Social Security (United States)
In the United States, Social Security is the used term for the federal Old-Age and Disability Insurance program and is administered by the Social Security Administration. The original Social Security Act was signed into law by President Franklin D. Roosevelt in 1935, the current version of the Act, as amended, encompasses several social welfare and social insurance programs. Social Security is funded through payroll taxes called Federal Insurance Contributions Act tax or Self Employed Contributions Act Tax. Tax deposits are collected by the Internal Revenue Service and are formally entrusted to the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund, the two Social Security Trust Funds. With a few exceptions, all salaried income, up to an amount determined by law, is subject to the Social Security payroll tax. All income over said. In 2018, the maximum amount of taxable earnings was $128,400. With few exceptions, all legal residents working in the United States now have an individual Social Security number.
Indeed, nearly all working residents since Social Security's 1935 inception have had a Social Security number because it is requested by a wide range of businesses. In 2017, Social Security expenditures totaled $806.7 billion for OASDI and $145.8 billion for DI. Income derived from Social Security is estimated to have reduced the poverty rate for Americans age 65 or older from about 40% to below 10%. In 2018, the trustees of the Social Security Trust Fund reported that the program will become financially insolvent in the year 2034 unless corrective action is enacted by Congress. Social Security Timeline 1935 The 37-page Social Security Act signed August 14 by President Franklin D. Roosevelt. Retirement benefits only to worker, welfare benefits started 1937 First Social Security Cards issued by post offices, over 20 million issued in first year 1937 Ernest Ackerman receives first lump-sum payout in January. 1939 Two new categories of beneficiaries added: spouse and minor children of a retired worker 1940 First monthly benefit check issued to Ida May Fuller for $22.54 1950 Benefits increased and cost of living adjustments made at irregular intervals – 77% COLA in 1950 1954 Disability program added to Social Security 1960 Flemming v. Nestor.
Landmark U. S. Supreme Court ruling that gave Congress the power to revise the schedule of benefits; the Court ruled that recipients have no contractual right to receive payments. 1961 Early retirement age lowered to age 62 at reduced benefits 1965 Medicare health care benefits added to Social security – 20 million joined in three years 1966 Medicare tax of 0.7% added to pay for increased Medicare expenses 1972 Supplemental Security Income program federalized and assigned to Social Security Administration 1975 Automatic cost of living adjustments mandated 1977 COLA adjustments brought back to "sustainable" levels 1980 Amendments are made in disability program to help solve some problems of fraud 1983 Taxation of Social Security benefits introduced, new federal hires required to be under Social Security, retirement age increased for younger workers to 66 and 67 years 1984 Congress passed the Disability Benefits Reform Act modifying several aspects of the disability program 1996 Drug addiction or alcoholism disability benefits could no longer be eligible for disability benefits.
The Earnings limit doubled exemption amount for retired Social Security beneficiaries. Terminated SSI eligibility for most non-citizens 1997 The law requires the establishment of federal standards for state-issued birth certificates and requires SSA to develop a prototype counterfeit-resistant Social Security card – still being worked on. 1997 Temporary Assistance for Needy Families, replaces Aid to Families with Dependent Children program placed under SSA 1997 State Children's Health Insurance Program for low income citizens – added to Social Security Administration 2003 Voluntary drug benefits with supplemental Medicare insurance payments from recipients added 2009 No Social Security Benefits for Prisoners Act of 2009 signed. A limited form of the Social Security program began, during President Franklin D. Roosevelt's first term, as a measure to implement "social insurance" during the Great Depression of the 1930s; the Act was an attempt to limit unforeseen and unprepared-for dangers in modern life, including old age, poverty and the burdens of widows with and without children.
Opponents, decried the proposal as socialism. In a Senate Finance Committee hearing, Senator Thomas Gore asked Secretary of Labor Frances Perkins, "Isn't this socialism?" She said that it was not, but he continued, "Isn't this a teeny-weeny bit of socialism?"The provisions of Social Security have been changing since the 1930s, shifting in response to economic worries as well as coverage for the poor, dependent children, spouses and the disabled. By 1950, debates moved away from which occupational groups should be included to get enough taxpayers to fund Social Security to how to provide more benefits. Changes in Social Security have reflected a balance between promoting "equality" and efforts to provide "adequate" and affordable protection for low wage workers; the larger and better known programs under the Social Security Administration, SSA, are: Federal Old-Age and Disability Insurance, OASDI Temporary Assistance for Needy Families, TANF Health Insurance for Aged and Disabled, Medicare Grants to States for Medical Assistance Programs for low income citizens, Medicaid State Children's Health Insurance Program for low income citizens, SCHIP Supplement
Power of attorney
A power of attorney or letter of attorney is a written authorization to represent or act on another's behalf in private affairs, business, or some other legal matter. The person authorizing the other to act is grantor, or donor; the one authorized to act is the agent, or in the attorney-in-fact. The term "power" referred to an instrument signed under seal while a "letter" was an instrument under hand, meaning that it was signed by the parties, but today a power of attorney does not need to be signed under seal; some jurisdictions require that powers of attorney be notarized or witnessed, but others will enforce a power of attorney as long as it is signed by the grantor. The term attorney-in-fact is used in many jurisdictions instead of the term agent; that term should be distinguished from the term attorney-at-law. In the United States, an attorney-at-law is a solicitor, licensed to be an advocate in a particular jurisdiction. An attorney-in-fact may be a layperson and is authorized to act pursuant to the powers granted by a power of attorney but may not engage in acts that would constitute the unauthorized practice of law.
