How did families manage dementia a hundred years ago?

We died young for the most part. It still happened, my grandmother died of it before I was born, not sure how they handled it.

But I think, really, this is a modern disease, we're so good at surviving heart attacks, diabetes and other diseases now that we live long enough to die of this one. And some of those things increase the likelihood of dementia in fact.

Right Beatty, and poor Charlie's mom took care of ALL of them!

Frances, your family reminded me of Charlie's family from Charlie and the Chocolate Factory? Remember them?

All four grandparents sharing a bed in the lounge room, all bed-bound. (Actually Grandpa Joe found he could walk).

I figure there weren’t many alternatives a hundred years ago, unless you had a lot of money and could hire full-time caregivers. Many of my ancestors lived into very old age. My grandmother said that both of her grandfathers lived when them, sharing a room until their deaths.

My grandfather had a severe stroke at 64 yrs. He was very cognately impaired and did not regain much. He lived to 84 yrs. He was left side paralyzed and had many other problems. He lived and worked on the farm until the last 18 months of his life. He couldn't use motorized equipment but was good keeping track of the cattle and managing the hay business. We all took care of him and helped him however we could. He went into a nursing home the last 18 months of his life and was very happy there. Another old farmer was his roommate. They enjoyed each others company and were favorites with the staff.

You know people didn't use to live nearly this long, as well. All of my grandparents but one were dead by the time I was old enough to know them at all. Died mostly in their early 60s, sometimes of things quite treatable for many years now such as CHF. Prior to WWII and antibiotics any simple infection was good enough to see someone elderly out (and elderly was about 60). Pneumonia then was called "The Old Person's Friend".

100 years ago the life expectancy in the USA was 46 for men and 48 for women.
Good possibility that "dementia" as we know it was not something they had to deal with.
If someone did live long enough to get "senile" the family would have kept them at home simply because mom was at home most of the kids were at home as well. And I am sure many did wander off and died of exposure. both summer and winter.

Wow, great question. I do think families (a village) took care of their own. Life was not as hectic and family was everything. Maybe that's not the answer you look for. But I want to tell you DO NOT FEEL GUILT about your situation. It will do nobody good if you have a mental or physical breakdown. Placing your parents is the ONLY thing you could do. I hope others can give more info about older generations & how they cared! Please be gentle with yourself.

Just thinking back within my own memory.. relatives with infections like UTI, blood infections, pnumonia, or cardio issues like stroke, heart attack, heart valve or pacemaker surgery. Or the 'begining of the end': a broken hip.

100 years ago, would any of them lived through their ailment or died of it?

The stark difference in my own family tree. From 10 children, women as homekeepers (& caregivers of all the children + elders) relatives all living close by or same town to today's families: less children, all women in paid work outside the home, families spread all over the country.

Diseases may be similar. But medicines & the social structure differ greatly.

There was the poor house and the asylum. Those things aren't ancient history either, my mom worked in the county home in the 50's and people who lived there were expected to work for their keep, that's where she learned to fear needing a nursing home.
I've heard stories of a neighbour that kept their mentally challenged auntie locked in an upstairs bedroom... for her own safety of course.
My grandfather had a stroke that led to a decade of ill health and "senility", my grandmother cared for him until he went to the hospital shortly before he died. We've come a long with with improvements in home care and medical equipment since the early 70's, she didn't even have access to disposable gloves and diapers were more apt to be cloth than disposable.


You mention an Amish/Mennonite background - very often the old folks were moved into the doddy house next door when the eldest son took over the farm, and it was his family that were expected to look after them. Of course since families were large and mostly lived near by there were many hands to call on if needed.
Oh, don't forget there was often that spinster auntie whose destiny seemed to be "family caregiver" in order to earn her keep.

There has always been some form of Nursing Home care. Had to be for those that did not have family but you probably did not live long i one. Before the 30s?, there was no Social Security. I don't think the first check was given out till 1940 or so and that was $25 I think. Medicaid did not come into the picture till 1965.

