["They are enjoying their first holiday ever"--working with the elderly, from the post-war years up to the early 1970s]

While, in the post-war years and into the 1950s, the building of old people's and care homes and the allocation of home places in those homes was seen as the main task of municipal care institutions for the elderly in Frankfurt am Main, in the decade that followed their main task shifted towards increasing the possibilities of providing care in people's own homes, delaying the move into old people's homes and breaking through the loneliness that elderly people were presumed to experience. Supported by the state, community housing was provided with flats for elderly people and with carers to look after their needs. The "warm rooms" of the post-war period changed into clubs, where members met and received guidance. In the late 1960s the clubs were extended into day-care centres, offering a range of consultation services, organized day trips and recreational holidays for the elderly. It was hoped that "meals-on-wheels" in combination with age-appropriate living conditions would delay the move into a home. But these plans were not adequately developed in the 1960s and often it was not clear who would pay the bills. The same was true of outpatient medical care which had traditionally been the task of community nurses, but was now increasingly carried out by local authority carers, who also provided household assistance. This kind of care could only ever be given for a limited period of time and, while it was able to delay the move into an old people's home, it could not replace it.

The Judaic-Christian Origin of Nursing Homes

Many nursing homes today have a religious heritage. While governmental regulations control how much of the care is delivered, the foundations and goals of many homes predate governmental rules and payment policies. This paper explores the basis of Jewish and Christian thought in providing groundwork for religiously based nursing homes. Although the underlying principles are similar, differences in approach and execution for the formation of these homes exist.

Harriet Tubman's last work: the Harriet Tubman Home for Aged and Indigent Negroes

This article focuses on the important contributions the venerable Harriet Tubman made to the field of housing for older persons and other populations at risk. It uses an historical approach to document the importance of early housing and self-help initiatives in the African American community. It embraces Harriet Tubman and other early housers for their good works and acknowledges them as contributors to the rich legacy of community social work practice and its sage principles of empowerment and self-help. The article presents a nexus between the current housing status of older Blacks and the double jeopardy status imposed by historical discrimination.

V. A. Kral, the Montreal Hebrew Old People's Home, and benign senescent forgetfulness

The term Benign Senescent Forgetfulness, introduced in 1958 by V. A. Kral, constitutes the origin of the concept of Mild Cognitive Impairment (MCI), a widely studied but controversial entity. The ambiguities surrounding MCI warrant a re-assessment of its historical origin. Any attempt at an in-depth investigation of Kral's works on that subject should begin with a description of the patient population and professional arena in the Montreal Hebrew Old People's and Sheltering Home, where Kral was a consultant. Based on archival and published sources, I describe the Home's facilities, population, staff and programmes/services, followed by an overview of the dynamic factors inducing a re-examination of its mode of operation in the mid-1950s when Kral joined the Home's professional staff as a consultant.

Nursing and care for the aged in Victoria: 1950s to 1970s

In the state of Victoria, Australia in the late 1950s and early 1960s, restorative treatment was introduced into the state-subsidized benevolent homes, and they were reclassified as geriatric hospitals. In the process, the nursing care of incapacitated old people was identified in terms of particular skills and knowledge, and specific forms of training were established for nurses at two levels of training: nurses' aides and supervisory nurses with a post-basic qualification. These institutional changes were complemented by the introduction of a nursing role into the body responsible for overseeing care for the aged in Victoria. Little was made of this opportunity to establish a leading role for nurses in the field of care for the aged. However, this episode raises fertile questions for further research into the development of nursing in Australia, as a set of practices divided along the lines of acute and chronic illness.

Nursing Homes for the Old (‘Gerocomeia’) in Byzantium (324–1453 AD)

BACKGROUND

Research into the welfare institutions for the elderly, which were established in the Byzantine Empire.

OBJECTIVE

The purpose of the study is the research into the texts of the Byzantine chroniclers and the contemporary historical sources so as to determine the social policy of the Byzantine State regarding the homes for the aged.

METHODS

The histories and chronicles of the Byzantine writers, written in the original Greek language, were studied and analysed, so as to locate the extracts in the texts concerning the interest shown by the Byzantine State to establish institutions for old and ailing people.

RESULTS

The care for the elderly in Byzantium was undertaken in special infirmaries, called 'gerocomeia', which operated all over the empire mostly in or near the monasteries. All these nursing homes were highly esteemed and the governor of the institution seems to have been a person of high importance. The most important nursing home was located in Constantinople and was established by Emperor John II Comnenus in the 12th century in the famous monastery and hospital of the Pantocrator.

