The 1800’s saw major changes both for humanity and seniors specifically. In Europe and North America, governments came to realize they had some sort of obligation to insure that indigent seniors at least had somewhere to live and something to eat.
“Workhouses” and “poorhouses” were built for seniors with no means and no family to take them in. While they were intended to be charitable, these so called workhouses or poorhouses were rather awful places to live. The seniors who resided in them were referred to as “inmates.” They were segregated by sex, forced to wear uniforms, and, if feasible, required to participate in work to upkeep the property. These poorhouses also often housed orphans, disabled people, mentally ill people and alcoholics.
In “History of Long Term Care,” Karen Stephenson writes that conditions “ranged from barely tolerable to horrific.” In 1901, an astounding 10% of elderly English men lived in workhouses
Gradually, care became more specialized, though not necessarily much better.
A law was passed that forbade housing orphans in poorhouses. Asylums opened for the mentally ill, while residences for indigent seniors developed. In 1823, the Philadelphia’s Indigent Widows’ and Single Women’s Society, one of the first homes for the elderly, opened in the U.S.
While elderly people were no longer forced into the poorhouse, these homes were oppressively institutional and still had much to be desired. America was rapidly industrializing and it was thought the efficiency of the factory could be applied to caring for seniors.
The kernels of the modern care system developed in the mid-1800’s. As an alternatives to state-run institutions for the elderly, fraternal organizations, tradesmen and religious groups began to open nonprofit homes for seniors. Examples of these groups include the German Benevolent Society, the Odd Fellows, Masons and Knights of Columbus. Young members of these groups would pay into a pool that would operate much like a pension plan today. The homes that they operated were often quite nice, and some still operate today.
In the 20th century, aging became, for the first time, an area of study in its own right. The terms “gerontology” (study of aging) and “geriatrics” (medical care for aging people) were both coined in the first decade of the century. Interestingly, Alzheimer’s disease was first identified and described in the same decade.
Furthermore, governments across the world Western world began instituting social welfare programs that provided income to older people who were no longer able to work. The first pension for retired workers was instituted in Germany in the 1880s but other nations were slow to follow. It was the Great Depression that provided impetus for the U.S. to finally create its own “old age pension,” and in 1935, Social Security was passed under the leadership of Franklin Delano Roosevelt. Now, nearly every developed nation provides a pension for retired workers. And just 30 years later in 1965, Medicare and Medicaid were formed, helping to ensure that seniors had access to medical care no matter what their means.
Today, the elderly population is increasing rapidly. Every day, 8,000 Americans from the Baby Boom join the 40 million Americans who are already 65+. This boom in the aging population, along with the need for alternatives to the classic institutional nursing homes, prompted many types of senior care to flourish across the U.S. and the rest of the developed world. To provide intermediate care for those who don’t need a nursing home but cannot live independently, assisted living communities have sprouted up all over the U.S. Other are types of senior care and senior housing have appeared and flourished too, including in-home care, memory care, continuing care retirement communities (CCRCs) and respite care.
Age related health issues are being made a priority too. For example, Obama administration has made Alzheimer’s disease research a priority and set an optimistic goal of finding a cure for Alzheimer’s by 2025, dedicating significant funding to the mission.