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Recently I was thinking about seniors in previous eras – who took care of them? Where did they live? I thought that nursing homes came into being fairly recently, say in the 1900s. In addition, I thought that before nursing homes were established families took care of their aging parents by bringing them into their homes.
Well, I was partly right.
Recent statistics indicate that nearly six percent of older adults live in a fully equipped residential facility that will provide for their care. Nursing homes have become quite common in the twenty-first century.
Where I was wrong was how the elderly were cared for prior to the twenty-first century. Before there were nursing homes, there were almshouses, institutions where there were no age restrictions. In fact, most elderly people who needed a place to live for whatever reason usually ended up in a horrible place the rest of their life, living among the homeless, the insane, and the inebriated.
Early Elder Care Concerns
Horrified that formerly established widows and single women had to live in such an awful place, churches and women’s groups began creating special homes for the aging. They were created in the beginning of the nineteenth century because of the concern for those of their own ethnic or religious background who might have to spend their last days with the most despised members of society.
Such homes appeared as early as 1823 with strict requirements as to who could live there. Many required a large entrance fee and a certificate validating their character. The goal of those who founded the homes was to separate their own needy from the riff-raff who lived in the asylums. Unfortunately, those who were poor still had to rely on the almshouse for their living arrangements in their old age.
The Beginning of Reform
By the end of the 1880s and into the early 1900s, it was recognized that a growing number of senior citizens were living in almshouses. In fact, by the early 1920s, almost 70 percent of the population of the so-called poor farms consisted of the elderly. In deference to the changing environment, the heads of these homes started renaming them to reflect the population shift.
For example, in New York City a public almshouse changed its name to the Home for the Aged and Infirm. Unfortunately, the name change did not change the conditions the elderly had to endure.
City and state leaders recognized that living conditions for the elderly were still not appropriate, and by the 1930s, they determined to make positive changes for their care. Recognizing that a growing number of elderly people needed support, they agreed that a small pension would help more people live on their own. Those pensions were only paid to those who did not live in an almshouse.
The New Deal
As a part of the newly established Social Security program under the New Deal, it was decided the elderly should receive federal benefits based on need hoping they could now live on their own.
President Franklin D. Roosevelt signed the Social Security Act into being on August 14, 1935. The Act provided matching grants to each state for Old Age Assistance to retired workers.
To discourage people from living in an almshouse, no provisions were paid to anyone living in public institutions. The result was the opening of a number of private old-age homes so that people at the care facility could receive their old age assistance.
Due to the depression, the homes were no better than living in the poorhouse, but at least a small amount of money was coming in to help with their support. After World War II, the demand for modern health care facilities still could not be met.
Tomorrow, the rest of the story.
