Some years ago, walking through an unfamiliar section of Victoria, British Columbia, I took an illicit shortcut and found myself at the entrance to the nursing home where my grandmother spent the final months of her life. In an instant I was twelve years old again, submerged in my grandfather’s grief, horrified by the flimsy curtains meant to offer patients a measure of privacy, and sickened by the smell of stale urine. I had visited the place only once, yet the experience was indelibly etched on my emotional map.

I am not alone in this response to institutions for the...

The struggle for self is a primal drama of old age. In our youth we quest to gain power, we bargain and fight to define who we are. In our middle years we seek to find ourselves in work and in the emotional worlds of partnership and parenting. In the last decades we no longer quest, but hold tight to personal autonomy garnered over the span of a lifetime. The diminution of the self, and the passage into the house of old, takes many shapes. It can be swift: a broken hip, a severe stroke, the death of a spouse....

Institutions are curious, chameleon-like creatures, taking on new roles unthought of when the cornerstones were first laid, or emerging from obscurity as need arises. They can be a symbol of public pride one decade, the focus of incensed newspaper editorials the next, or ignored by all but a handful of government inspectors for their entire existence. The history of old age homes in British Columbia underscores the fact that the old age home, like most other institutions, is an evolving narrative, a story with a shifting plot.¹ Moreover, the elderly also found shelter in other institutional settings – the general hospital,...

Pushed by public pressure and new professional concerns, efforts were made throughout the 1940s and 1950s to sever the historical link between the workhouse and the old age home and to reshape residential accommodation for the aged into middle-class medical institutions. The growth of interest in old age and concerns about institutional provision for the infirm and indigent elderly followed a similar pattern in Canada, the United States, Britain, and Australia.¹ Public geriatric institutions were scorned for being too regimented, for having a “prison-like atmosphere,” and for being irrelevant reminders of the antiquated Poor Law in the modern welfare state.²...

Entering an old age home is a transitional moment in the life cycle, but has none of the positive possibilities of other rites of passage like marriage, giving birth, or receiving your first pay packet. What kind of institutional world awaited those who became residents of the old age home through the period of this study? And what meaning did the institutional community take within the hearts and minds of its residents? Reactions to the institutional experience were, of course, highly individualized. For some, especially single working-class men, elements of institutional life echoed previous experiences in boarding homes and logging...

“Care in the community” and “sheltered accommodation” are the buzzwords of geriatric care at the turn of the twenty-first century.¹ In British Columbia and elsewhere across Canada, innovative community programs have given people unprecedented opportunities to remain in their own homes as they grow older and infirm.² Regardless of which place on the political spectrum they come from, both current professional thinking and state policy are strongly supportive of old people remaining outside the old age home.

Those who formulate and implement community living programs tend to present their work as modern and unprecedented. Today’s gerontologists, however, should conceptualize these...

Our understanding of the development of the old age home in Canada must take into account the historical moment at which the institution came into being in different regions of the country. Institutions, odd and metamorphic creatures that they are, bear forever the stamp of the era in which they were constructed and the purpose for which they were created. The old age home in British Columbia stands apart from patterns of institutional evolution in other parts of Canada. The pace of non-aboriginal settlement was different in the west, where residential facilities for the elderly were established later than in...