The Evolution of Senior Care

Throughout history, families, both immediate and extended, have
borne the primary responsibility for taking care of their elderly, just
as they do today. Elder care institutions and organizations beyond
the home appear to have been rare before modern times.

elderly woman

Still, a few advanced societies through the ages may have recognized
a community responsibility for the elderly. One of those societies was
the Byzantine Empire. Weak and ill older citizens
were sometimes cared for in special infirmaries, called gerocomeia,
according to several researchers at National Athens University
in Greece. In the twelfth century, Emperor John II Comnenus
established the most famous of the gerocomeia in the Constantinople
monastery and hospital of the Pantocrator. In their heyday,
these forerunners of the modern nursing home operated all over
the empire, mostly in or near the monasteries. They were highly
esteemed, and the governor of the institution seems to have been
a person of real importance.

The evolution of community participation in elder care was
more complicated in many parts of the world and not such an
honored undertaking. As an example, for several centuries in
England, seniors were subject to the country’s Poor Laws, which
often left them with “a stark choice between destitution and the
workhouse.” Indeed, according to the 1901 census, more than
208,000 people were residents of workhouses in England and

German Chancellor Otto von Bismarck pioneered the recognition
of seniors as a group worthy of special protection by instituting
an old-age social insurance program in 1889. Other developed
nations followed. For instance, the 1935 passage in the United
States of the Social Security Act addressed the pressing issue of
long-term economic security for the country’s seniors—a population
whom President Franklin Roosevelt said previously may have
“spent their remaining years within the walls of a poorhouse.”
Thus, the Social Security Act may have played a major role in the
evolution in the United States of the proprietary nursing home.

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