CONCLUSION

The study and analysis of the historical texts of the Byzantine period (324-1453 AD) prove that human-oriented behaviour, which derived from the intervention of religion, contributed to the foundation of many welfare institutions for the elderly by the Byzantine emperors, the church and some individuals who showed great interest in them.

Nursing home ownership: an historical analysis

The need to care for dependent elderly in the United States has been a constant since colonial times. Today, as in the earliest days, most care is provided at home by family members. Personal and health services outside the home are sometimes provided by nursing homes. The nursing home industry is large, dominated by private, for-profit ownership, and receives much of its income from public funds. Why are nursing homes publicly funded? Why are nursing homes privately rather than publicly owned? Why is ownership for-profit or proprietary rather than not-for-profit or voluntary? The answers to these questions are found in the history of social policies in the United States.

[The development of dual specialization: the clinical geriatrician and the nursing home practitioner, 1945-1990]

Why are there in the Netherlands two geriatric disciplines and how have the professions of clinical geriatricians and nursing home practitioners been developed? Only written sources have been used for the research: articles, annual reports, archives of scientific associations and umbrella organisations. For the elderly chronic patients increasingly less space was available in hospitals after 1945. These patients obstructed circulation in this institution, which focused more on treatment rather than nursing. Although everyone acknowledged the need for more medical attention for this old age group, there was a lot of opposition against the development of special geriatric units in hospitals. Other specialists agreed that they could effectively treat the elderly patient and felt no need for a geriatrician. Contrary to the geriatric units in hospitals, the development of nursing homes flourished. In these facilities, the nursing home medicine evolved and, as opposed to geriatrics in hospitals, less resistance was encountered. The system of registration of medical specialists made it impossible to recognise only one geriatrician, since they worked in both hospitals as well as in nursing homes. The professional development of nursing home practitioners and clinical geriatricians was delayed partly as a result of the general hesitation of the KNMG in acknowledging new medical disciplines and as a result of internal domain discussions.

Old and cared for: place of residence for elderly women in eighteenth-century Toulouse

Although they lacked the ideological and economic advantages of patriarchal authority, women in eighteenth-century France were no less likely than men to receive support in their old age from friends and family. Elderly women rarely lived on their own, and when they could not rely on their children for support, they found care in more distant kin and friends. This support was not derived from economic coercion but from a vague sense of moral duty. Informal networks of care sufficed for both the rich and the poor except in cases of extreme illness.

[Institutional care for frail elderly from Weimar to Bonn (1924-1961)]

The article deals with the development of institutionalized care and its overall discourse concerning the elderly sick people in Germany from 1924 to 1961. This period of time embraces an ambivalent process of modernization that falls short of any unilinear success story. Neither politics nor the medical sciences had the impact to make the nursing homes catch up with the advanced hospitals. They became low-grade institutions within the national welfare system. These homes evolved from poor-law houses with no specialized care whatsoever. The chronically ill and infirm old people emerged during the 19th century not as the result of straight forward professionalization. The Social Hygiene in the Weimar period and the racist paradigm of the Nazi-period turned a blind eye to the chronically ill elderly people well into the era of the murderous "euthanasia". At least in the second half of World War II chronically sick old people were increasingly regarded as so called "useless eaters" and, thus, doomed to be killed or starved to death. The mortality rate remained very high after the end of the war due to wide-spread hunger. The situation did not improve until 1948 and in the 50s this part of state welfare took advantage of the general expansion in the social and health care system.

The acute sick versus the chronic sick: the takeover of Fairmile House by the NHS

This study investigates the changes the introduction of the National Health Service (NHS) brought to a former workhouse. The take-over by the NHS changed this workhouse from an infirmary mainly caring for the aged and chronic sick to a hospital mostly caring for acutely ill people. As a consequence, nursing at this institution probably lost some of the expertise it possessed in caring for the aged and the chronic sick.

History and evolution of the role of the medical director

Federal regulations that were published in 1974 required a physician to be employed full or part time as the medical directory by a skilled nursing facilities. Negotiation was needed in each facility to reconcile the traditional role of the physician who care for individual patients with the new role of the physician who would be involved in decisions regarding the care of groups of residents. Professional and provider organizations attempted to define the new role, which developed through experience, networking, and educational opportunities. A consensus conference held in January 1988 identified the functions and tasks associated with medical direction, and, subsequently, educational opportunities focusing on the competencies associated with performing these tasks and functions were developed. This article traces the history and evolution of the formalization of the medical director's role.

