Which had a major influence in shifting the care of older adults away from almshouses and public institutions and stimulated the growth of commercial nursing homes?
a. Medicare
b. Social Security Act
c. Hartford Institute for Geriatric Nursing
d. Health maintenance organizations (HMOs)
B
With the passage of the Social Security Act of 1935, federal monies were provided for "old-age" insurance and public assistance for needy older people not covered by insurance. To combat the fear of almshouse placement, Congress stipulated that the Social Security funds could not be used to pay for care in almshouses or other public institutions. This move is thought to have been the genesis of commercial nursing homes. During the next 10 years, many almshouses closed, and the number of private boarding homes providing care to older adults increased. Because retired and widowed nurses often converted their homes into such living quarters and gave care when their boarders became ill, they can be considered the first geriatric nurses and their homes to be the first nursing homes. The Hartford Institute has sponsored significant improvements in gerontological nursing practice, research, and education. HMOs have had a significant impact on the management of care but were virtually nonexistent in the 1930s and 1940s.
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