Friday, June 28, 2002


From Karen Stevenson Brown, publisher of ElderWeb:
I have begun a comprehensive look at the history of long term care in America over the years, both how we have provided care and how we have paid for it. It provides some fascinating insight into when and why our long term care system evolved as it did, and I have created a special section of the ElderWeb site for this information.

This is still a work in process, and I have been going back and re-writing sections as I uncover more information. The posted material covers the period from the inception of the country in 1776 to just before the Great Depression started in 1929. I will be bringing the story forward to the current environment in the weeks to come.

Some tidbits from the information posted so far:

► In colonial days, “old age security” meant having children and/or property. Old men and women who had no children to care for them and no money had few good options available.
► The first “institution” for the poor elderly was the poorhouse, where “inmates” had to give up all their rights. It was like a prison, inmates couldn’t leave or have guests without permission. They were even forbidden to wear their own clothes—they had to wear a uniform. Many of the elderly shared space with the mentally-ill, who were sometimes chained and kept in pens or stalls.
► “Benevolent Societies” created one of the first organized old-age assistance programs. Members paid monthly dues to the Society while they were young and healthy, then received help when they were elderly, infirm, or in need.
► “Old age homes” were developed during the 1800’s to protect “respectable” people from the “indignity” of the poorhouse. Some of them required the recipient to pay an up-front fee and turn over whatever income and assets they had in exchange for a guarantee that they would have a home as long as they liked—an early version of what we now call “lifecare”.
► Early retirement communities were also developed during the 1800’s.
One had “convenient two-story brick cottages”, a community center, a hospital, and its own water system.
► While fewer people lived to age 65 or age 85 in 1900, those that did had nearly as many years ahead of them as people of those ages do today. There were reports of hundreds of people who lived past 100.
► Urbanization and the migration to the west in the 18th and 19th centuries reduced family sizes and disbursed families so that older people could not count on having a family member available to care for them, increasing the need to develop alternative solutions.

You’ll want to read the story online so you can see the photographs of poorhouses and old age homes of the time. You’ll also want to take a look at dozens of interesting pictures, narratives, graphs, and charts collected in the appendix, many from the wonderful Library of Congress American Memories collection. more...