ABSTRACT
This chapter provides a two overviews, one a history, the other and broadside examining the present performance of nursing homes. It attempts to demonstrate the futility of fatalism and the benefits that can accrue from community commitment. There may be a hidden formula at work in every government welfare program: The weaker its commitment to the poor, the more vague its procedures and the less accessible its bureaucracy. Everything the federal government does betray its reluctance to make a firm commitment to those who must live in nursing homes. In the 1940s, as monthly social security checks began to flow in earnest, more and more retired workers applied them against the costs of long-term care in homes for the aged. The impression one gets as one reads each sad family scenari—and there is thousands—is of a vast social helplessness to match the physical or mental helplessness of the institutionalized loved one.
