes 

used no special aids (fig. 1). This figure presents a clearer picture of the health of residents in the three types of homes, since eyeglasses 

and hearing aids are probably not as good indicators of health as the other special aids. It follows 

from the above statements that a higher percent 

of residents using one or more special aids were 

in homes providing the most skilled care. 

2 
66,200 

than 6 months than by residents who had been in 

the institution 5 or more years. This may be 

because of a condition or illness which prompted 

the admission of the residents to the homes; 

therefore, their health was not as good as that 

of residents who had been in the home several 

years. Also, because of the care provided in the 

home a person may rely on certain aids less 

after he is admitted to a nursing home than before. 

A comparison of figures 1 and 2 indicates that 

the use of special aids by residents is more dependent on the type of home than on the length 

of stay. About four and one-half times as many 

residents of homes providing nursing care used 

two or more special aids as residents of homes 

providing personal care. 

Age, Sex, and Mobility 

Age has a definite influence on the use of 

Figure 2. Percent distribution of residents, by number of many special aids. Compare residents under 65 

special aids used (excluding hearing aids and eye- years of age with those over 85. In the older 

glasses) according to length of stay. group the use of eyeglasses was notably higher, 

the use of walkers was about double, and the use 

of hearing aids was five times greater (tables 

a short time than among residents who had been B and 3). In contrast, the use of crutches was 

in the homes longer periods of time. Two or more only about one-half as frequent and that of 

special aids were used by almost twice as many braces and artificial limbs only about one-sixth 

residents who had stayed in the institution less as prevalent. This may be because the older resiTable B. Number and percent of residents using specified special aids, by age: United 

States, May-June 1964 

[Percents do not add to 100 because of duplication of aids] 

Aid 

Number 

of Age residents Hear- Walk- Crutches Braces Eye- No ing ers glasses aids aids 

Percent 

All ages-- 554,000 4.4 8.7 2.1 1.0 21.2 0.4 59.7 28.7 

Under 65 

65-74 years-------- 104,500 kz z-58 z-z 22.3 A:2 37.9 45.4 

75-84 years--- 230,900 415 . 0:7 22.4 g.; g.; ‘years--- 19.5 

85+ years----- 152,400 6.8 E 0.4 22.4 64:0 24:6 

3 
chairs 

-- 

Male---------- 

Table C. Number and percent of residents using specified special aids, by sex: United 

States, May-June 1964 

[Percents do not add to 100 becauseof duplication of aids] 

Aid 

Number 

of Sex resi- Hear- -Nalki Artidents ing ers Crutches Braces Whee1- ficial Eye- No 

aids limbs glasses aids 

Both 

sexes 554,000 4.4 8.7 

Female-------- ;Ex~:, 

dents were less ambulatory and hence unable to 

effectively continue using some of the aids. It is 

apparent that the overall use of special aids was 

more prevalent among the older residents; 55 

percent of the residents under 65 years of age 

used special aids compared with 75 percent of 

those over 85. The basic reason for this difference is probably the increased use of eyeglasses 

by Qlder residents. 

The distribution of special aids according to 

se k- is given in table C. A higher percent of female residents used hearing aids, walkers, and 

eyeglasses than did male residents. It was 

noted above that the use of these three aids was 

higher among older residents. Use of these aids 

may be more closely related to age than to sex, 

as the majority of the older residents were females (table 4). The sex of the resident apparently had little effect on the use of braces and 

wheelchairs. However, the percent of male residents using crutches was about double that of 

females, and the percent of male residents using 

artificial limbs was about four times that of 

females. This difference may be explained by 

the fact that, because of military and/or occupational hazards, males are more susceptible to 

injuries or conditions leading to the use of these 

aids. Overall, more females (76 percent) used 

special aids than males (63 percent) because, 

Percent 

2.1 1.0 21.2 0.4 59.7 28.7 

z*;. 

as noted above, substantially more females than 

males used hearing aids, walkers, and eyeglasses. 

The distribution of residents according to 

the number of special aids used (excluding hearing 

aids and eyeglasses) is given in table D. A larger 

percent of both male and female residents using 

one aid were reported to be restricted to their 

beds than residents who used no aids or two or 

more aids (table 5). In order to better understand 

this phenomenon, it is necessary to look at the 

frequency with which each special aid appears 

among the residents. This procedure reveals 

that the wheelchair is by far the most widely 

used special aid when eyeglasses and hearing 

aids have been excluded from consideration. Hence 

it is reasonable to hypothesize that in general 

it is the wheelchair that is being used if only 

one aid is being used. If two or more aids are 

being used, it is again quite likely that one is a 

wheelchair, because of its high frequency of 

appearance, and the use of one or more other aids 

would tend to help the resident in moving about. 

Thus it seems reasonable that a resident using 

two or more aids would be less restricted in 

mobility than a resident who uses only one aid. 

Another interesting observation is that more 

residents using no aids were restricted to their 

beds than residents who used two or more aids. 

This may be because many of the residents who 

4 
--------------------------------------- 

--------------------------------------- 

--------------------------------------- 

Table D. Number and percent distribution of residents, by number of special aids used 

(excluding hearing aids and eyeglasses) and mobility status according to sex: United 

States, May-June 1964 

Number of aids and mobility status 

Total residents -------_----------------------------

No aids 

All residents--------------------------------------

Restricted to bed----------------------------------------

Restricted to room

Unrestricted---------------------------------------------

One aid 

All residents--------------------------------------

Restricted to bed----------------------------------------

Restricted to room

Unrestricted---------------------------------------------

Two aids or more 

All residents--------------------------------------

Restricted to bed----------------------------------------

Restricted to room

Unrestricted--------------------------------------------­

used no aids were physically unable to use them 

and hence were severely restricted in mobility. 

Selected Chronic Diseases and Impairments 

The residents who used special aids were 

classified in the following categories: those who 

had one or more chronic diseases and no impairments, those who had one or more impairments and no chronic diseases, those who had 

II I 

Number 

554,000 193,800 360,200 

393,200 143,200 250,000 

Percent distribution 

100.0 II 100.0 I 100.0 

15.2 II 12.8 I 16.7 

18.9 ‘7;-: 21.3 

65.9 . 62.0 

Number 

139,100 11 43,900 1 95,200 

Percent distribution 

21,700 11 6,700 15,000 

Percent distribution 

100.0 II 100.0 I 100.0 

10.7 

29.6 

59.7 

both chronic diseases and impairments, and those 

who had no chronic diseases or impairments. 

When certain selected chronic diseases and impairments (listed in footnotes to table E) were 

considered, it was found that their presence 

increased the likelihood that a resident used 

some type of special aid as shown in table E. 

Chronic diseases appeared to be a .major 

cause leading to the use of walkers, crutches, 

5 
------------------------------- 

Table E. Number and percent distribution of residents using specified special aids,

by report of selected chronic diseases1 or impairments2: United States, May-June 1964 

Wheel- $itfal Chronic condition Walkers Crutches Braces chairs 

limbs 

Number 

All residents------------------------ 48,000 1 11,600 1 5,4001117,400 1 2,100 

Percent distribution 

Total-------------------------------- 100.0 100.0 100.0 100.01 100.0 

One or more chronic diseases and no 

impairments 48.1 35.4 12.6 37.1 4.9 

One or more impairments and no chronic diseases---------------------------------- 13.3 13.4 7.2 34.1 

Both chronic diseases and impairments------ 4::; 43.7 67.5 50.5 56.1 

Neither chronic diseases nor impair- ments------------------------------------- 6.8 7.6 6.5 5.2 4.9 

‘Chronic diseases: diabetes mellitus, vascular lesions, multiple sclerosis, Parkinson’s disease, diseases of the heart, hypertension, arteriosclerosis, arthritis, 

rheumatism, other diseases of the musculoskeletal system, and fracture of the femur. 

paralysis or palsy due to stroke; paralysis or palsy due to other 

major extremities; impairment of limbs, back, or trunk. 

and wheelchairs; while impairments, as expected, were women, this was not surprising since 

were the apparent cause leading to the use of nearly two-thirds of the residents were women. 

artificial limbs. The use of braces was unique Actually, the proportion of men using wheelin that a combination of chronic diseases and chairs (20 percent) was almost that of the women 

impairments appears to be the cause. However, (22 percent). Figure 3 shows the age distribuwith the exception of walkers, each aid was used tion of the men and women using wheelchairs. 

most often when both chronic diseases and impairments were reported. 

Less than 8 percent of the residents who I 

used walkers, crutches, braces, wheelchairs, PERCENT DISTRIBUTION 

I I I t I I 

impairments. Also there was little variation -

SW 

between the types of aids. MOk 

TYPE OF AID 

or artificial limbs had no chronic diseases or 0 20 40 60 60 100 

Female 

Wheelchairs 

There were an estimated 117,400 residents 

using wheelchairs at the time of the survey, 

representing about one person in five of the 

554,000 residents in nursing and personal care Figure 3. Percent distribution of residents using wheelhomes. Although about two-thirds of the users chairs, by age according to sex. 

