Senior Living History: 1800 – 1899

Families Scatter Across The Country

By the early 1800s, family was, by far, the primary source of care for older Americans and care took place in the home. Without formal safety nets, an individual's well-being in old age was almost entirely dependent on their family's ability and willingness to provide support.

This reliance on kinship ties had deep roots in farming society. Multiple generations often lived and worked together on farms, creating a natural system of mutual support. However, rapid industrialization and increasing migration from rural areas to cities began to strain these traditional systems.

The Homestead Act and Westward Expansion

The nation expanded westward and cities grew. The 1862 Homestead Act offered 160 acres of free land to settlers willing to farm it for five years1. This was unoccupied public land in public domain states. That meant any part of the country outside the original 13 colonies, Tennessee, Kentucky, Texas, and Hawaii.

The completion of the transcontinental railroad in 1869 made it even easier for young adults to move far from home seeking opportunities, too. The railroad connected the east and west coasts, enabling easier and faster trade between both markets. This led to the growth of new towns and industries along the rail lines.

Economic shifts meant fewer adult children remained on the family farm. While today, senior women can thrive as solo agers, many senior women during the 1800s struggled. Often outliving their husbands and without family around to help, they had few financial assets or formal job opportunities in their later years.

As traditional family support systems fell apart, older adults, both men and women, were left behind. The geographic separation created a crisis for aging parents. Their adult children were scattered across the country and many seniors found themselves alone and vulnerable.

The Poorhouse Problems

For those without family support or financial means, the “poorhouse” became the last resort. These institutions, also known as almshouses or workhouses, saw their populations explode in the early 1800s.

They were originally conceived as a catch-all solution to poverty. They were supposed to provide basic shelter, food, and sometimes work for anyone deemed indigent, including seniors, the sick, the disabled, orphans, and even those considered insane2.

Conditions inside these institutions were grim and inhumane. A minimum amount of funds were dedicated to the welfare of their residents. Poorhouses were typically run by politically appointed individuals whose main objective was cost-cutting.3

Poor sanitation, inadequate food, untrained staff, and overcrowded facilities created horrific conditions. That wasn’t all. Older adults, often frail and confused, were housed indiscriminately along with criminals and individuals suffering from mental illness or alcoholism. This dangerous mix created unsafe environments for vulnerable older adults.

Reformers like Dorothea Dix exposed shocking abuses. In her submission (as women could not present at the time) to the Massachusetts legislature, she reported findings of individuals chained and kept in pens in some poorhouses4. A staunch advocate for the mentally ill, in 1854, Congress approved her mental health reform bill, but it was subsequently vetoed .

Glimmers of Charitable Care

Public awareness about these conditions grew and alternative care models began. Some states established oversight boards to monitor these facilities and began separating the poor from the rest. New York City even purchased an entire island (Blackwell’s island now known as Roosevelt Island) to separate different vulnerable populations.[/citations]

Specialized state institutions for the mentally ill were created, though unfortunately, many seniors still remained in mixed-population poorhouses.

During the latter half of the 19th century nonprofit organizations, private charities, and religious organizations really stepped up and built old age homes to keep “respectable” poor people out of the poorhouse. In fact, these benevolent societies or fraternal organizations were affiliated with nearly every ethnic, religious, trade, profession, and social group imaginable.

These groups began establishing more humane “homes for the aged,” motivated by compassion and a desire to provide a better quality of life in elder care facilities. Hundreds of organizations – including Irish, German, and Hebrew benevolent societies, plus fraternal groups like the Odd Fellows and Masons – created homes for the aged that were far superior to poorhouses.

Operating like early insurance programs, members paid monthly dues while young and healthy so they could receive care when they aged. When seniors could no longer live independently, the societies provided clean, safe housing with basic medical care. In Brooklyn, New York, you could find dozens of these facilities by the end of the century including the Baptist Home, Brooklyn Home for Aged, and the German Evangelical Home.

The Little Sisters of the Poor was another example that opened their Home for the Aged Men and Women in Washington, D.C., in 1873. This institution provided housing and care regardless of religion or race, often funded by private donations and small government 6appropriations5.

These benevolent societies were the beginning of more structured and dignified senior care outside the often-inhumane public almshouse system.

Medical and Nursing Care Advances

Typically, professional care up to the 1800s happened in the patient's home, often with the assistance of female caregivers. The late 1800s saw the birth of professional nursing and home health care. As hospitals developed training programs, wealthy families began hiring nurses as live-in caregivers for older and sick relatives.

Inspired by figures like Florence Nightingale in Europe, visiting nurse programs were established in the United States. Often sponsored by wealthy individuals or philanthropic groups, these nurses provided vital care, hygiene education, and assistance.

These nurses also helped the urban poor who lacked access to other forms of medical help. The visiting nursing model can be traced to nursing pioneer Lillian Wald who taught home classes about health care to poor immigrants on New York’s lower East Side in 81893[/citation.

Visiting nurses brought basic health care and dignity to many seniors.

Government Benefits Begin

The Civil War (1861-1865) created major needs for veteran support. About 12 percent of the U.S. population served during the war. With many casualties and 600,000 deaths, the federal government dramatically expanded benefits.

They wanted to encourage enlistment and prevent disabled soldiers, their families, and widows from ending up in poorhouses8.

Employers Start Pension Programs

Private companies began offering limited retirement benefits. American Express created the first employer-sponsored pension in 1875, though it was only available to incapacitated workers who had been with the company for 20 years or more.

In 1882, the Alfred Dolge Company which built pianos and organs, offered one of the first pensions in the country. Dolge withheld 1 percent of each workers’ pay and the company added 6 percent interest to it each year. Unfortunately, the pension program was pretty unsuccessful. Labor mobility meant few workers spent their whole working career with one employer then and now. The company went out of business a few years later.

The Baltimore and Ohio Railroad followed in 1884, offering a pension plan which required mandatory retirement at age 65 and a minimum of 10 years of employment.9

Early Retirement Communities

We can see during this period the start of the modern retirement communities. Sailors' Snug Harbor on Staten Island, established in 1833, created a 130-acre campus for retired seamen. The will of the heir to a shipping fortune required that the estate be used to operate a haven for “aged, decrepit, and worn-out sailors.” The facility included dormitories, gardens, workshops, a hospital, library, and entertainment venues10.

Another early example of a planned community for seniors, the William Enston Home in Charleston, South Carolina was built in 1889. Situated on beautiful, landscaped grounds, it featured 24 cottages, a community building, an infirmary, an engine house, and a water tower as a centerpiece of a waterworks system11.

Senior Leisure Activities

Seniors valued a strong sense of community during the 1800s. Older adults who had time indulged in storytelling, Whist, a popular card game, quilting, berry picking, fishing, and whittling. Common pastimes included reading Harriet Beecher Stowe's Uncle Tom's Cabin, Dickens’ books, or Mark Twain's The Adventures of Tom Sawyer—extremely popular books of the time.

For transportation, older adults used horse-drawn carriages, wagons, and stagecoaches. For travel on rivers, you could take a steamboat. While train travel was not always cheap, the price of tickets depended on both the class and distance traveled. So, second- or third-class tickets could be had at economical prices.

Community events like church socials, square dances, and neighborhood picnics served as social outlets for seniors. Entertainment included the circus, theater, and brass bands.

In the 1800s we saw the groundwork laid for future advancements for seniors. While the family remained central and the poorhouse system presented challenges, charitable efforts and the development of formalized medical and nursing care began. Government welfare programs, private pension programs, and the beginning prototype for retirement communities also came into existence.