Beyond Activities – The Changing
Face of Life in Residential Care
Part 1
– From Custodial Care to Nursing Homes A Historical Glimpse of Care for Older Adults
The story of residential care begins long before the term nursing home existed.
In the 19th and early 20th centuries, many older adults who could no longer live independently were placed in workhouses.
These institutions offered basic shelter and safety but were primarily designed for poverty relief, not wellbeing. Residents lived under strict routines, with limited privacy or personal choice. The emphasis was on maintenance and order, reflecting the belief that ageing was a period of decline rather than continued participation in life.
The Shift Toward Medical Care By the mid-20th century, the development of nursing homes marked a move away from custodial care toward a more medical model. These settings provided much-needed professional attention for physical health and safety. However, daily life often resembled hospital routines — regimented, clinical, and impersonal. Older adults were seen mainly as patients, with care focused on physical needs rather than emotional or social wellbeing.
Although standards of cleanliness and medical care improved, individuality and autonomy remained limited. Daily Life Behind Closed Doors For many residents, life was safe but monotonous. Personal items were minimal, shared spaces were uniform, and decision-making was rarely encouraged.
Social life depended largely on visitors or organised religious observances. The prevailing belief was that older people needed care and protection, not engagement or stimulation. It would take several more decades before this perception began to shift — and with it, the birth of 'activities' as part of everyday care.
Looking Ahead Part 2 of this mini-series will explore how the idea of activities and recreation first entered residential care — and how it transformed the concept of ageing from passive care to active living.
All the best,
Liz
– From Custodial Care to Nursing Homes A Historical Glimpse of Care for Older Adults
The story of residential care begins long before the term nursing home existed.
In the 19th and early 20th centuries, many older adults who could no longer live independently were placed in workhouses.
These institutions offered basic shelter and safety but were primarily designed for poverty relief, not wellbeing. Residents lived under strict routines, with limited privacy or personal choice. The emphasis was on maintenance and order, reflecting the belief that ageing was a period of decline rather than continued participation in life.
The Shift Toward Medical Care By the mid-20th century, the development of nursing homes marked a move away from custodial care toward a more medical model. These settings provided much-needed professional attention for physical health and safety. However, daily life often resembled hospital routines — regimented, clinical, and impersonal. Older adults were seen mainly as patients, with care focused on physical needs rather than emotional or social wellbeing.
Although standards of cleanliness and medical care improved, individuality and autonomy remained limited. Daily Life Behind Closed Doors For many residents, life was safe but monotonous. Personal items were minimal, shared spaces were uniform, and decision-making was rarely encouraged.
Social life depended largely on visitors or organised religious observances. The prevailing belief was that older people needed care and protection, not engagement or stimulation. It would take several more decades before this perception began to shift — and with it, the birth of 'activities' as part of everyday care.
Looking Ahead Part 2 of this mini-series will explore how the idea of activities and recreation first entered residential care — and how it transformed the concept of ageing from passive care to active living.
All the best,
Liz
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