6 
Table F. Number of residents with selected chronic diseases or impairments and percent of these residents who use wheelchairs: United States, May-June 1964 

-

Residents with chronic 

diseases and/or impairments 

Chronic diseases and impairments T 

Number Percent using wheelchairs 

Diabetes mellitus---------------------------------------- 44,300 Vascular lesions----------------------------------------- 188,100 % Parkinson's disease-------------------------------------- 12,500 34:5 

Multiple sclerosis--------------------------------------- 3,300 77.2 Diseases of the heart------------------------------------ 156,500 22.1 

Hypertension--------------------------------------------- 35,100 Arteriosclerosis----------------------------------------- 43,500 x 

A;LhA;;;;all types-------------------------------------- 114,600 25:7 . ----_------------------------------------------ 7,700 20.3

Other diseasesthe of the musculoskeletal system------------- 4,800 35.8 Fracture of fermzr------------------------------------ 43.3 Paralysis or palsy due to stroke------------------------- ix: 

Paralysis or palsy due to other causes------------------- 26: 000 22 Absence, major extremities------------------------------- 11,600 72:6

Impairment of limbs, back, or trunk---------------------- 75,200 31.8 

The distribution of residents using wheel- residents using wheelchairs, 51 percent were 

chairs was not affected by age, as seen from the unrestricted as to mobility. Restriction to room 

fact that 88 percent of all residents were 65 or bed was divided quite evenly, with 25 percent 

years or over and 88 percent of all residents restricted to their rooms and 24 percent to their 

who used wheelchairs were 65 or over. Further- beds. There was very little difference between 

more, neither the distribution of males nor of the mobility status of the men and the women 

females using wheelchairs differed much by age. using wheelchairs, as seen in table 6. What this 

As is pointed out in table E, the majority table does not show is that 38 percent of all 

of the residents using wheelchairs had both residents were restricted either to their rooms 

chronic diseases and impairments, so there or beds; so although the population using wheelwere many patients with several conditions. Be- chairs was not greatly restricted in its activicause of this, it was impossible to verify which ties, it was more restricted than was the popudisease or impairment was directly responsible lation which did not use wheelchairs. 

for the use of a particular aid. For instance, Whereas 67 percent of all residents lived in 

someone with a heart disease and a back im- homes providing nursing care as their primary 

pairment might be using a wheelchair because and predominate service, 83 percent of those 

of his back, because of his heart, or because of using wheelchairs lived in such homes. This 

both. Some selected chronic diseases and im- difference, 83 percent to 67percent, indicated that 

pairments that could conceivably require the use residents using wheelchairs hadaccess toa higher 

of a wheelchair are given in table F. Residents level of nursing care than did those not using 

with multiple sclerosis or without one of the wheelchairs. This was true for both the older and 

major extremities (probably a leg) were very younger age groups (table G). 

likely to be using a wheelchair, whereas residents All homes in this survey were classified 

with arthritis or heart disease were not. according to type of ownership into three major 

The use of a wheelchair does not imply categories: (1) proprietary homes, (2) nonprofit 

immobility, however. of the estimated 117,400 homes, and (3) government homes. About 23 

7 
Table G. Number and percent distribution 

of total residents and of residents 

using wheelchairs, by age and type of 

service: United States, May-June 1964 

Percent Age and type Yumber distri­ of service bution 

TOTAL RESIDENTS 

Under 65 years 

All services----- 66,200 100.0 

Nursing care----------- 40,600 61.3 

Personal care with

nursing--------------- 18,400 27.8 

Personal care---------- 7,200 10.9 

65 years and over 

All services----- 487,800 100.0 

Nursing care----------- 332,700 68.2 

Personal care with

nursing--------------- 127,000 26.0 

Personal care---------- 28,100 5.8 

WHEELCHAIR USERS 

Under 65 years 

All services----- 14,700 100.0 

Nursing care----------- 12,500 84.6 

Personal care with

nursing--------------- 2,000 13.9 

Personal care---------- 200 1.5 

65 years and over 

All services----- 102,700 100.0 

Nursing care----------- 85,000 82.8 

Personal care with nursing--------------- 16,700 16.3 

Personal care---------- 1,000 0.9 

percent of the residents both in proprietary and 

in government homes used wheelchairs, compared 

with only 15 percent in nonprofit homes (table 7). 

Eyelgilasses 

Almost 330,900 residents (60 percent) wore 

eyeglasses, precisely the percent of the noninstitutionalized adult population who wear glasses. 

Approximately half of the total male residents 

and just under two-thirds of the female residents 

wore glasses. In addition, 38 percent of the residents who were under 65 wore glasses, compared 

with the 63 percent of the residents who were 65 

and over who wore them. In the noninstitutionalized 

population, over 90 percent of those 55-79 years 

wore glasses;6 of the residents innursing andpersonal care homes, however, only 62 percent of 

those 55 and over wore glasses. An explanation 

for this may be that many residents are bedridden 

and in such poor health that they could not use 

glasses even if they had them. 

The residents who wore eyeglasses were 

less restricted in their mobility than the residents who did not wear them. Maybe they would 

not be restricted if they wore glasses; on the 

other hand, perhaps those who do not wear 

glasses are very old and feeble, restricted because of ill health rather than poor eyesight. 

An important aspect that should be considered’ 

here is the mobility status of residents who had 

a disease of or impairment to their eyes. Five 

eye categories were available for analysis of 

which three were diseases and two impairments. 

These diseases (glaucoma; other chronic diseases 

of the eye; and cataract, all forms) and impairments (visual impairments defined by the inability 

to read a newspaper with or without glasses; and 

other visual impairments) could quite possibly 

affect the mobility of the residents. A comparison 

was made between all residents with an eye condition who wore glasses and all residents withthe 

same condition who did not wear glasses. The 

comparison showed that for each eye condition 

the residents wearing glasses hadrelativelyfewer 

mobility restrictions than did the residents without glasses (fig. 4). 

Thus persons with these diseases and impairments apparently would have more mobility 

if they wore glasses. The exceptions to these, 

of course, are those persons whose diseases 

or impairments are so severe that eyeglasses 

are useless. 

An interesting fact was discovered when the 

two classifications of eye impairment were explored. They are, as defined before, (1) the inability to read newspaper print with or without 

glasses, and (2) any eye impairment which does 

not prevent a person’s reading newspaper print. 

8 
NOT WEARING EYEGLASSES to bed 

60 

of the eye (inability to read a 

newspaper) 

WEARING EYEGLASSES 

80 

0 

cotaroct Glaucoma Other chronic diseases Visual impairments 

of the eye (inability to read (I 

newspaper) 

Figure 4. Percent distribution of residents with specified eye diseases and impairments, 

according to whether eyeglasses were worn. 

impairments 

Other visual 

impairments 

by mobility status 

Of the residents classified in the first group less 

than 48 percent wore glasses. In other words, of 

the more than 66,000 residents who could not see 

well enough to read a newspaper, less than 32,000 

of them wore glasses. In the second classification 

83 percent of the residents wore eyeglasses, 

The question therefore arose as to why the 

majority of residents who had a serious eye 

impairment did not wear glasses. Would they be 

able to see well enough to read if they had 

glasses, or was their eyesight so poor that eyeglasses would not help? Since the questionnaire 

asked only “do you wear glasses?” and not “why 

don’t you?” the-,question cannot be answered at 

this time. 

Throughout this section, questions have been 

raised and answers suggested for many of the 

findings. Further study in the area of eyeglasses 

and eye conditions should prove valuable when 

dealing with the institutional care of old people. 

It is a well known fact that persons who are not 

constantly stimulated with outside interests become depressed. Since reading is an important 

source of outside stimuli for older people, one 

of the problems for administrators is substituting 

appropriate stimuli for people with poor vision. 

9 
Hearing Aids 

Approximately 4 percent of the 554,000 residents used hearing aids. Most of the hearing aids 

were worn by persons 75 years of age and over 

(86 percent), with only 4 percent of theusers less 

than 65 years. More women (87 percent) than men 

(80 percent) aged 75 and over used hearing aids. 

In the overall resident population, only 1 

percent of the persons under 65 years of age 

used hearing aids. About 5 percent of the residents 65 years and over used hearing aids, of 

which 4 percent were men and 5 percent, women. 

The lack of good hearing can affect a person’s activities. The two areas of primary concern here are chronic diseases of the ear and 

hearing impairments. There were nearly 1,600 

residents who had chronic diseases of the ear; 

about 16 percent of these were restricted to 

their beds, another 25 percent were restricted 

to their rooms, and the remaining 59 percent 

were unrestricted. Hearing impairments were 

reported by more than 103,900 residents. About 

20 percent of these were restricted to their beds, 

25 percent to their rooms, and 55 percent were 

unrestricted. 

Not all residents with hearing impairments 

used hearing aids; in fact, only 20 percent did. 

The extent to which bad hearing affects mobility 

is uncertain, since 61 percent of the residents 

who used hearing aids and 62 percent of the 

residents who did not use hearing aids were 

unrestricted in their mobility. 

Braces 

More than twice as many braces (nearly 5,400) 

were used than artificial limbs. About 29 percent 

of both male and female residents wearing 

braces were under 65 years of age, in contrast 

to the 12 percent of the total residents who were 

under 65. One-half of the residents who used 

braces were women 65 years and over. 

Nearly all the residents who used braces 

had a chronic disease or an impairment (93 

percent). In fact, the majority of the residents 

using braces (68 percent) had both chronic diseases and impairments (table E). A slightly 

larger percentage of the female residents who 

used braces were unrestricted (72 percent) than 

were the male residents (65 percent). 

Crutches 

Approximately 11,600 residents were reported as using crutches at the time of the survey. 

Of these, about 80 percent were 65 years of age 

and over, with 62 percent 75 and older. 

This is surprising, for when older people 

are disabled one would not expect them to resort to crutches for assistance, but rather to 

wheelchairs or walkers since manipulating the 

latter two requires very little strength. One 

possible explanation is that these people were 

using crutches only rarely and were, in fact, 

using wheelchairs or walkers most of the time. 

Because women made up such a large proportion of the resident population (almost twothirds), it did not seem unreasonable to find that 

nearly half (5,700) of the residents using crutches 

were women. However, about 90 percent of these 

women were 65 and over, and nearly 70 percent 

were 75 and over. Again the previous explanation 

is relied upon. 

The persons using crutches generally had at 

least one chronic disease, with 35 percent having 

one or more chronic diseases and no impairments, 

and 44 percent having both chronic diseases and 

impairments. Only 13 percent had one or more 

impairments and no chronic diseases, leaving 

8 percent with neither (table E). 

