America Had Almost No Nursing Homes Until 1965 — Who Took Care of Grandma?

America Had Almost No Nursing Homes Until 1965 — Who Took Care of Grandma? There is something that may actually surprise you. Until 1965, America had almost no nursing homes. No Medicare, no Medicaid, no specialized facilities for the elderly, not a single federal dollar flowing into a long-term care system, not a single federal standard defining who received care and how that care was delivered. Tens of millions of Americans still grew old, still grew frail, still needed someone to cook every meal, change every set of clothes, steady every step, and still spent the last years of their lives somewhere, under someone’s care, for nearly two centuries. Who took care of your grandmother before nursing homes existed? And perhaps more important, what happened in 1965 that made an entire industry worth hundreds of billions of dollars spring up almost overnight, changing forever the way America treats its old people? The answers to those questions take us deep into a story about poorhouses where the elderly lay beside people labeled insane and orphaned children, about a paradoxical law written to free the old that accidentally created a billion-dollar market, about a massive federal money stream that turned nursing homes into a printing press for private corporations, and about the sharp tension between a society growing older and a care system collapsing right in front of us. Because this is what most people do not realize.