"Medicare & Medicaid: keeping us healthy for 50 years
On July 30, 1965, President Lyndon B. Johnson signed into law legislation that established the Medicare and Medicaid programs.Dec 1, 2021"

My great-grandfather and his daughter lived with my grandmother in 1958 when he died. My Aunt continued to live there until my grandfather retired at 65 and told her my Grandmother (age 62) could no longer care for her because she had health problems of her own and Aunt went to a nice NH. That was just about 1965.

100 years ago the family took relatives in. My one Aunts Mom came for a visit and never went home. Never met Mom because she stayed in upper level of the house but heard she was mean. Even if there were NHs, they were not the best unless u were rich. And as said, people that had health problems were not kept alive like now. Modern Medicine is keeping people alive longer. In 1966 my grandfather died at age 68 (1966)from a massive stroke caused by "hardening if the arteries" another name for High Cholesterol and plaque build up. No meds for Cholesterol back when his heart problems started.

My daughter says things will get worse now the Baby Boomers are coming of age. They also did not take care of themselves.

On my Dad's side of the family many ancestors lived into their 80's, 90's, and even one great-great-great aunt was 103. Those who lived the longest were farmers, who got exercise working the farm, eating organic, and had large families.

It wasn't unusual to see in the 1800's and early 1900's farm families with a lot of children, anywhere from 15-20 children. So when the grand-parent needed care, there were many hands to help. One thing interesting the children who later married and continue farming had 10-15 children. Those who moved to the big city had 1-4 children and passed much younger. Only a few Mom's died in or not long after child birth.

Only remember one great-grandfather being senile. Not sure if he really was as he would go for a walk around town [it was a Mayberry size town] and be gone for several hours. The family thought he was missing. I think he wanted to get away from the womenfolk and their constant chatter and probably stopped at a friend's house :)

One thing that but a hiccup in the longevity charts was the flu pandemic of 1918-1922.

People died a LOT younger in the older times than they do now, before dementia set in. And when dementia did set in, life went on and it was called 'hardening of the arteries' and other such things. How did families manage with 16 children when that was the 'norm'? They took care of one another, that's how.

Feeling 'guilty' for placing your parents in AL makes no sense. We should all be so fortunate to be able to afford AL if we need it in our old age. My parents AL was like a nice hotel and their apartment was an upscale unit with brand new and luxurious amenities. The gardens outside won awards every year, and so on and on. The entertainment was top notch, and the buffets the chef put on were wonderful too.

When my mother had to segue into the Memory Care bldg of the same AL, it too was an upscale bldg where she had a beautiful suite and caregivers looking after her 24/7. Did she want to be there? Nope, she wanted to be back in regular AL where she didn't have dementia and had a lot more going on, etc. But nobody wants to deal with a dementia diagnosis in the first place, so I think you should be grateful you were able to keep your folks TOGETHER in AL. That's the main thing at this stage of life: keeping them together and not having mom in AL and dad needing Skilled Nursing. So let's hope that doesn't turn out to be the case for them, b/c then you've got another whole mess on your hands to deal with.

I was the only child and had over 10 years of disease & dementia to deal with for both of my parents, so I know it's not easy. But we do what we can and hope for the best. Wishing you the best of luck.

@ Grandma,

Perhaps you need to read up a bit on modern medical care; asylums were not a dumping ground for the elderly. Asylums were filled with victims of other types of personal tragedies and family intolerances, old age not among them, except in rare instances where no family survived or abhorred the aged and that was very rare.
And people lived to their 80s - 90s as a matter of course, if they were strong enough the survive the many barriers to that survival, incl infections, etc.
And the median life expectancy does not factor in the survival of infants, it's a totally separate set of statistics. People were 'aged' in their 40s and 50s back in the Middle Ages when the life expectancy was around 30!
Indigenous cultures the world wide have always had greater longevity because of plant medicines, the use of which was crushed among Europeans over the course of 3 centuries and eventually came to US shores with white colonialism in what we refer to as the 'witch burnings.' Interesting how so many of our standard medicines come from plants?