Sixty-two percent of the residents who used 

crutches were unrestricted in their mobility. 

This was the same percent as that for the entire 

resident population. Thirty percent of those who 

used crutches were restricted to their rooms 

and 8 percent to their beds. 

While 65 percent of the persons using crutches 

resided in homes providing primarily nursing 

care, 26 percent were in homes providing some 

nursing care-referred to as personal care with 

nursing-and 9 percent resided in homes providing primarily personal care. This is nearly identical to the 67 percent of all residents who lived 

in nursing care homes, the 26 percent who lived 

in personal care with nurtiing homes, and the 

7 percent who resided in personal care homes. 

10 
Artificial Limbs 

Since only about 2,100 residents used artificial limbs, in only a few areas were the numbers 

sufficiently large to insure statistical validity. 

These areas are discussed below. 

Approximately 63 percent of the residents 

who used artificial limbs were 65 years and over 

(88 percent of the total residents were 65 and 

over). About 73 percent of the users were men, 

whereas only 35 percent of the total resident 

population was male. 

Most of the persons (90 percent) usingartificial limbs were not restricted in their activities, 

and those who were (10 percent) were restricted 

to their rooms. For about 6,600 men and 5,000 

women an extremity was reported missing. In 

this group, only 23 percent of the men and 12 

percent of the women used artificial limbs. 

Possible reasons for this low usage are 

numerous. Expense is a big factor. Some may 

have tried using artificial limbs and decided 

against it, whereas others may not have wanted 

to take the time and effort required to learn how 

to use them. In the case of artificial legs, the 

elderly quite possibly were too weak to use them 

and were better off on crutches or in a wheelchair. 

Some probably had other conditions which so disabled them that artificial limbs would do no good. 

Walkers 

There were an estimated 48,000 residents 

using walkers at the time of the survey. Only 

8 percent of these were under 65, and 23 percent were males. Of the residents using walkers, 

around 15 percent of the males and 6 percent of 

the females were under 65 years of age. 

Here again as with crutches there is the 

situation of nearly all the users being 65 and 

over. Unlike crutches, however, a walker is 

used more to balance a patient than to support 

him, and so less physical strength is required. 

It was not surprising to find that more than 

88 percent of the residents who used walkers had 

a chronic disease (table E). And since only 5 percent had an impairment and no disease, it is 

obvious that chronic diseases led to the use of 

walkers. These diseases left the residents weak 

PERCENT DISTRIBUTION 

0 20 40 60 60 100 

I I 1 I 1 I 

lheelchairs 

Under 65 

65.t 

Crutches 

Under 65 

65C 

Walkers 

Under 65 

65~ 

Braces 

Under 65 

65+ 

m m Restricicd to Restrlcfed to Unrestricted 

,OOnl 

Figure 5. Percent distribution of residents using specified special aids, by age according to mobility status. 

but not disabled; thus they did not need crutches 

but did need the support of walkers. 

A higher proportion of the residents using 

walkers were restricted to their rooms and beds 

than were the residents using braces or crutches. 

Of those using walkers, 58 percent were unrestricted, 31 percent were restricted to their 

rooms, and 11 percent were restricted to their 

beds (table 6). About the same percentage of 

women using walkers were unrestricted as were 

men (59 percent and 55 percent, respectively). 

Comparison of Aids 

Since wheelchairs, crutches, walkers, and 

braces all pertain to walking, these aids have 

been brought together in this section for comparison. It should be understood that some 

residents were using several aids and hence 

11 
were included in more than one of the following 

percents. 

of the 554,000 residents, approximately 21 

percent used wheelchairs, 9 percent used walkers, 

2 percent used crutches, and 1 percent used 

braces. More persons using wheelchairs (67 percent), crutches (62 percent), and walkers (78 

percent) were 75 years of age and over than were 

those using braces (41 percent). 

More residents wearing braces were unrestricted in their mobility (70 percent) than 

were the users of wheelchairs (51 percent), 

crutches (62 percent), and walkers (58 percent). 

The distribution by age and mobility of the 

residents using these aids is given in figure 5. 

Chronic diseases appeared to be the main 

cause leading to the use of walkers, crutches, 

and wheelchairs. Braces, however, were just 

as likely to be used by residents with impairments as by those with chronic diseases (table E). 

REFERENCES 

lNationa1 Center for Health Statistics: Employees in nursing and personal care homes, United States, May-June 1964. 

Vital and Health Statistics. PHS Pub. No. lOOO-Series 12-

No. 5. Public Health Service. Washington. U.S. Government 

Printing Office, Sept. 1966. 

2National Center for Health Statistics: Employees in nursingand personal care homes, number, work experience, special 

training, and wages, United States, May-June 1964. Vi’ital and 

He&h Statistics. PHS Pub.No. 1000Series l2-No. 6. Public 

Health Service. Washington. U.S. GovernmentPrinting Office, 

Jan. 1967. 

3National Center for Health ‘Statistics: Chronic illness 

among residents of nursing and personal care homes, United 

‘States, May-June 1964. Vital and Health Statistics. PHS Pub. 

No. 1000Series 12-No. ‘7. Public Health ‘Service. Washington. 

US. Government Printing Office, Mar. 196’7. 

4National Center for Health ‘Statistics: Prevalence of 

chronic conditions and impairments among residents of nursing and personal care homes, United States, May-June 1964. 

Vital and Health Statistics. PHS Pub. No. 1000Series 12. 

No. 8. Public Health Service. Washington. U.S. Government 

Printing Office, July 1967. 

5National Center for Health Statistics: Charges for care in 

institutions for the aged and chronically ill, United ‘States, 

May-June 1964. Vital and Health Statistics. PHS Pub. No. 

1000Series 12-No. 9. Public Health ‘Service. Washington. US. 

Government Printing Office, Aug. 1967. 

6National Center for Health ‘Statistics: History and examination findings related to visual acuity among adults, United 

States, 1960-1962. Vital and He&h Statistics. PHS Pub. No. 

1000Series 11-No. 28. Public Health ‘Service. Washington. 

U.S. Government Printing Office, Mar. 1968. 

INational Center for Health ‘Statistics: Development and 

maintenance of a national inventory of hospitals and institutions. Vital and Health Statistics. PHS Pub. No. 1000Series 

l-No. 3. Public Health Service. Washington. U.S. Government 

Printing Office, Feb. 1965. 

8National Center for Health’statistics: Origin, program, and 

operation of the U.S. National HealthSurvey. Vital and Health 

Statistics. PHS Pub. No. 1000Series l-No. 1. Public Health 

Service. Washington. U.S. Government Printing Office, Aug. 

1963. 

000 

12 
DETAILED TABLES 

Page 

Table 1. Number and percent of residents using specified special aids, by type of service 

and length of stay: United States, May-June 1964-------------------------------- 14 

2. Number and percent distribution of residents, by number of special aids used 

of St-y: United aids and eyeglasses) according to type of service and length 15 (excluding hearingStates, May-June 1964-------------------------------------------

3. Number and percent of residents using specified special aids, by type of service and age: Unit-d States, May-June 1964------------------------------------------- 16 

4. Number and percent of residents using specified special aids, by sex and age: Unit-d States, May-June 1964---------------------------------------------------- 17

5. Number and percent distribution of residents, by number of special aids used 

(excluding hearing aids and eyeglasses) and mobility status according to sex and age: Unit-d States, Hay-June 1964----------------------------------------------- 18 

6. Number and percent distribution of residents using specified special aids, by mobility status according to sex and age: United States, May-June 1964---------- 20 

7. Number of residents and percent of specified special aids used by residents, by 

type of ownership and type of service: United States, May-June 1964------------- 21 

13 
- Table 1. Number and percent of residents using specified special aids, by type of service and length of 

stay: United States, May-June 1964 

All services 

Total------------------. 554,OOC 

I

4.4 8.7 2.1 

Percent 

21.2 0.4 59.7 28.7 

Less than 6 months------------ 106,5OC 4.6 1o.c 2.8 1.1 23.1 0.4 59.5 27.4 

6 months to less than 1 year-- 77,8OC 4.3 9.5 2.4 1.1 24.9 0.5 61.1 25.4 

1 year to less than 2 years--- L13,OOC 4.4 10.1 1.9 0.5 22.3 0.2 60.5 27.5 

2 years to less than 3 years-- 76,lOC 4.7 7.9 1.9 0.; 20.0 0.5 59.4 29.9 

3 years to less than 5 years-- 82,4OC 4.1 7.5 1.9 0.5 19.5 0.2 59.2 30.4 

5 years or more--------------- 98,2OC 4.3 6.6 1.8 1.1 17.2 0.5 58.7 31.6 

Nursing care 

Total------------------- 373,3oc 4.1 10.3 2.0 1.1 26.1 0.5 58.1 28.1 

Less than 6 months------------ 79,5oc 4.9 11.4 2.6 1.1 27.3 0.5 60.0 25.0 

6 months to less than 1 year-- 56,2OC 3.6 11.0 2.8 l.C 29.8 0.6 59.0 25.5 

1 year to less than 2 years--- 80,600 4.1 11.9 1.7 1.1 26.3 0.2 59.1 27.2 

2 years to less than 3 years-- 52,600 4.9 9.3 1.7 0.7 23.8 0.6 58.0 29.1 

3 years to less than 5 years-- 53,400 3.3 8.9 1.9 1.2 24.3 0.2 56.7 30.8 

5 years or more--------------- 51,000 3.1 8.0 1.3 1.8 24.0 0.9 54.0 33.0 

Personal care with nursing 

Total------------------- 145,400 5.0 5.8 2.1 0.7 12.9 +c 64.2 28.3 

Less than 6 months------------ 21,600 4.2 6.9 3.0 1.0 12.8 58.9 32.7 

6 months to less than 1. year-- 16,700 6.1 6.0 1.5 1.6 14.8 68.2 22.8 

1 year to less than 2 years--- 26,300 4.4 6.5 2.0 0.6 14.5 63.1 27.8 

2 years to less than 3 years-- 18,600 4.4 5.2 2.5 0.8 13.9 t 62.9 30.6 

3 years to less than 5 years-- 23,000 5.8 5.4 1.7 9< 12.6 65.3 26.6 

5 years or more--------------- 39,200 5.2 5.0 1.9 0.4 10.8 66.0 28.5 

Personal care 

35,300 5.6 3.1 2.9 0.6 3.3 0.6 58.6 37.2 

Less than 6 months------------ 5,500 1.9 1.8 4.7 4 2.1 53.5 41.7 

6 months to less than 1 year-- 4,800 6.7 4.5 -k 9< 3.5 60.9 33.5 

1 year to less than 2 years--- 6,100 7.8 t 3.5 -2 2.6 68.2 29.3 

2 years to less than 3 years-- 5,000 4.3 2.3 f< 2.0 61.0 35.9 

3 years to less than 5 years-- 6,000 4.4 3.7 1.9 3.6 56.4 41.3 

5 years or more--------------- 7,900 7.5 4.8 4.2 5.3 53.5 39.6 

[Percentsdo not add to 100 becauseof duplication of aid4 

Aid 

Number 

Type of service and of

length of stay resi- Hear- Wheel- Arti- Eye- No dents ing Walkers Crutches Braces chairs Limbs ficial glasses aids

