The family and its members

by Anna Garlin Spencer

Pension Laws.—For example, in Great Britain, the pension law made all eligible to state aid who were over seventy years of age and whose personal income did not exceed one hundred and five dollars per year. Such were entitled to aid to the extent of $1.25 a week, and those having incomes above that sum were entitled to receive a graduated series of state benefits. This aid from the state has doubtless made the condition of many aged persons far more tolerable and even happy in families where, previous to the passage of that Act, the extra expense involved in caring for the grandparents was the last straw that broke the back of independency. In all cases where the addition of a few dollars weekly to the family income is an actual and obvious help to family comfort, state pensions for the aged have worked good results in family feeling and good-will and affection. Where, however, the state aid comes without any contributory savings from the individual or his employer and where to qualify for its benefit all must have an income of very small proportion, it is in effect a class measure and obviously for the relief of the very poor.

The higher family interest demands that every system of insurance or of subsidy, or of occasional aid to any member of the family, should tend directly and powerfully toward and not away from thrift, work capacity, and sound business principles. Society-at-large must now make good in some makeshift fashion for many social failures of the past, but its main currents of pressure upon the individual life should be in the production of a line of normal and successful men and women, rather than attempts to make all share alike, whatever their personal quality, when old age comes on. This principle makes it imperative that some larger and wiser plan than has as yet been attempted shall make all systems of financial care of the aged a positive aid toward self-dependence and social serviceability.

Old-age Home Insurance.—In this connection a radical suggestion is offered, namely, a scheme for Old-age Home Insurance. It is a well-known fact that the waiting list of most private Homes for the Aged is long, and that men and women wait piteously for the death of an "inmate" to give them entrance to the only place of comfort and security life can offer them. It is also well known that there are more aged persons who need the companionship of those of their own generation, who need quiet and relief from the noise and excitement of young children, than can now secure those requirements in the homes of their daughters or their sons. It is again true, although not so well recognized or understood, that most aged persons unable financially to retain a personal home would prefer a choice between residence in a child's family, however dutiful and generous that child might be, and residence elsewhere. It is also true that the care of aged parents in her own home is often too great a tax upon the time and strength of the housemother when there are many young children. Again, it is true that many aged people prefer a place they can call "home," even if it is only one room, to which they can invite their friends and from which they may pay visits to their relatives, even their nearest and dearest, and return to their own small quarters at will. It is also true that although most elderly persons live for years in quite good health and need little actual nursing, they do profit by occasional attentions which a nurse can give, and few such elderly people can afford or obtain this occasional service in either a home of their own or in one shared with a child.

These facts indicate a need for a larger and a more democratic provision of homes for the aged, a provision that can be more easily made by personal effort through the younger years of life, and one that can receive social aid at less cost to personal dignity and with less rigid rules of managing "Boards" than the present prevailing type of Homes for the Aged supply. The boarding house sought by many aged persons who prefer independence of life to living in the family of their children, and sought also by many well-to-do elderly widows and widowers who find that the personal home is too lonely or too expensive to keep up for one alone—the average boarding house is a sorry substitute for a home. For the young, who hope to escape it soon, it is tolerable. For the aged, who need to feel settled, it is often a most unhappy dwelling-place. Beside, any one who tries to find a place for the elderly boarder will find that prices are often prohibitive for all but the rich, and few boarding mistresses want old people.

A state pension has often, as has been said, been proposed for all aged people. Let us suppose that instead of this some scheme of State Insurance for Old-age Homes be devised; a scheme in which after the payment of a certain specified sum a share in a Boarding Home might be secured. If the state or if any private Agency or Foundation could provide the "plant," a suitable building and its repairs and fundamental expenses of upkeep, with one salaried superintendent whose character and ability could be guaranteed, the running expenses of a Boarding Home could be met easily by the limited means of many who now lack the security of an institutional provision and in consequence lack also many essentials of old-age comfort.

