WASHINGTON — Holocaust survivors in the United States are better off aging at home and that requires assistance for the tens of thousands who cannot afford it, according to the top Democrat and Republican on the Senate Special Committee on Aging.

“The emphasis on caring for aging survivors must be on creating a safe space surrounded by a trusting caretaker, familiar environment, and a basic sense of control over daily life,” said Sen. Bill Nelson (D-Fla.), who chairs the committee, said Wednesday.

Government programs and health insurance providers generally favor institutional over home care for elderly needing assistance.

“For many of these seniors, this means staying in their homes to receive medical care in their twilight years, a model of care not supported by the traditional Medicaid model, for instance,” Nelson said, referring to the federal medical funding program for the impoverished.

According to the Senate committee, one fourth of the roughly 140,000 survivors in America live at or below the poverty line, the Washington Jewish Week reported.

Many face significant health and mental illnesses beyond normal aging due to nutritional deprivation and the lack of medical care during World War II.

Sen. Susan Collins (R-Maine), the committee’s top Republican, said institutional living presents added challenges for survivors.

“The emotional triggers that can be set off by institutional care can be devastating for them,” she said. “Things that other residents would likely ignore can take aging Holocaust survivors psychologically and emotionally back to their traumatic youth or childhood. Confinement is an institutional setting with certain rules, schedules and uniformed staff can literally bring back nightmares. Everyday experiences — showers, doctors, hunger, a lack of privacy — can trigger flashbacks and nightmares.”

Vice President Joe Biden last month laid out a program to assist impoverished Holocaust survivors, including appointing a Health Department envoy to the community and creating additional capacity for volunteers to help the survivors.

Jack Rubin, a constituent of Nelson’s and a survivor of several Nazi concentration and death camps, said the way it is now, many Holocaust survivors are living below the poverty line and can’t afford two hearing aids let alone someone to come into their house daily to help out.

He suggested that the German government should contribute. “US taxpayers are already burdened enough,” he said, adding, “We are not schnorrers. We are not beggars. What we are asking for is what we deserve.”

Besides Rubin and Anat Bar-Cohen, a daughter of survivors, several organization leaders testified for the need for increased funding, including the Jewish Federations of North America and Selfhelp, a community services organization that helps survivors living in New York.

“Living in poverty, plagued by immeasurable loss, they are at risk of falling into isolation and despair,” Lee Sherman, the president of the Association of Jewish Family and Children’s Agencies, said in her testimony.

The Conference on Jewish Material Claims Against Germany provided written testimony.