aids 
-------------------------------- 

Table 2. Number and percent distribution of residents, by number of special aids used (excluding

hearing aids and eyeglasses) according to type of service and length of stay: United States, 

May-June 1964 

Type of service and length of stay 

All services 

Less than 6 months-----------------------------------------

6 months to less than 1 year-------------------------------

1 year to less than 2 years--------------------------------

2 years f-0 less than 3 years-------------------------------

3 years f-0 less than 5 years-------------------------------

5 years or more--------------------------------------------

Nursing care 

Total------------------------------------------------

Less than 6 months-----------------------------------------

6 months f-0 less than 1 year-------------------------------

1 year to less than 2 years 

2 years to less than 3 years-------------------------------

3 years to less than 5 years-------------------------------

5 years or more--------------------------------------------

Personal care with nursing 

Total------------------------------------------------

Less than 6 months-----------------------------------------

6 months to less than 1 year-------------------------------

1 year to less than 2 years--------------------------------

2 years to less than 3 years-------------------------------

3 years to less than 5 years -____--------_-----------------

5 years or more--------------------------------------------

Personal care 

Total------------------------------------------------

LOSS than 6 months-----------------------------------------

6 months to less than 1 year-------------------------------

1 year f-0 less than 2 years--------------------------------

2 years j-0 less than 3 years-------------------------------

3 years to less than 5 years-------------------------------

5 years or more--------------------------------------------

Number Two 

of Total One aids 

residents aid or 

more 

Percent distribution 

554,000 100.0 71.0 25.1 3.9 

106,500 100.0 68.1 27.0 4.9 

77,800 100.0 67.6 27.0 5.4 

113,000 100.0 69.6 25.7 4.7 

76,100 100.0 72.7 24.0 3.3 

82,400 100.0 72.7 24.7 2.5 

98,200 100.0 75.4 22.1 2.5 

373,300 100.0 65.3 29.9 4.9 

79,500 100.0 63.3 31.3 5.5 

56,200 100.0 62.3 31.3 6.5 

80,600 100.0 64.8 29.4 5.7 

52,600 100.0 68.1 28.1 3.9 

53,400 100.0 66.8 30.2 3.0 

51,000 100.0 67.8 28.5 3.7 

145,400 100.0 80.9 16.9 2.2 

21,600 100.0 80.0 16.6 3.4 

16,700 100.0 79.4 17.3 3.3 

26,300 100.0 79.0 18.7 2.2 

18,600 100.0 80.0 17.5 2.4 

23,000 100.0 81.7 16.7 1.6 

39,200 100.0 83.2 15.5 1.3 

35,300 100.0 90.6 8.3 1.1 

5,500 100.0 91.5 6.5 2.0 

4,800 100.0 89.7 10.3 

6,100 100.0 92.3 6.8 Jc 

5,000 100.0 94.5 4.3 * 

6,000 100.0 91.0 7.1 1.9 

7,900 100.0 86.3 13.1 * 

15 
Table 3. Number and percent of residents using specified special aids, by type of service and 

age: United States, May-June 1964 

[Percents do not add to 100becauseofduplication of aids] 

Aid 

Type of service and age 

All services 

All ages-----------

Under 65 years-----------

65-74 year---------------

75-84 years--------------

85 years and over--------

Nursing care 

All ages -_--e---e--

Under 65 years-----------

65-74 year---------------

75-84 years--------------

85 years and over--------

Personal care 

with nursing 

All ages-----------

Under 65 years-----------

65-7A yea,----------------

75-84 yea,-s--------------

85 years and over--------

Personal care 

All ages-----------

Under 65 years-----------

65-74 yea,-s-------------T 

75-84 years--------------

85 years and over--------

Jumber 

of 

resi- Wheel- i:E:,, Eye- No dents '~~~- Walk- Crutches Braces chairs ers glasses aids aids 

554,000 4.4 8.7 

66,200 1.3 i.8 

LO4,500 2.6 6.5 

230,900 4.5 9.2 

152,400 6.8 10.6 

373,300 4.1 10.3 

40,600 1.5 8.3 

71,700 2.8 7.8 

154,900 4.2 10.9 

106,100 5.8 12.0 

limbs 

Percent 

2.1 1.0 

3.4 2.3 

2.1 1.5 

1.9 0.7 

1.8 0.4 

2.0 1.1 

4.7 3.3 

2.0 1.9 

1.7 0.7 

1.5 0.4 

2.1 0.7 

1.0 0.8 

2.4 0.6 

2.2 0.E 

2.2 0.2 

2.5 

2.2 

1.2 

3.9 

2.8 

21.2 

22.3 

22.4 

19.5 

22.4 

26.1 

30.7 

27.6 

23.8 

26.7 

12.9 

11.1 

13.t 

12.' 

13.5 

3.: 

3.c 

0.4 59.7 !8.7 

1.2 37.9 b5.4 

0.4 56.9 30.9 

0.3 64.5 z5.7 

0.2 64.0 24.6 

0.5 58.1 28.1 

1.7 40.8 35.9 

0.5 56.1 29.8 

0.3 61.9 26.5 

0.3 60.4 26.2 ' 

3< 64.2 28.3 

* 35.: 57.4 

59.: 31.1 

7! 70.1 22.6 

71.1 21.8 

2! 58.1 37.2 

27.' 67.9 

145,4oc 5.0 

18,40( 1.2 

26,10( 1.5 

62,OOC 4.5 

38,90( 9.c 

35,30( 5.t 

7,20( 3 

6,60( 4.c 

14,000 6.5 

7,500 10.0 

5.8 

2.7 

4.3 

6.2 

7.5 

3.1 

1-i 

3.5 

6.6 

* 55.: 42.4 

3.4 67-C 30.0 

5.8 75.8 16.4 

16 
Table 4. Number and percent of residents using specified special aids, by sex and age: United 

States, May-June 1964 

[Percents do notadd to 100 becauseof duplication of sids] -

Aid 

Number 

of Sex and age resiing ers 

Eye- No dents Hear- Walk- Crutches Braces chairs 

limbs glasses aids aids 

Both sexes Percent 

All ages----------- 554,000 4.4 8.7 2.1 1.0 21.2 0.4 59.7 28.7 

Under 45 years----------- 13,800 1.8 4.7 2.3 2.9 23.4 * 22.3 57.0 

45-54 years-------------- 15,600 0.7 3.2 -2 2.3 20.5 0.7 30.9 55.5 

55-64 years-------------- 36,800 1.4 7.3 5.2 2.2 22.6 1.7 46.7 36.7 

65-74 years-------------- 104,500 2.6 6.5 2.1 1.5 22.4 0.4 56.9 30.9 

75-84 year--------------- 230,900 4.5 9.2 1.9 0.7 19.5 0.3 64.5 25.7 

85 years and over-------- 152,400 6.8 10.6 1.8 0.4 22.4 0.2 64.0 24.6 

Male 

All ages----------- 193,800 3.2 5.6 3.0 0.9 19.5 0.8 49.7 36.9 

Under 45 years----------- 7,000 -k 3.6 3.7 2.9 17.9 J- 12.0 68.1 

45-54 years-------------- 9,400 -2 2.2 -k 1.1 16.0 1.1 ‘28.0 61.0 

55-64 years-------------- 19,800 1.8 5.8 6.9 1.0 18.3 2.9 41.6 42.9 

65-74 years-------------- 40,400 1.8 4.3 2.5 1.3 21.0 0.5 49.6 36.9 

75-84 years-------------- 74,100 3.2 7.0 2.8 0.7 20.3 0.5 55.3 31.9 

85 years and over-------- 43,100 6.1 5.5 2.6 0.5 18.1 0.5 54.5 32.6 

Female 

All ages----------- 360,200 5.1 10.3 1.6 1.0 22.1 0.2 65.2 24.3 

Under 45 years----------- 6,800 2.9 5.9 -2 2.9 29.0 32.9 45.5 

45-54 years-------------- 6,300 -2 4.7 4.1 27.2 35.2 47.2 

55-64 years-------------- 17,000 0.9 9.2 3.3 3.5 27.6 Jx 52.6 29.5 

65-74 years-------------- 64,000 3.2 8.0 1.8 1.7 23.3 0.3 61.5 27.1 

75-84 years-------------- 156,800 5.1 10.2 1.5 0.7 19.1 0.1 68.8 22.7 

85 years and over-------- 109,300 7.1 12.6 1.5 0.4 24.1 0.1 67.7 21.4 

17 
Table 5. Number and percent distribution of residents, by number of special aids used (excluding

hearing aids and eyeglasses) and mobility status according to sex and age: United States, MayJune 1964 

