Commercial nursing and boarding homes in Philadelphia.

PHILADELPHIA faces a problem with serious implications for the health and welfare of its citizens in the lack of adequate facilities to care for chronically ill persons and for persons who are unable to assume the responsibilities of living alone and do not have relatives or friends willing or able to undertake responsibility for their care. This problem is not restricted to the indigent but touches all but the highest economic level, at which families can afford to care for the ill, feeble, or handicapped person in his own home or in expensive institutions. The group most seriously affected , however, comprises recipients of public and private aid and persons living on a marginal income level, at which any adverse circumstance may necessitate dependence on public assistance. There are chronically ill persons in every age group, but by far the majority are concentrated in the upper age brackets. In 1940, 7 percent of the city's population were in the ages 65 years or over, and the proportion is showing a steady upward trend. Moreover, the present lack of facilities for caring for nonacute illnesses of younger persons is developing an increasingly larger group of chronically ill in the older age levels. More than 90 percent of the public assistance recipients in commercial nursing homes are over 65 years. Thus, while the problem of caring for the chronically ill must be closely, but not exclusively, identified with care of older persons, constructive emphasis must be laid simultaneously on prevention of chronic illness by early diagnosis, treatment, and adequate care. Nonprofit institutions care for only a small fraction of the aged population , because of the scarcity of such institutions and their restrictions on admission. Some of these homes operate on a contractual basis that automatically excludes recipients of public assistance. Many are limited with respect to church affiliation or race. Few will accept nonambulatory persons or persons with chronic or progressive ailments. Philadelphia has only 4 nonprofit institutions for the chronically ill, with a bed capacity of about 500. Practically no hospital accommodations exist for the chronically ill of any age group. The few available facilities are limited to caring for persons suffering from particular diseases, such as rheumatic fever, cancer, and so on. The shortage of nonprofit homes forces persons in need of sheltered care into commercially operated nursing or boarding homes. The distinction between these two types of homes …