200+ Years of Senior Living History

The 1700s were challenging for older adults, especially those without family members to care for them. Poorhouses, almshouses, and other county infirmaries became homes for the indigent elderly.

A positive aspect of these early years was the creation of federal pension programs. One of the first acts of the new government in 1776 was to authorize pensions for disabled Revolutionary War veterans. This led the way to present-day Veterans aid and assistance and Veterans housing.

The 19th century brought increased support for the aged. Nonprofit old age homes offered room, board, and care. However, these homes were vastly different from modern-day assisted living facilities (and their federal and state assisted living home regulations). Professional home health care emerged in the late 1800s, leading to the creation of the Visiting Nursing Association (VNA).1

1900-1929

Old age homes, home health care services, and chronic care facilities increased dramatically in the early 1900s. Before the Great Depression, an estimated two to four percent of the aged 65 and older population lived in an institutional setting. Planning (and saving) for the future was easier with the inception of state-sponsored pension plans and private company retirement programs.

1930-1939

The 1930s were a decade filled with financial distress due to the Great Depression. Millions of people were unemployed, and most of the older population in America lived in dependency.2 However, this decade also marked several milestones in caring for them. In 1935, the Social Security Act was signed into law, creating the Old Age Assistance (OAA) and welfare programs.

1940-1949

Newly disabled veterans (and surviving spouses) felt the immense effects of World War II. Post-war, there was a clear need for increased long-term care. Overall, the size of the aging and disabled population was growing. Many were now eligible for Veterans benefits, old-age assistance, Social Security, or unemployment assistance.

1950-1959

The 1950s marked the beginning of three decades of deadly nursing home fires across the United States. The nursing home boom led to unsafe facilities and toxic fire hazards. Because of this, legislation focused on building codes, safety, and the development of residential care (also known as assisted living) and long-term care facilities. These tragic events also brought to light the urgent need for senior fire prevention.

Towards the late 1950s, the Section 202 program of the Housing Act of 1959 helped expand the supply of affordable housing with supportive services for older adults.3 The Housing Act of 1959 paved the way for today’s affordable independent housing, including low-income senior apartments and Section 8 Department of Housing and Urban Development (HUD) dwellings.

1960-1969

In 1960, 9.2 percent of the total U.S. population was 65 years or over. Due to the rise in nursing home residents, national spending on nursing home construction increased. Nursing home quality concerns continued to escalate, with an estimated 44 percent of nursing home beds failing fire and health standards.

1965 was a year marked by significant milestones. In response to concern by policymakers about a lack of community social services for older persons, Congress passed the Older Americans Act (OAA) and Administration on Aging (AOA) agency, which approved grants to states for aging-related community planning and programs.4 On July 30, 1965, Medicare and Medicaid were signed into law,5 signifying a monumental day for older Americans.