-

No aids 

Number 

Sex and age of

residents F Total Restriction 

Number Percent Bed Room None 

Both sexes Percent distribution 

All ages------------------------- 554,000 393,200 100.0 15.2 18.9 65.9 

Under 45 years------------------------- 13,800 10,000 100.0 18.3 8.0 73.7 

45-54 years---------------------------- 15,600 12,000 100.0 7.0 6.3 86.7 

55-64 years---------------------------- 36,800 25,400 100.0 10.6 11.5 77.9 

65-74 years---------------------------- 104,500 74,800 100.0 13.9 16.2 69t9 

75-84 years---------------------------- 230,900 166,600 100.0 14.3 18.7 67.0 

85 years and over-----,----------------- 152,400 104,400 100.0 19.5 25.4 55.1 

Male 

All ages------------------------- 193,800 143,200 100.0 12.8 14.8 72.4 

Under 45 years------------------------- 7,000 5,400 100.0 13.8 6.5 79.7 

45-54 years---------------------------- 9,400 7,600 100.0 6.4 1,.2 92.4 

55-64 years---------------------------- 19,800 14,500. 100.0 7.6 8.7 83.7 

65-74 years---------------------------- 40,400 29,800 100.0 11.2 14.7 74.1 

75-84 years---------------------------- 74,100 53,300 100.0 12.9 16.4 70.7 

85 yea,-s and over---------------------- 43,100 32,600 100.0 17.6 19.6 62.8 

Female 

All ages------------------------- 360,200 250.000 100.0 16.7 21.3 62.0 

Under 45 years------------------------- 6,800 4,600 100.0 23.7 9.9 66.4 

45-54 years---------------------------- 6,300 4,400 100.0 8.1 15.1 76.8 

55-64 years---------------------------- 17,000 10,900 100.0 14.6 15.3 70.1 

65-74 years---------------------------- 64,000 44,900 100.0 15.7 17.3 67.0 

75-84 years---------------------------- 156,800 113,300 100.0 15.0 19.8 65.2 

85 years and over---------------------- 109,300 71,900 100.0 20.3 28.1 51.6 

18 
Table 5. Number and percent distribution of residents, by number of special aids used (excluding hearing aids and eyeglasses) and mobility status according to sex and age: United States, May- June 1964-Con. 

-

One aid Two aids or more 

Total Restriction f Total II Restriction 

Number Percent Bed Room None Number PlrcenfII Bed ) Room 1 None 

Percent distribution Percent distribution 

139,100 1oo.c 21.4 26.2 52.4 21,700 100.0 11.6 28.3 60.1 

3,100 1oo.c 12.8 22.7 64.5 700 100.0 20.8 -A 71.4 

3,000 1oo.c 18.2 13.3 68.5 600 100.0 19.1 18.6 62.3 

9,100 1oo.c 19.1 27.8 53.1 2,300 100.0 4.3 10.7 85.0 

25,600 100. c 21.7 21.2 57.1 4,100 100.0 8.5 12.3 79.2 

56,000 1oo.c 20.5 26.8 52.7 8,300 100.0 14.5 35.3 50.2 

42,300 1oo.c 23.7 29.2 47.1 5,700 100.0 10.7 40.1 49.2 

43,900 1oo.c 23.0 23.3 53.7 6,700 100.0 13.6 25.3 61.1 

1,200 1oo.c 21.5 -2 74.2 400 100.0 -2 87.3 

1,400 1oo.c 14.3 14.7 71.0 300 100.0 -2 -2 59.2 

4,100 1oo.c 17.4 24.4 58.2 1,300 100.0 -2 15.7 80.3 

9,300 100. c 23.9 20.9 55.2 1,300 100.0 11.4 19.4 69.2 

18,400 100. c 20.6 25.5 53.9 2,400 100.0 18.8 38.5 42.7 

9,500 1oo.c 30.7 24.4 44.9 1,000 100.0 14.7 25.8 59.5 

95,200 100.0 20.6 27.5 51.9 15,000 100.0 10.7 29.6 59.7 

1,900 1oo.c 7.4 34.1 58.5 300 100.0 -‘- -2 49.5 

1,600 100.0 21.7 12.1 66.2 300 100.0 4 -k 64.9 

5,000 100.0 20.6 30.5 48.9 1,100 100.0 -2 * 90.5 

16,400 100.0 20.4 21.4 58.2 2,700 100.0 7.1 8.9 84.0 

37,600 100.0 20.4 27.4 52.2 5,900 100.0 12.7 34.1 53.2 

32,700 100.0 21.6 30.7 47.7 4,700 100.0 9.7 43.3 47.0 

19 
Table 6. Number and percent distribution of residents using specified special aids, by mobility status 

according to sex and age: United States, May-June 1964 -

7-

Walkers Crutches 

Sex and age Total Restriction Total Restriction 

Number ,,,,,.,[Bed Number 1,.,,.,,I/ 

Both sexes Percent distribution Percent distribution 

48.000 100.0 10.7 31.3 58.0 11.600 f 100.0 8.0 29.6 1 62.4 

Under 65 years----------- 3,900 100.0 20.9 71.5 2,300 100.0 *

Jc 

% 

78.1 65-74 years-------------- 6,800 100.0 ;p:; 22.3 66.9 2,100 100.0 73.9 75-84 years----------- 100.0 32.3 55.9 100.0 34:8

85 years and over-------- E%2 100.0 10:1 36.3 53.5 4% 100.0 195:: 33.8 :x . , 

Male 

All ages--------- 10.900 100.0 12.9 31.8 55.3 5,900 100.0 4.4 

Under 65 years----------- 1,600 100.0 12.4 18.6 69.0 1,700 100.0 

75-84 yea,------------

85 years and over--------

5,200

2,400 

100.0 

100.0 

2.1;

1714 

3 

34:5 

52.8 

48.2 

2,100

1,100 

100.0 

100.0 

7.4* 

Female 

All ages-------- 37,100 100.0 10.1 31.2 58.7 5,700 100.0 11.7 

Under 65 years----------- 65-74 years-----------

2,300

5,100 

100.0 

100.0 11.: 

22.6 

19.1 

73.3 100.0 

100.0 

8.2 

65-74 years----------- 1,700 100.0 59.5 1,000 100.0 7-c 

75-84 years----------- 16,000 100.0 11.5 Es; 100.0

85 years and over-------- 13,700 100.0 8.9 % . 54:5 100.0 

Braces Wheelchairs 

Sex and age Total II Restriction Total II Restriction 

Number Percenillv Number Percent 11 Bed / Room 1 None 

Both sexes Percent distribution Percent distribution f All ages-------- 100.0 9.4 .17,400 f 100.0 24.0 25.1 50.9 

Under 65 years----------- 100.0 16.3 14,700 100.0 19.3 20.6 60.1 

75-84 yea,-s------------

85 years and over--------

100.0 

100.0 * %::, 

100.0 

100.0 

24.2 

26.7 

26.6 

29.3 % . 

Male 

All ages--------- 1,800 100.0 37,700 100.0 26.8 21.4 51.8 

Under 65 years----------- 65-74 years------------

75-84 yea,-s-----------

85 years and over--------

500 

600 

500 

200 

100.0 

100.0 

100.0 

100.0 

6,400

8,500

15,000

7,800 

100.0 

100.0 

100.0 

100.0 

18.4 

26.8 

25.8 

35.4 

:z 

25:0 

21.2 

64.2 

54.9 

cz*z 

65-74 years------------ 100.0 9.3-2 23,400 100.0 22.7 18.9 58.4 

. 

Female 

All ages------- 3,600 100.0 9.8 79,700 100.0 22.7 26.9 50.4 

Under 65 years----------- 1,000 100.0 14.29< 19.7 

?C 

66.1 8,400 100.0 20.0 23.0 65-74 yea,--------------- 100.0 86.4 20.4 19.3 E 75-84 yea,-s-------------- x% 100.0 Jx 24.9 70.0 %'i% EC: 23.4 27.5 49:1

85 years and over-------- ‘500 100.0 Jx * 4 26:400 100: 0 24.1 31.7 44.3 

20 
Table 7. Number of residents and percent of specified special aids used by residents, by type of 

ownership and type of service: United States, May-June 1964 

[Percents do not add to 100 becauseofduplication of aids] 

Aid 

Number 

Type of ownership and of 

type of service residents Ilear- Valk- ing Crutches ers aids 

All homes Percent 

All services------- 554,000 4.4 8.7 2.1 1.c 

Nursing car-------------- 373,300 4.1 10.3 2.0 1.1 

Personal care with nursing----------------- 145,400 5.0 5.8 2.1 0.7 

Personal care------------ 35,300 5.6 3.1 2.9 0.6 

Proprietary homes 

All services-------

Nursing care-------------

Personal care with nursing-----------------

Personal care------------

Nonprofit homes 

All services-------

Nursing care-------------

Personal care with nursing-----------------

Personal care------------

Government homes 

All services-------

Nursing car--------------

Personal care with nursing-----------------

Personal care------------

333,300 4.2 9.6 2.4 1.0 

258,700 4.4 10.6 2.2 1.0 

53,600 3.0 6.7 2.9 0.8 

21,000 5'.1 3.4 4.1 0.7 

L32,800 6.6 7.5 1.6 0.9 

53,300 5.6 10.1 1.5 1.3 

71,700 7.2 6.0 1.7 0.6 

7,800 8.8 3.4 2 

87,800 1.8 7.1 1.7 1.1 

61,300 0.8 9.2 1.9 1.3 

20,000 1.1 2.5 1.3 0.5 

6,500 13.2 1.7 1.6 -': 

21.; 

26.1 

12.5 

3.: 

23.3 

26.6 

15.2 

3.9 

14.9 

21.3 

11.5 

1.9 

22.7 

28.4 

11.6 

3.3 

I 

Eye- No 

glasses aids 

0.4 59.; 28.7 

0.5 58.1 28.1 

.'- 64.2 28.3 

0.6 58.6 37.2 

0.4 56.8 30.3 

0.4 56.4 29.4 

57.4 32.8 

1.0 59.9 35.0 

0.2 72.3 20.1 

0.5 69.0 20.1 

* 74.7 19.5 

73.1 25.7 

0.6 51.8 35.6 

0.8 55.6 29.3 

-94 45.0 47.7 

37.0 58.1 

21 
APPENDIX I 

A. TECHNICAL NOTES ON METHODS 

Gene&.-The Resident Places Survey-2 (RPS-2) 

was conducted during May and June 1964 by the Division 

of Health Records Statistics in cooperation with the 

U.S. Bureau of the Census. It was a survey of resident 

institutions in the United States providing nursing or 

personal care to the aged and chronically ill, of their 

patients or residents, and of their employees. The 

institutions within the scope of the survey included such 

places as nursing homes, convalescent homes, rest 

homes, homes for the aged, other related facilities, and 

geriatric hospitals. To be eligible for the survey an 

establishment must have maintained three or more beds 

and must have provided some level of nursing or personal care. The procedure for classifying establishments for the RPS-2 universe is described in appendix 

II-B. 

