Nursing Homes
| Author | Jeffrey Wilson |
| Pages | 1265-1268 |
Page 1265
With more people living longer and with the first of the Baby Boom generation reaching retirement age,, it is hardly surprising that the number of people requiring some sort of long-term nursing care is growing. According to the American Association of Homes and Services for the Aging (AAHSA), people who reach the age of 65 have a 40 percent likelihood of entering a nursing home; by 2020, approximately 12 million older Americans will need long-term care. The type of care available today fills a variety of needs; traditional nursing care for the infirm or incapacitated, assisted living for people who are still somewhat independent, adult day care for those who need supervision when the family is not available, and home health care for those who want or need to remain in their own homes.
Until the twentieth century, elderly people who could no longer take care of themselves were taken in by family members; those without money or family were placed in almshouses. Older Americans today have much better options and can expect a much better quality of life. With so many facilities (17,000 nursing homes alone), choosing the right one can be a challenge. Those who must reside in nursing homes—and their families—need to determine the best option based on quality of care, comfort level, location, and cost. The smart consumer will do enough research to know exactly what to look for in choosing a nursing facility.
The concept of a residence set aside solely for the elderly and infirm was unknown until the nineteenth century. Before that, it was understood that elderly people would be taken in by family once they were unable to care for themselves. Those who had no family could rely on servants if they had the financial resources, but for those who were alone and poor the only choice was the local almshouse.
As the Industrial Revolution brought more people to cities, families spread out and often people had no local extended family to fall back upon when they were in need. The result was a growing number of single and widowed people who had no one to take care of them in their old age. The first homes for the elderly were established by churches and women's groups, catering to widows and single women who had limited resources. Homes such as the Indigent Widows' and Single Women's Society in Philadelphia and the Home for Aged Women in Boston were a far better option than an almshouse. These early homes were not open to all. Many of them required entrance fees, and some asked for certificates of good
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character. Requirements like these shut out the neediest, who were still relegated to the almshouse.
By the beginning of the twentieth century, sensibilities about caring for the poor and incapacitated had begun to change. Specialized facilities were built for children, the mentally ill, and younger infirm individuals. But little was done for the elderly, and they merely became a larger percentage of the almshouse population. In 1880, one third of the residents of almshouses in the United States were elderly; by 1923, two thirds were elderly.
It was not until the 1930s that things began to change for older people in need. The Social Security Act of 1935, part of President Franklin D. Roosevelt's New Deal, provided monthly payments to those over the age of 65. Although the payments were relatively small, they were an important step. Some older people were able to leave the almshouses and live on their own. Others were able to enter private facilities.
There was an unforeseen downside. Private facilities were unregulated, which meant that many were poorly run—dirty, overcrowded, unresponsive to residents' needs. Public facilities were at least regulated, but part of the Social...
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