You have not failed your parents, you placed them in a setting where they'll receive the 24/7 care that a cadre of staff members can provide; people who work their 8 or 12 hour shifts and manage their stress levels or leave healthcare altogether. We always have to chose our children over our elders, that is the natural order of things and you've made the best and only choice available to you. Please love your parents now as their daughter and not their 24/7 caregiver and focus on your family; it's what they would choose for you if still of sound mind.

We didn't used to have people living to such an old age with multiple health and cognitive issues because 'the wonders of modern medicine' didn't intervene in the life cycle of 'the fittest' as 'modern medicine' does now. We didn't have people with multiple serious health conditions surviving into these late years, they were taken mercifully by pneumonia, CHF, renal failure, diabetes, strokes, etc. and were not alive into old age to become a burden. If people weren't healthy, they didn't survive. Diet, lifestyle and that old happiness meter play a huge role in aging with vitality.

You can bet that old time country doctors provided many a family with an 'out' for the elders' families as a matter of course. In fact, Laudanum, aka opium, in the US, was legal to buy and self-dispense, without any central registry until close to 1918, as were a number of other elixirs made from now-illegal drugs.

Parkinson's and ALZ due to amyloids in the brain is a 'modern' cause of senility and the former has only been around since the advent of this industrial age, pointing to heavy metal toxicity as the cause. Just as we now have 1 in 44 US children on the Autism Spectrum as the proud leader of childhood vaccines (a relative rarity as recently as the '80s and spiked right in synch with upward vaccine trends). These are simple facts and I'm not here to debate any of it. It's just a fact that we are not as healthy as we used to be and yet, are living longer lives, although the male US life expectancy is in current decline.

Be glad that you decided on your kids, your own family and not the elder generation - you had to make that choice - and we must always turn toward our futures when given the choice.

I hope that you can recover your personal health - both mental and physical - and continue to be their loving daughter, overseeing their care and advocate strongly for them. Don't be surprised if their cognition dips for 3-5 months while they make the 'transition adjustment' to the new setting. The broken brain takes time to adjust and we can't blame ourselves for the lack of cognitive bandwidth in our beloved elders.

Wishing you and yours the best.

Thank you everyone, for your words of encouragement and thoughts on this. Personally, I'd much rather die earlier from pneumonia or something like that, then the slower than snail rate of decline I am seeing my parents go through. It is horrible.

My dad used to talk about the elders he’d known calling pneumonia “the old persons friend” It was long ago known as a common sickness in the elderly with little treatment and a not bad way to end life. Dementia was always around, and families certainly had to deal with it “in house” but without all the medical treatments it didn’t drag on so long

My great-grandmother was born in 1880 or so. When she was a young wife, her neighbor became sick and asked her if she would take care of him for the rest of his life, and she did. He had no wife or children. Their agreement was that she'd inherit everything he had, and she did. It was considerable.

@rancks10

In the time before antibiotics your father would have died from the UTI long before he became an invalid from dementia.

@Grandma

You are mistaken. People commonly think that people didn't live past the age of 45 or 50 in modern times. Maybe in medieval times they didn't, but in the 19th and 18th century they did.
I was recently in a colonial-era cemetary where most of the graves were from the late 1600's up to the early 1800's. Most of the people buried there who did not die in their early years (infancy, childhood, early adulthood) lived to be in their upper 70's and 80's. Most of the graves were people that were either very young, or quite old.
Mostly old people died of infections or illnesses like colds and flu.
Lots of people in the town died of a condition called the 'morbid sore throat'. It was a strep throat infection.

Up until the 1940s, people tended to have "A" single health crisis, decline fairly rapidly, then die. No, people didn't die at 45-50 (the average lifespan was low because of high infant mortality), but their heart issues, lung issues, and so forth took them out quickly.

As an example, my mother developed vascular dementia as a result of having pleural effusion when she was 85. Her rocket scientist of a GP 🙄 diagnosed her with depression for three weeks, so she likely had low oxygen levels that led to the micro-strokes that caused the dementia. The doctors treated her, drained fluid out of her lung area FIVE times, and she also developed congestive heart failure. Mentally, she was never the same.