This appendix presents a brief description of the 

survey design, general qualifications of the data, and 

the reliability of estimates presented in this report. 

Succeeding appendixes are concerned with classification procedures, definitions, and questionnaires used 

in the survey for collecting information about employees. 

Sampling @ame. -A “multiframe” technique was 

used in establishing the sampling universe for RPS-2. 

The principal frame was the Master Facility Inventory (MFI) which contained the names, addresses, and 

descriptive information for about 90-95 percent of the 

nursing and personal care homes in the United States. 

Establishments not listed in the MFI were, theoretically, on another list referred to as the Complement 

Survey List. A description of the MFI and the Complement Survey has been published. 7 

The Complement Survey is based on an area 

probability design, using the sample design of the 

Health Interview Survey (HIS).* In the HIS, interviewers make visits each week to households located 

in probability samples of small segments of the United 

States. In addition to collecting information about the 

health of the household members, the interviewers are 

instructed to record the names and addresses of hospitals and institutions located wholly or partially within the specified areas. The Complement Survey list is 

composed of the establishments identified in these 

sample areas between January 1959 and July 1963 

which were not listed in the MFI but which were in 

22 

business as of July 1, 1962. The Complement Survey 

sample for RPS-2 included four establishments representing an estimated total of about 800 such facilities 

in the United States not included in the Master Facility 

Inventory. 

Sample des@n.-The sample design was a stratified, two-stage probability design. The first stage was 

a selection of establishments from the MFI and the 

Complement Survey, and the second stage was a 

selection of employees and residents from registers 

of the sample establishments. In preparation for the 

first-stage sample selection, the MFI was divided into 

two groups on the basis of whether or not current 

information was available about the establishment. 

Group I was composed of establishments which had 

returned a questionnaire in a previous MFI survey. 

Group II contained places which were possibly within 

the scope of RPS-2 but which were not confirmed in 

the MFI survey, e.g., nonresponses and questionnaires 

not delivered by the post office because of insufficient 

addresses. Group I was then sorted into three type-ofservice strata: nursing care homes, includinggeriatric 

hospitals; personal care with nursing homes; and personal care homes. Group II was treated as a fourth 

type-of-service stratum. Each of these four strata was 

further sorted into four bed-size groups, producing 16 

primary strata as shown in table I. Within each primary 

stratum, the listing of establishments was ordered by 

type of ownership, State, and county. The sample of 

establishments was then selected systematically after 

a random start within each of the primary strata. 

Table I shows the distribution of establishments 

in the MFI and in the sample by primary strata and 

the final disposition of the sample places with regard 

to their response and in-scope status. of the 1,201 

homes originally selected, 1,085 were found to be in 

business and within the scope of the survey. 

The second-stage sample selection of residents 

was carried out by Bureau of the Census interviewers 

at the time of their visit in accordance with specific 

instructions given for each sample establishment as 

contained in the Resident Questionnaire (appendix III). 

All residents on the register of the establishment on 

the day of the survey were listed on the Establishment 

Questionnaire. Using predesignated sampling instruc-
Table I. Distribution of institutions for the aged and chronically ill in the Master Facilit 

Inventory and in the RPS-2 sample, by primary strata (type of service and size of institution 21 and by response status to the RPS-2: United States 

-

T Number of homes in sample 

In scope and 

Type of service and size of institution of 

in 

homes out of T in business 

MFIl 

the Total scope or 

homes1 out of Nonre- Re­ zsiness sponding aponding homes homes 

All types--------------------------------- 19,520 .,20 116 12 1,073 

Nursing care2----------------------------- 8,155 634 37 8 589 

Under 30 beds----------------------------------- 4,400 179 21 5 153 

30-99 beds-------------------------------------- 3,247 260 11 3 246 

100-299 beds------------------------------------ 448 135 3 132 

300 beds and over------------------------------- 60 60 2 58 

Personal care with nursing---------------- 4,972 381 12 367 

Under 30 beds----------------------------------- 3,168 128 10 117 

30-99 beds-------------------------------------- 1,423 114 1 112 

100-299 beds------------------------------------ 345 103 1 102 

300 beds and over------------------------------- 36 36 36 

personal care----------------------------- 3,621 113 13 98 

Under 30 beds----------------------------------- 3,187 64 11 53 

30-99 beds-------------------------------------- 402 32 31 

100-299 beds------------------------------------ 29 14 2 11 

300 beds and over------------------------------- 3 3 3 

Group IIB-----------------_---------------- 2,772 73 54 19 

Under 25 beds----------------------------------- 2,578 52 37 15 

25-99 beds-------------------------------------- 185 15 12 3 

100-299 beds------------------------------------ 6 3 3 

300 be& and over------------------------------- 3 3 2 1 

'The universe for the RPS-2 sample consisted of the M.FI and the Complement Survey. Included in

the RPS-2 sample were 4 homes from the Complement Survey. 

'Includes geriatric hospitals. 

3Group II consists of those institutions assumed to be in scope of the RPS-2 survey but for 

which current data were not available. 

23 
tions, the interviewer then selected the sample of 

residents. For each sample resident a questionnaire 

was completed by the interviewer from information 

furnished by the respondent. The total sample selected 

from establishments cooperating in the survey consisted 

of 10,560 residents. 

Survey procedure. --The Bureau of the Census employed about 140 of their regular interviewers for the 

survey. All were experienced in the continuing surveys 

conducted by the Bureau of the Census; about half were 

employed in the Health Interview Survey-one of the 

major programs of the National Center for Health 

Statistics-and about half in other surveys. Since the 

interviewers were well trained in general survey methodology, it was relatively easy to train them in the 

specific methods used in RPS-2. Briefly, their training 

consisted of home study materials and observation by 

the Census Regional Supervisor on the first interview 

assignment. 

The initial contact with an establishment was a 

letter signed by the Director of the Bureau of the Census. 

The letter (appendix III) notified each administrator 

about the survey, requested his cooperation, and 

stated that a representative would contact him for an 

appointment. The interviewer’s telephone call usually 

followed within 3 or 4 days. 

During the course of the interview, the interviewer 

collected data about the establishment, the residents, and 

the employees. The establishment and resident information was obtained by personal interview, and the 

staff information was collected by personal interview 

and by means of a self-enumeration questionnaire. The 

B. GENERAL 

Nonresponse and imputation of missing data.-

The survey was conducted in 1,073 homes, or about 

89 percent of the original sample. About 7 percent of 

the sample places were found to be out of business, and 

an additional 3 percent were found to be out of scope of 

the survey, that is, they either did not provide nursing 

or personal care to their residents or maintained fewer 

than three beds. Only 12 homes, or about 1 percent of 

the sample, refused to cooperate in the survey (table 

I). The response rate for the in-scope sample was 

98.9 percent. 

Statistics presented in this report were adjusted 

for the failure of a home to respond by use of a separate nonresponse adjustment factor for each servicesize stratum further stratified by three major ownership groups. This factor was the ratio of all m-scope 

sample homes in a stratum to the responding in-scope 

sample homes in the stratum. 

Data were also adjusted for nonresponse of sample 

residents within an establishment by a procedure which 

imputed to residents for whom data were not obtained 

respondent for the Resident (Patient) Questionnaire 

was a member of the staff who had close contact with 

the resident, thus having firsthand knowledge of the 

resident’s health condition. This was usually a nurse 

who was responsible for the individual sample resident. One nurse might have completed questionnaires 

for all residents in a small home or shared the responsibility in a large home. The interviewer was 

instructed to encourage maximum use of records 

by the respondent. For data on chronic conditions 

and impairments, medical records, if available, were 

routinely used to supplement the information provided 

by the respondent. 

The Census regional offices also performed certain 

checks during the course of the survey to insure that 

the interviewers were conducting the survey according 

to specified procedures. They reviewed all questionnaires for completeness prior to transmittal to the 

Washington office and made inquiries as necessary to 

obtain the missing information. 

The completed questionnaires were edited and 

coded by the National Center for Health, Statistics, and 

the data were processed on an electronic computer. 

This processing included assignment of weights, ratio 

adjustments, and other related procedures necessary 

to produce national estimates from the sample data. 

It also included matching with basic identifying information contained in the Master Facility Inventory, as 

well as carrying out internal edits and consistency 

checks to eliminate “impossible” responses and errors 

in editing, coding, or processing. 