A skilled budget-maker could determine the numbers required in each household to make the board low and a sympathetic social worker could suggest the coöperative features of management most likely to give successful results in the composite home. The entrance age in such a Boarding Home could be lower than that required in the usual type of privately endowed Home for the Aged and thus a felt need be met for a suitable home for those between the ages of fifty-five and sixty-five. In these privately endowed Homes for the Aged the entrance fees range from $100 to $1,000, and beneficiaries are required to give up all the property of any kind of which they may be possessed when they enter this permanent residence. This is not unjust, but it is often an added trial to the independent nature. There is need of far larger provision for the old in Homes for Aged Men, Aged Women, and Aged Couples. No one can give anything but gratitude for the opportunities they now offer or fail to hope for their increase. There is, however, a special need for some social engineering which can initiate Boarding Homes for the Elderly. Many of these are still strong and well, but need special consideration in particular ways. Many others are not ill, but delicate, and in need not of full-time nursing care but of occasional good offices of trained helpers. One nurse, a "practical nurse" or a trained nurse past in age and strength full service of her profession, could easily give occasional service needed for twenty or more elderly persons in usual health or for ten or more aged, in greater need of care but not helpless, if all were under the same roof. The coöperative plans that often fail in serving the family of father, mother, and children, may be found exactly suited to special classes, and among them the aged. The Social Settlements were started to serve and have served the neighborhood needs of the poor and the immigrant. They have also, incidentally, demonstrated the financial advantages of coöperative housekeeping. A company of congenial people living together in groups of twenty to forty can secure the essentials of food, shelter, and necessary service at a cost per person far below the average expense for boarding or private housekeeping. This does not mean that families can combine easily in multiple households. The personal equation counts for its greatest influence in the real family group, of father, mother, and their children under eighteen years of age. Few, if any, schemes of coöperative housekeeping have as yet worked well for the combination of such groups.

The aged, especially the aged widow or widower, are not in the direct family group. They belong to but they are not inside the inmost circle. If one alone is left the life of the personal home is broken for the elderly, however dear and kind the children may be. For such there surely needs something easier than the attempt to maintain a separate home with half its life gone. And also something more independent and more secure than either enforced residence with children or compulsory use of the ordinary commercialized boarding house.

To Prevent Premature Old Age.—The second social demand, that premature old age shall be more effectively prevented, is one that is pressed upon this generation with new and imperative considerations. A knowledge of health conditions shows that although infant mortality is greatly lessened and infectious and epidemic diseases greatly brought under control, the diseases of middle age, such as hardening of arteries and kidney and digestive disorders, have increased relatively, while insanity is much more frequent than of old. These facts give us all deep concern. From the failure of health in middle life comes the premature senility and the invalid weakness of old age. The cause of the increase of middle-life diseases, relatively to those of other periods of life, seems to be principally the pressure of business and industrial life upon the worker. The high speed of machinery, the extreme competition in business, the monotony of the specialized manufacturing groups, the weight of great financial enterprises and the struggle to make the family setting equal to the family desires or even the family needs, all tend to make men in middle life fail so often in health and so often leave behind their better sheltered and more tenderly cared-for wives. There is a new movement of great social importance, and one tending directly toward the saving of one-half of the family circle, which is now taking a front place in social interest; namely, the movement for annual medical examinations. The work of the Life Extension Institute leads toward this end and seeks the better adjustment of life and work in the interest of simplicity and mutual service in the family and the better health of all its members.

It is not, however, in the power of the wisest and most unselfish of individuals to so manage the work-power as to insure against premature old age from too great speeding and overstrain. There must be social movement of the most thorough-going sort to prevent the waste of the laborers in all fields. Social workers should remember that it is not alone important to try to safeguard the health and strength of mothers and of potential mothers by laws protecting women and girls in industry. It is as vital a need to safeguard the health and strength and perpetuate the work-power of fathers and potential fathers in order that old age may be not a terror but a blessing to the family. This is emphasized by recent indications that the increase of the diseases of middle age is already checked and that we are gaining ground in this particular.

A recent report of the Federal Department of Commerce through the Bureau of Census shows that there has been a decline in the death-rate for all age periods during the last decade. In the rate for infants under one year of age a decline of twenty-six per cent., or from 13,804 per 100,000 in 1910 to 9,660 per 100,000 in 1920. The death-rate for middle-aged and old people shows an encouraging decrease, that of twelve per cent., in the period above seventy-five years of age. This shows that we are gaining on disease and premature death with every new advance in preventive medicine and the crusade against bad living conditions. This, again, means that in the future we shall have more aged persons in ratio of population than we have had in the past, and indicates the great need of taking measures betimes to make old age not only more mentally strong but more happy and comfortable in condition.