View South, 1987 Photo(See 1898-1987: History of the Odd Fellows Home of Springfield Ohio.)
In response to the problems of the poorhouses, numerous nonprofit organizations began building old age homes to give "respectable" poor people a way to avoid the degradation of the poorhouse.
"Benevolent societies" or "fraternal organizations" affiliated with nearly every ethnic, religious, trade, profession, and social group imaginable were established during the 19th century. Hundreds of benevolent societies emerged, including the Irish Benevolent Society, the German Benevolent Society, the Hebrew Benevolent Society, the Odd Fellows, the Masons, and the Knights of Columbus. These were called "voluntary" organizations, because each eligible person could choose whether or not to join.
Although they had other purposes for their existence, the benevolent societies created one of the earliest 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. The Societies provided cash and food to support people in their own homes. Since that wasn't enough for older members who couldn't live alone any longer, the benevolent societies began to build "homes for the aged" where their elderly members could live. The significant expenses of erecting and maintaining these buildings were paid for by the members of the benevolent societies.
Some of the earliest voluntary homes were designed to house both orphans and the elderly, but eventually state-run orphanages were built and the orphans were moved into them. As that happened, the benevolent societies closed down their facilities for children and concentrated their attention on the elderly. (Odd Fellows Home History)
New laws were written in the 1800's to allow the creation of charitable organizations that could operate like corporations. In addition to those established by the benevolent societies, many charities were established by bequests from wealthy benefactors, whose wills included stipulations that the money or property be used to provide assistance to people who fit certain criteria, like "deserving widows and deserted wives" or "colored persons over the age of fifty of respectable character" or "old and worn out seamen." To carry out their work, the organizations built "old age homes" to house those who couldn't live on their own.
In sharp contrast to the poorhouses, the voluntary and charitable facilities seemed luxurious. Many were newly-constructed buildings, built specifically to house the elderly, and others were stately old mansions whose owners had died. The facilities were much nicer, but they were still operated with the paternalistic viewpoint of the times. "Inmates" were under the supervision of a "matron" who had complete control. Residents generally had to get permission even to have visitors or leave the facility. In most, "inmates" were also expected to do chores, and to do sewing or other services that could help bring in money to support the cost of the home's operation.
Some of these facilities required the recipients to pay an up-front fee and turn over their pensions and any other income or assets they had to the facility, in exchange for a guarantee that they would have a home as long as they needed it. This concept re-emerged a century later as something we now call "lifecare".
Eliza Huntington Memorial Home, Norwich, CTBuilt prior to 1800-1833. "A home for respectable and indigent, aged and infirm females." Library of Congress: Historic American Buildings Survey (HABS)
(See 1850: Aged Women's Home, Baltimore, MD.)
As an example of some of the homes that were built in Brooklyn, New York in this century, Polk's Medical Register lists the following:
- Baptist Home, 665 Greene Avenue, established in 1869 with 60 beds
- Brooklyn Home for Aged Men, 745 Classon Avenue, established in 1878, 150 beds
- Brooklyn Methodist Episcopal Church Home, New York Ave & Park Place, established in 1882, 70 beds
- Denmark Home for Aged, 1051 41st, established in 1906, 20 beds
- German Evangelical Home, Chauncey & Bushwick, established in 1881, 265 beds
- Graham Home for Old Ladies, 320 Washington Avenue, established in 1851, 80 beds
- Greenpoint Home for Aged, 137 Oak, established in 1882, 15 beds
- Home for Aged, 464 Herkimer, established in 1850, 60 beds
- Home of the Aged of the Little Sisters of the Poor, Bushwick and De Kalb
- House of the Good Shepherd, Hopkinson & Pacific, established in 1868, 500 beds
Although they seem to be a precursor to nursing homes, most of the old age homes were more residential than medical. They probably provided something ranging from "room and board" or "board and care" to what we now call "assisted living". There are references to "infirmaries" in some old-age homes, and others included a separate building or section that they called a "hospital" where people who were very ill would be housed. The infirmary or hospital section of these facilities was probably comparable to what we call a "nursing home" today.