QUALIFICATIONS 

the characteristics of residents of the same age and 

in the same type of home. For item nonresponse on 

age, the adjustment was restricted to characteristics 

of residents in the same type of home. Adjustment for 

nonresponse in resident data for responding homes 

ranged from 0.7 percent for age to 3.5 percent for 

date last saw doctor. 

Rounding of numbers. -Estimates relating to residents have been rounded to the nearest hundred. For 

this reason detailed figures within the tables do not 

always add to totals. Percents were calculated using 

the original unrounded figures and will not necessarily 

agree with percents which might be calculated from 

rounded data. 

Estimation procedure.- Statistics reported in this 

publication are the result of two stages of ratio adjustments, one at each stage of selection. The purpose of 

ratio estimation is to take into account all relevant 

information in the estimation process, thereby reducing 

the variability of the estimate. The first-stage ratio 

adjustment was included in the estimation of establish24 
Figure I. Approximate relative standard errors of estimated numbers of residents and conditions 

shown in thik report 

100.0 

80.0 

60.0 

40.0 

10.0 

8.0 

6.0 

4.0 

E 

0.6 

0.4 

Size of estimate 

Example of use of fi re I: An estimate of 109,000 total conditions has a relative standard error

ok 3 3 ( d%om scale at left side of figure). The estimate has a standard error of 

3,306 (Y;‘~L2e;L;“taof 100,000). 

ment and resident data for all primary service-size 

strata from which a sample of homes was drawm. This 

factor was a ratio, calculated for each stratum. The 

numerator was the total beds according to the Master 

Facility Inventory for all homes in the stratum. The 

denominator was the estimate of the total bedsobtained 

through a simple inflation of the Master Facility Inventory data for the sample homes in the stratum. The 

effect of the first-stage ratio adjustment was to bring 

the sample in closer agreement with the known universe 

of beds. The second- stage ratio adjustment was included 

in the estimation of resident data for all primary strata. 

For resident data, the second-stage ratio adjustment 

is the product of two fractions: the first is the ratio of 

the total number of residents in the establishment to 

the number of residents for whom questionnaires were 

completed within the home; the second is the sampling 

fraction for residents upon which the selection is based. 

Reliability of estimates.-Since statistics presented in this report are based on a sample, they will 

differ somewhat from figures Khatwouldhave been obtained if a complete census had been taken using the 

same schedules, instructions, and procedures. 

As in any survey, the results are also subject to 

reporting and processing errors and errors due to 

nonresponse. To the extent possible, these types of 

errors were kept to a minimum by methods built into 

survey procedures. 

The sampling error (or standard error) of a 

statistic is inversely proportional to the square root 

25 
Table II. Approximate standard errors of percentages shown in this report for residents 

(patients) and conditions 

Base of per- cent (number of residents) 

Estimated percent 

Standard error expressed

in percentage points 

13.6 15.8 6”2 8.6 10.0 

412 

3.0 ::5 ;:o’ 

2.1 

1.7 

::?3 

1.1 

:*a5 

E 0:8 

0:4 0.5 

000 

of the number of observations in the sample. Thus, as 

the sample size increases, the standard error decreases. The standard error is primarily a measure 

of the variability that occurs by chance because only a 

sample rather than the entire universe is surveyed. As 

calculated for this report, the standard error also reflects part of the measurement error, but it does not 

measure any systematic biases in the data. The chances 

are about two out of three that an estimate from the 

sample differs from the value which would be obtained 

from a complete census by less than the standard error. 

The chances are about 95 out of 100 that the difference 

is less than twice the standard error and about 99 out 

of 100 that it is less than 2% times as large. 

Relative standard errors of aggregates shown in 

this report can be determined from figure 1. The 

relative standard error of an estimate is obtained 

by dividing the standard error of the estimate by the 

estimate itself and is expressed as a percent of the 

estimate. An example of how to convert the relative 

error into a standard error is given with figure I. 

Standard errors of estimated percentages are shown 

in table II. 

26 
APPENDIX II 

A. DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT 

Chronic diseases and impairments: slings, bandages, trusses, belts, or crutches. 

These are defined as the diseases and impairments Dental braces are also excluded. 

contained in cards D and E of appendix III. This 3. A crutch is a device of wood or metal, ordi­ list was expanded, based on the further query narily long enough to reach from the armpit “Does he have any other chronic conditions listed to the ground, with a concave surface fitting in his record you have not told me about? and on under the arm and a crossbar for the hand, additional questions about specified conditions. used for supporting the weight of the body. Length of stay: 

Length of stay is defined as the current period 4. An eye@ass is a device used to correct de- of stay in the institution. The period of stay starts fects of vision; it typically consists of a pair with the date of last admission to the institution of glass lenses and the frame by which they and ends with the date of the survey. are held in place. Mobility status: 

Restriction in mobility is defined in this report 5. A hearing aid is any kind of mechanical or 

as limitation to bed or room. All other residents, electrical device used to improve hearing. 

including those who were routinely taken out of the 6. A walker is a supportive device with or withroom in a wheelchair for most of the day, were out wheels; crutches and wheelchairs are ex- considered neither bed nor room limited. cluded. Resident: 

A resident is defined as a person lvho has been 7. A wheelchair is a chair mounted on wheels and 

formally admitted to an establishment but not usually propelled by the occupant; wheeled 

discharged, All such persons were included in the Walkers” and nonwheeled devices used for 

survey even though they were not physically present. support are excluded. 

Special aid: 

A special aid is a device used to compensate for Government (operated) home: 

A home operated under Federal, State, or local defects resulting from disease, injury, impairment, government auspices. or congenital malformation. Aids included in this Nonprofit home: 

survey are artificial limbs, braces, crutches, A home operated under voluntary or nonprofit eyeglasses, hearing aids, walkers, and wheelchairs. auspices, including both church-related institu1. An artificial limb is a device used to replace a tions and institutions that are not church-related. 

missing leg, arm, hand, or foot. PYopYiQtaYyhomQ: 

2. A brace is defined as any kind of supportive A home operated under private commercial ownerdevice for the arms; hands, legs, feet, back, ship. 

neck, or head, excluding temporary casts, 

27 
B. CLASSIFICATION OF HOMES BY TYPE OF SERVICE 

For purposes of stratification of the universe prior nursing care during the week prior to the survey 

to selection of the sample, the homes in the MFI were in the home, with an RN or LPN employed 15 

classified as nursing care, personal care with nursing, hours or more per week. In this report, geripersonal care, or domiciliary care homes. The latter atric hospitals are included with the nursing 

two classes were combined to produce the three types care homes. 

of service classes shown in table I, appendix I. Details 

of the classification procedure in the MFI have been 2. A personal care with nuvsing .home is defined 

as one in which either (a) over 50 percent of the published.7 residents received nursing care during the week Due to the 2-year interval between the MFI prior to the survey, but there were no RN’s or 

survey and the RPS-2 survey, it was felt that, for LPN’s on the staff; or (b) some, but less than producing statistics by type of service from the RPS-2 50 percent, of the residents received nursing survey, the homes should be reclassified on the basis care during the week prior to the survey, re- of the current data collected in the survey. This classi- gardless of the presence of RN’s or LPN’s on the fication procedure is essentially the same as the MFI staff. scheme. The three types of service classes delineated 

for RPS-2 are defined as follows: 3. A personal care home is defined as one in which 

residents routinely received personal care, but 1. A nursing care home is defined as one in which no residents received nursing care during the 50 percent or more of the residents received week prior to the survey. 

000 

28 
APPENDIX III 

FORMS AND QUESTIONNAIRES 

U.S. DEPARTMENT OF COMMERCE 

B”REAU OFTHEc!zNS”S 

WAsHnuGroN. DC. 20233 

1 

J 

Dear Administrator: 

The Bureau of the Census, acting as the collecting agent for the 

United States Public Health Service, is conducting a nationwide survey 

of nursing homes, homes for the aged, and other establishments providing 

nursing, personal, and domiciliary care to the aged and infirm. The 

purpose of this survey is to collect much needed statistical information 

on the health of residents and on the types of employees in these homes. 

This survey is part of the National Health Survey program authorized by 

Congress because of the urgent need for up-to-date statistics on the 

health of our people. 

The purpose of this letter is to request your cooperation and to inform 

you that a representative of the Bureau of the Census will visit your

establishment within the next week or so, to conduct the survey. Prior 

to his visit, the Census representative will call you to arrange for a 

convenient appointment time. 

All the information given to the Census representative will be.kept

strictly confidential by the Public Health Service and the Bureau of 

the Census, and will be used for statistical purposes only. 

Your cooperation in this important survey will be very much appreciated. 

Sincerely yours, 

(2G-f-J 

Richard M. Scammon 

Director 

Bureau of the Census 

29 
Budget Bureau No. 6&R620.R2; hpptoval Expires December 31. 1964 

Establishment number 1 Resident’s (patient’s) line No. I

I Month ‘Year 

1. What is the month and year of this resident’s (patient’s) birth? I 

2 sex 1 0 Male (Ask qusation 3) 2 0 Female (Go to qubation 4) 

30. Her he served in -3rNO-TE-m-IN-ZYRVIEWER: 

the Armed Forcer of Source of v**er&?l stat&9 

the United States? t 0 Yes (Ask Q. 3b) 2 I-J No (Go to Q. 4) 3 0 Unknown information 

b. Did he servo In 1 j-J Record z j-J Sample persor 

World War I? 10 Yes ZI-JNO 3 0 Unknown 3 n Respondent 

4. Is this resident (patient) married, I 0 Married B 0 Divorced 5 0 Never married widowed, divorced, separated, or 2 0 Widowed 4 0 Separated never married? 