The heart issues were controlled with medication from then on, and she lived another seven years, with her dementia becoming the primary issue that led to her being placed in a nursing home.

She should have died in 2014 when this all started, but thanks(?) to modern medicine, she got another seven years of a life of significantly lower quality.

A hundred years ago when people got dementia or as they called it back in the day 'senile' they died before it progressed to the point where they were total invalids that have to be diapered and spoon-fed.
There wasn't medical technology available that could keep a person alive in such a state for years and years like there is now. I think people with advanced dementia back then were better off because they weren't kept alive. The Mennonite/Amish community is a very different life than the outside world. Their communities work together. Their women don't work outside the home. There's no such thing as a single mother who has to work and bring up the kids. The providing is up to their men. So if a woman has a demented elder at home she isn't usually alone. The older female children help with the care. The woman with a demented elder in the house usually has multiple siblings too who help with the care. The women in the community do to. That's how they cope. You didn't grow up Mennonite/Amish. These people's lives are hard. Their lives are simple, but hard. They work sun up to sun down six days a week. Their women - seven days a week.
You did not fail your parents. You made the right decision putting your parents into AL. Your family at home needs you and they have to come first.
Ask yourself. Would it have been fair to your children to have their home turned into a nursing home?
Or to watch their mother so broken down by the miserable drudgery of caring for two demented, incontinent invalids that they grow up with a burned-out nurse instead of a mom?
You did the right thing placing them and your kids will thank you for it.

You didn’t fail your parents! Quite the opposite. You made sure they got the help and care they need. You would have failed them if you kept trying to do alone.

If polio, tetanus, whooping cough, pneumonia or measles didn't get you in childhood--then you might have made it to 80. That would have been unusual. Then came High Blood Pressure, strokes and heart attacks. My maternal grandfather died at age 63 from a stroke. High blood pressure and no treatment for it. I thought he was ancient, but I am 66 and now fully aware that 66 is NOT ancient.

I do the genealogy for my family and am surprised at the fact that one family had 10 children and all but 1 (she died in childbirth) lived well into their 90's and one great uncle made it to 100.

On my DH's side, sadly, there were 9 or 10 babies born and only 3 or 4 would live past their first birthdays.

Comparing 100 yrs ago to now is like comparing apples and oranges. You were either blessed with a good constitution or you didn't live long.

I never saw a single family member go into 'care'. The families just rallied round them and worked it out. There is no mention in diaries or such of any resentment about this--just a fact of life. I'm sure it existed, but I haven't read anything (in my background) to indicate it was anything other than normal to care for your folks or relatives who grew old and needed care.

with difficulty

Life was extremely different 100 years ago. You can't compare what was to what is.

You are doing the best you can to ensure that everyone is getting the best care possible and that is the only thing anyone can do.

Placing a parent, IMO, is the hardest decision we will ever make. You are doing great, cut yourself some slack and know that their care now needs a village. You got them that village, well done!

Now you get to be an advocate and a daughter that isn't on the verge of a breakdown because it is all to much for 1 person.

Many people did not live past 45, 50 years of age so dementia was not seen the way we see it now.
People often died of conditions that are very much preventable or curable now. From infections to high blood pressure, child birth and even a cold or flu.
As people lived longer there are more mentions of "senility" and they have the hallmarks or one form of dementia or another.
And sadly there are / were the "insane asylums" and the "nursing homes" that people still think of today that housed many people in wheelchairs lined up in a hall.

I hadn't thought of the antibiotics issue --- dad has had several serious UTI's over the last couple of years. In a way, this would have been a blessing --- my dad's situation right now is heartbreaking and I can't bear to see him go through stage 7 dementia.

They didn’t have the antibiotics that we have. Pneumonia would have taken out the older person.

Same with heart medication.

Blood pressure meds. Same.

I think that this accounts for a lot of the reason that we are even seeing many dementias now.