OLD AGE/NURSING HOMES. The origins of community responsibility for the elderly in Cleveland can be traced to the Northwest Territorial law for the relief of the poor, enacted in 1795. This act placed the obligation for maintaining needy relatives upon "father and grandfather, and the mother and grandmother, and the children of every poor, old, blind, lame and impotent person." During the early 19th century, assistance to Cleveland's needy, including the aged, continued to come primarily from traditional sources—the family, private benevolence, and public relief (see PHILANTHROPY, WELFARE/RELIEF). This changed somewhat in 1855, with the establishment of the City Infirmary, which housed and sustained the poor, aged, insane, and handicapped. The first local home to provide particular care for the elderly was not established until 1870, by the LITTLE SISTERS OF THE POOR. The evidence suggests that a growing dissatisfaction with the City Infirmary impelled religious leaders and social reformers to establish special homes for the aged. Between 1870-1908, 10 such institutions opened in Cleveland. The Home for Aged Women and the ELIZA JENNINGS HOME, both managed by the Women's Christian Assn. (later the YOUNG WOMEN'S CHRISTIAN ASSN.), sheltered elderly women.

Most private homes for the aged in Cleveland manifested the concern of "women of the church" for the dependent elderly. The Baptist Home of Ohio, the Cleveland Dorcas Society's Invalids Home, and the A. M. MCGREGOR HOME were 3 other private institutions for the elderly established by women or women's organizations. Cleveland's Jewish community established the Home for Aged and Infirm Israelites (see MONTEFIORE HOME) in 1882, supported by a fraternal organization, and the Orthodox Old Home (see MENORAH PARK) in 1906. There was, however, a notable lack of activity on the part of other local fraternal societies to establish old-age homes. Despite Cleveland's large immigrant population, there were only 2 ethnic institutions, the German ALTENHEIM (1886) and the Home for Aged Colored People (1897, see ELIZA BRYANT VILLAGE).

At the turn of the century, the City Infirmary, the sole support for some elderly, was transformed into Cooley Farms, which became a national model. A unique feature of this new village for the poor, infirm, insane, and aged, was a separate building where elderly married couples could continue to live together. This modernization came at a time, however, when Clevelanders were beginning to question institutionalization as the sole solution to the needs of an expanding aged population. In 1909, for instance, the BENJAMIN ROSE INSTITUTE organized to assist the elderly in their own households, and was the first foundation in the U.S. established to respond primarily to the needs of the aged.

Other forms of noninstitutional support evolved during the Depression. In 1933 the general assembly enacted the first Ohio law to provide public funds for the needy aged, and Title I of the federal Social Security Act of 1935 appropriated $49,750,000 to enable each state to assist needy older persons. One of the stipulations was that federal money could not be paid to aged people living in public institutions. This provision led nationally to the decline of the poorhouse as an asylum for the elderly and contributed to the rise of the "proprietary home." Locally, the rapid growth of the proprietary home was evidenced by the establishment of 70 such institutions in Cuyahoga County by 1942 and by the passage of a state licensing law that same year. The arrival of these new nursing homes was not universally welcomed, and Mary C. Jarrett, in her 1944 report "The Care of the Chronically Ill of Cleveland and Cuyahoga County," suggested that the existing proprietary nursing homes were close to a "public scandal." In Jan. 1946 Eugene S. Lindemann, chair of the local Coordinating Committee on the Chronically Ill, reported that in 1945 there were 34 nursing and rest homes, with 1,130 beds, licensed by the state to operate in Cuyahoga County, and that an additional 9 operated without a license.

The homes did serve a growing need for better health services for the elderly. Older persons lived longer, and most private benevolent homes only accepted able-bodied older persons as residents. New facilities developed to provide for chronically ill or mentally incapacitated older persons. In 1932 a 169-bed chronic hospital was constructed on the colony farm, and in 1938 the Cuyahoga County Nursing Home opened as a shelter for relief patients who were permanently and totally disabled. These facilities could not accommodate the need, however. In 1952 the City of Cleveland and the board of Cuyahoga County commissioners transferred the land and buildings on the Cooley Farms to the county to facilitate construction of a new chronic hospital, later known as Highland View CUYAHOGA COUNTY HOSPITAL SYSTEM.

The 1950s witnessed some improvement in nursing-home care, as represented in the activities of the Welfare Federation's Chronic Illness Information Center. The center maintained contact with area nursing homes and provided information to the chronically ill of all ages, including the elderly, and offered recommendations about the homes best designed to meet the individual needs. By Oct. 1957 there were 37 proprietary nursing homes licensed by the division of social administration of the department of public welfare to offer care in Cleveland and Cuyahoga County. The MARGARET WAGNER HOME, built in 1960, owned and operated by the BENJAMIN ROSE INSTITUTE, served those requiring long-term care, as well as individuals needing only rehabilitation care for broken bones or strokes. The 1960s brought the implementation of some policies that directly affected the aged. For example, the enactment of Medicare and Medicaid further spurred the growth of commercial nursing homes. The Cleveland city directory recorded 26 nursing homes in 1965 and 31 in 1972; the east and west suburban directories included 34 additional facilities.

The vital role that the nursing home continues to play in providing shelter and medical care for the elderly in Cuyahoga County is best illustrated by the 6 pages of listings and advertisements for approximately 130 such institutions published in the most current Cleveland consumer directory.

Judith G. Cetina

Cuyahoga County Archives

Bing, Lucia Johnson. Social Work in Greater Cleveland (1938).

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