1 Month- ! Year I 5. In what month and year was he (lost) admitted to this home? I 

6. With whom did he live ot 1 0 Spouse only 7 0 In another nursing home ot 

ths’tlme of his admission? 2 0 Children only related facility 

(Check

tbet the FIRST B 0 Spouse ond children B 0 In mental hospital box applies) 4 0 Relatives other than spouse ot 9 0 In a long-term specialty hospital 

children (except mental) 

5 0 Lived in apartment ot own home - IO 0 In a general ot short-stay hospital 

alone ot with unrelated persons I I 0 Other place (Specify) 

6 0 In boarding home 

7. How often do friends or I 0 At least once a week 3 0 Less than once a month relatives visit him? 

(Check the FIRST z 0 Less often than once a week but at 4 0 Never 

box thaf applies) least once a month -

8a. Does he stay in bed all or most of the day? I 0 Yes (Go to question 9) z?0 No (Ask question Sb) 

b. Does he stay in his own room all or most of the day? t 0 Yes 2 j-J No (Ask question SC) 

c. Does he go off the premises just to walk, shop, or 

visit with friends or relatives and so forth? t 0 Yes ZI-JNO 

9. Which 

does this resident (patient) 

use? (slmw card C) t 0 Hearing aid 4 0 Braces 7 0 Eye glasses 

2 0 Walker 5 m Wheel chair OR 

B 0 Ctutches 6 0 Artificial limb(s) 8 0 None of these aids used 

of these special aids (Check all that appZy) 

10. During his stay here when did he lost see c- 0 Never saw doctor doctor for treatment, medication, or for an 

examination by the doctor? 

lla. During his stay here, 

has he seen B dentist? I 0 Yes ;.bk qzmlton llb) 2 0 No (Go to question 12) 

1 Month lYeat 

b. When was the lost time he raw D dentist? I I 

120. Has he lost ALL of his teeth? I 0 Yes ,ksk quesIion 12b) 2 0 No (Go to question 13) 

i. Does he wear full upper and lower dentures? 3OYfS 4[7NO 

13. Does this resident (patient have any of these conditions? 

(Show card D. Record in 7Jable 1 each wndifion wfrich the patient has) ,a Yes 20NO 

14. Does he have any of these conditions? 

(Show cam’ E. Record in Tebfe 1 each condition which the patient has) 10 Yes 2ONO 

150. Does ha have any other CHRONIC conditions listed in his record that you have not told me about? I 0 Yes 2ONO 

If “Yes,:’ ask: 

b. What are they? 

(Recordin Table 1 each chronic catdition mentioned) 

30 
Table 1 

Enter conditions from questions 13, 14 ot 15 For the following conditions ask rhese questions 

ILL EFFECTS OF STROKE. . . . . What are +be present ill effects? 

SPEECH DEFECT. . . . . . . . . . . What caused the speech defect? Do 

PARALYSIS, PERMANENT “CI, 

Eater the words used by the respondent to STIFFNESS . . . . . . . . . . . . . . . What port of the body is affeaed? write 

describe the condition. TUMOR, CYST, OR GROWTH. . . . what pm+ of the body is affeaed? 

Is it malignant or benign? 

in 

this 

DEAFNESS, HEARJNG TROUBLE, column 

OR ANY EYE CONDITION. . . . :; Is one or both ears (eyes)

(Include glaucoma ard cataracts) affected? 

(a) (b) (C) 

1. 

2. 

3. 

4. 

5. 

G. 

7. 

8. 

16. If any eye conditions have been recorded in Table 1, a& 0 No eye condition reported (Go to questicn 17) 

YOU tild me about this resident’s (patient’s) eye condition 

Can he see well enough to read ordinary newspaper print ii+h glasses? 10 Yes 2UNO 

,?. During the pas+ I 0 Help with dressing, shaving, 7 days which of or care of hair these services 

did this resident z 0 Help with rub bath 

(patienl) receive? or shower 

3 0 Help with eating 

(Show card F and (feeding the residcnr(patient)) 

check each one 4 0 Rub and massage 

mentioned) 5 0 Administtarioa of 

. medications ot treatment 

6 0 Special diet 

7 0 Application of sterile 

dressings ot bandages 

8. At +he time this resident (patient) was admitted to 

this home, what kind of core did he receive-primarily 

nursing care, primarily personal care, or mom and 

board only? (Check one box cnry) 

8 0 Temperature-pulseresplrarion 

9 0 Full-bed bath 

IO 0 Enema 

11 0 Catheterization 

12 0 Bowel and bladder 

rerrnining 

13 0 Blood pressure 

14 0 Irrigation 

15 0 Oxygen therapy 

16 0 Hypodermic injection 

17 0 Intravenous injection 

18 0 Inrramusculat injection 

19 0 Nasal feeding 

OR 

20 f-J None of the above 

services received 

10 Primntily 2 0 Primarily 3 0 Room and nursing perSOd bead only c3te cam 

Amount 

9. Who+ ~0% +he TOTAL charge for this resident’s (patient’s) care last month? S 

0a Who+ is the PRIMARY source of pcvyment for his core? l ’ 20b. Are there my addirional sources of payment?

(Check ONE box only) I (check ALL boxes that apply) 

1 0 Own income or family support (Include prfvate 

retirement funds, social security, etc.~ 

plans, I 

I 

I 0 Own income or family suppott (Include

refircment funds, social security, etc.) 

private plans, 

2 i--J Church support 

3 0 Veterans benefits 

I 

I 

I 

z 0 

3 0 

Church support 

Veterans benefits 

4 0 Public assistance or welfare I 4 c] Public assisrmce ot welfare 

5 0 Initial payment - life care 

6 0 Other (Please descrfbe) 

I 

I 

I 

5 0 

6 17 

Initial payment - life care 

Other (Please describe) 

I 

I 

I OR 

I -/ I-J No additional sauces I 

31 
Card D 

LIST OF CHRONIC CONDITIONS 

Does this resident have any of these 

conditions? 

1. Asthma 

2. CHRONIC bronchitis 

3. REPEATED attacks of sinus trouble 

4. Hardening of the arteries 

5. High blood pressure 

6. Heart trouble 

7. Ill effects of a stroke 

8. TROUBLE with varicose veins 

9. Hemorrhoids or piles 

10. Tumor, cyst or growth 

11. CHRONIC gall bladder or liver trouble 

12. Stomach ulcer 

13. Any other CHRONIC stomach trouble 

14. Bowel or lower intestinal disorders 

15. Kidney stones or CHRONIC kidney trouble 

16. Mental illness 

17. CHRONIC nervous trouble 

18. Mental retardation 

19. Arthritis or rheumatism 

20. Diabetes 

21. Thyroid trouble or goiter 

22. Epilepsy 

23. Hernia or rupture 

24. Prostate trouble 

25. ADVANCED senility 

-000 

Card E 

LIST OF SELECTED CONDITIONS 

Does this resident have any of these 

conditions? 

1. Deafness or SERIOUS trouble hearing with one or both ears 

2. SERIOUS trouble seeing with one or 

both eyes even when wearing glasses 

3. Any speech defect 

4. Missing fingers, hand, or arm--toes,

foot, or leg 

5. Palsy 

6. Paralysis of any kind 

7. Any CHRONIC trouble with back or spine 

8. PERMANENT stiffness or any deformity of the foot, leg, fingers, .arm, or back 
Series 1. 

Series 2. 

Series 3. 

Series 4. 

Series 10. -.. 

Series 11. 

Series 12. 

Series 13. 

Series 14. 

Series 20. 

Series 21. 

Series 22. 

OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publication No. 1000 

Programs and collection pvocedures.- Reports which describe the general programs of the National 

Center for Health Statistics and its offices and divisions, data collection methods used, definitions, 

and other material necessary for understanding the data. 

Data evaluation a& methods ).esearch. -Studies of new statistical methodology including: experimental tests of new survey methods, studies of vital statistics collection methods, new analytical 

techniques, objective evaluations of reliability of collected data, contributions to statistical theory. 

Analytical studies.- Reports presenting analytical or interpretive studies based on vital and health 

statistics, carrying the analysis further than the expository types of reports in the other series. 

Documents and committee repovts.- Final reports of major committees concerned with vital and 

health statistics, and documents such as recommended model vital registration laws and revised hirth 

and death certificates. 

Data from the Health Interview Survey.- Statistics on illness, accidental injuries, disability, use of 

hospital, medical, dental. and other services, and other health-related topics, based on data collected 

in a continuing national household interview survey. 

Data from the Health Examination Surcey.- Data from direct examination. testing, and measurement of national samples of the population provide the basis for two types of reports: (1) estimates 

of the medically defined prevalence of specific diseases in the United States and the distributions of 

the population with reqpect to physical, physiological, and psychological characteristics; and (2) 

analysis of relationships among the various measurements without reference to an explicit finite 

universe of persons. 

Data from the Institutional Population Surveys.- Statistics relating to the health characteristics of 

per sons in institutions, and on medical, nursing, and personal care received, based on national 

samples of establishments providing these services and samples of the residents or patients. 

Data from the Hospital Discharge Survey.- Statistics relating to discharged patients in short-stay 

hospitals, based on a sample of patient records in a national sample of hospitals. 

Data on health yesouyces: manpower and facilities.-Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health 

manpower occupations, hospitals, nursing homes, and outpatient and other inpatient facilities. 

Data on mortality.- Various statistics on mortality other than as included in annual or monthly 

reports- special analyses by cause of death, age. andother demographic variables, also geographic 

and time series analyses. 

Data on natality, ma?kage, and divorce. -Various statistics on natality, marriage, and divorce other 

than as included in annual or monthly reports -special analyses by demographic variables, also 

geographic and time series analyses, studies of fertility. 

Data from the National Natality and Mortality Sulrueys.- Statistics on characteristics of births and 

deaths not available from the vital records, based on sample surveys stemming from these records, 

including such topics as mortality by socioeconomic class, medical experience in the last year of 

life, characteristics of pregnancy, e+z. 

For a list of titles of reports published in these series, write to: Office of Information 

National Center for Health Statistics 

U.S. Public Health Service 

Washington, D.C. 20201