ABSTRACT
Changing patterns of illness in the United States modified the context for sick care during the first half of the twentieth century, presenting both dilemma and challenge to policy makers and professionals. Non-profit agencies were unable to respond too many of the dilemmas in long-term care due to small size, insufficient funds, delayed response to changing needs, and other commitments to existing constituencies. Both public and non-profit agencies believed in their own capacity to address universal needs for long-term care. Nevertheless, serious gaps emerged as the long-term care system grew. Between 1945 and 1965, needs for long-term care services were frequently addressed through programs based in a single agency. While disagreements over the definitions of social welfare and health characterized discussions and debates about long-term care services, the medical approach gradually dominated. The chapter also presents an overview of the key concepts discussed in this book.