The development of geriatric medicine in Australia

Geriatric medicine has been slow to evolve in Australia for bureaucratic and other reasons. The rapid increase in the aged population demands that a coordinated approach be taken in the future.

[Elder care in nursing homes during national socialism in Germany]

The situation of the elderly during the Third Reich has hitherto been neglected by research. This paper deals with the living conditions and the fate of the aged in institutional homes in Saxony. Those no longer able to care for themselves were subjected to the aggressive social and military goals pursued by the National Socialists and were victimized in the organisation of medical care. Many conditions contributed to the destruction of their lives: not only the emptying of homes for the elderly to make room for military hospitals, disorienting relocation programmes, and the murderous "T4" programme, but also the death of children during the war, the destruction of property and the loss of a home due to forced dislocation.

[Charity. Poor welfare as care for the elderly in the 2nd half of the 19th century]

In the second half of the nineteenth century poor relief of the church was especially directed at the elderly. Firstly, this is clear from the existence of almshouses and the so-called old people's homes. Secondly, in allocating poor relief age played an important role. Permanent outdoor relief was supplied from the age of fifty. This article will portray this nineteenth century permanent outdoor relief. A group of 239 permanently endowed people will be analyzed on the basis of parish registers of the Evangelical-Lutheran church in Amsterdam. This specific group (orphanages, almshouses, old people's homes and boarders will not be considered) consisted largely of elderly people.

The decline in family care for the aged in nineteenth-century Ontario: fact or fiction

Two myths exist concerning the care of the aged in the past. The first purports that the aged were cared for by their families and that public assistance for the aged destroyed familial responsibility towards the elderly. In response to this contention, a second myth, which argues that the aged were not cared for by relatives, highlights the sufferings of abandoned and destitute aged people in institutions. In nineteenth-century Ontario, while the aged were not always cared for by kin, they were rarely willingly abandoned by their families. Evidence from diaries, letters, and institutional records indicates that families regularly provided whatever amount of care their resources would allow. However, financial restrictions, or the illness or senility of an aged person, often made it impossible for a family to cope with the demands this care entailed. When this occurred, many families institutionalized their aged in a House of Industry or an Asylum. While families have been blamed for subjecting the aged to the harsh conditions of these institutions, in most instances, they did so out of necessity and not by choice. It was the lack of public assistance and adequate facilities for the care of the aged, and not the irresponsibility of families, which caused the suffering which was so common among the aged poor during the last century.

[Institutional care for the aged in the 2d half of the 19th century. A case study]

This study focuses on the residents of three ecclesiastical homes for the elderly in 19th century. The Hague. These homes took in poor members of the church who were at least 60 years old. Most of the elderly who resided in these homes had received poor relief prior to admission. The main reason to request admission was that they were no longer able to independently run a household. Most of the residents were well past the age of 60 upon entering the home, women generally being a few years older than men. There were no significant gender differences in duration of residence. The female age at death was a few years higher than for males. The health of the residents appeared to be worse than that of the total elderly population of The Hague, resulting in a higher death rate. In general, residents had independently run a household prior to admission.

Regulation of board-and-care homes: research to guide policy

Information about board-and-care homes reported in the media and in federal committee hearings indicates that they are shoddy and exploitative environments that do not provide adequate care. Research done in board-and-care homes in recent years, however, demonstrates that they can provide adequate care and a satisfying environment for some of the people they serve. Policy at the federal, state, and local levels should be guided by both the need to assure the health and safety of board-and-care residents and the needs of residents and operators identified in scientific studies.

The infant geriatrics

Recent histories of geriatrics suggest that early physicians contributed to the degradation of old age by labeling it a disease. This diagnosis provoked little or no interest in the "illness," and active plans for treatment of the elderly were not developed. An analysis of the records of the Boston Almshouse Hospital indicates that, even for elite doctors, assessments of the elderly's morbidity were prompted as much by the desire for self-advancement as by the elderly's needs.

An alternative to the service 'too young to benefit from lessons in its own history'

The Government's Green Paper on the elderly suggests the possibility of NHS nursing homes. Is this really a good idea? Author looks back over the history of Springbok House, one of four experimental rest homes for the infirm elderly run by the National Corporation for the Care of Old People in the fifties and the early sixties, and suggests that this might provide some answers.

Changes for Bicêtre and its elderly residents: the paradox of progress

Recent changes at Bicêtre, the historic French institution, exemplify an old paradox in the care of the elderly: improvements which benefit part of a society can mean more misfortunes for others. The effect of relocation of its elderly residents to make way for renovations poses important questions of priorities in societal values.