In the context of the unincorporated reciprocal inter-insurance exchange the attorney-in-fact is a stakeholder/trustee who takes custody of the subscriber funds placed on deposit with him, uses those funds to pay insurance claims. When all the claims are paid, the attorney-in-fact returns the leftover funds to the subscribers; the Uniform Power of Attorney Act employs the term agent. As an agent, an attorney-in-fact is a fiduciary for the principal, so the law requires an attorney-in-fact to be honest with and loyal to the principal in their dealings with each other. Care must be taken when selecting an attorney-in-fact, as some attorneys-in-fact have used their authority to steal the assets of vulnerable individuals such as the elderly; the person who creates a power of attorney, known as the grantor, can only do so when he/she has the requisite mental capacity. Suppose the grantor loses the capacity to grant permission after the power of attorney has been created. In some powers of attorney the grantor states that he/she wishes the document to remain in effect after he/she becomes incapacitated.
This type of power is referred to as a durable power of attorney. If someone is incapacitated, it is not possible for that person to execute a valid power, although in some jurisdictions, it may be possible for someone to have the capacity to execute a power of attorney if they do not have the capacity to make the decisions that they are delegating. If a person does not have the capacity to execute a power of attorney the only way for another party to act on their behalf is to have a court impose a conservatorship or a guardianship. Depending on the jurisdiction, a power of attorney may be oral and, whether witnessed, will hold up in court, the same as if it were in writing. For some purposes, the law requires a power of attorney to be in writing. Many institutions, such as hospitals, banks and, in the United States, the Internal Revenue Service, require a power of attorney to be in writing before they will honor it, they will keep a duplicate original or a copy for their records. Nursing homes follow the same practice.
The equal dignity rule is a principle of law that requires an authorization for someone performing certain acts for another person to have been appointed with the same formality as required for the act the representative is going to perform. This means, for example, that if a principal authorizes someone to sell the principal's house or other real property, the law requires a contract for the sale of real property to be in writing the authorization for the other person to sign the sales contract and deed must be in writing too. In common-law jurisdictions other than the U. S. a power of an attorney to execute a deed must be itself executed as a deed. In order for a power of attorney to become a enforceable document, at a minimum it must be signed and dated by the principal; some jurisdictions require that a power of attorney be witnessed, notarized, or both. When not required, having the document reviewed and signed by a notary public may increase the likelihood of withstanding a legal challenge.
If the attorney-in-fact is being paid to act on behalf of the principal, a contract for payment may be separate from the document granting power of attorney. If that separate contract is in writing, as a separate document it may be kept private between the principal and agent when the power of attorney is presented to others for the purposes of carrying out the agent's duties. A power of attorney may be: special, temporary. A special power of attorney is one, limited to a specified act or type of act. A general power of attorney is one that allows the agent to make all personal and business decisions A temporary power of attorney is one with a limited time frame. If required, a durable power of attorney can be revoked or changed as long as the principal is still mentally competent to act. Under the common law, a power of attorney becomes ineffective if its grantor dies or becomes "incapacitated," meaning unable to grant such a power, because of physical injury or mental illness, for example, unless the grantor specifies that the power
A fiduciary is a person who holds a legal or ethical relationship of trust with one or more other parties. A fiduciary prudently takes care of money or other assets for another person. One party, for example, a corporate trust company or the trust department of a bank, acts in a fiduciary capacity to another party, for example, has entrusted funds to the fiduciary for safekeeping or investment. Asset managers, including managers of pension plans and other tax-exempt assets, are considered fiduciaries under applicable statutes and laws. In a fiduciary relationship, one person, in a position of vulnerability, justifiably vests confidence, good faith and trust in another whose aid, advice, or protection is sought in some matter. In such a relation good conscience requires the fiduciary to act at all times for the sole benefit and interest of the one who trusts. A fiduciary is someone who has undertaken to act for and on behalf of another in a particular matter in circumstances which give rise to a relationship of trust and confidence.
Fiduciary duties in a financial sense exist to ensure that those who manage other people’s money act in their beneficiaries' interests, rather than serving their own interests. The Fiduciary Duty in the 21st Century programme finds that, "far from being a barrier, there are positive duties to integrate environmental and governance factors in investment processes." The programme concludes that “integrating ESG issues into investment research and processes will enable investors to make better investment decisions and improve investment performance consistent with their fiduciary duties.” See section'fiduciary duty and pension governance'. A fiduciary duty is the highest standard of care in law. A fiduciary is expected to be loyal to the person to whom he owes the duty such that there must be no conflict of duty between fiduciary and principal, the fiduciary must not profit from his position as a fiduciary; the nature of fiduciary obligations differs among jurisdictions. In Australia, only proscriptive or negative fiduciary obligations are recognised, whereas in Canada fiduciaries can come under both proscriptive and prescriptive fiduciary obligations.
In English common law, the fiduciary relation is an important concept within a part of the legal system known as equity. In the United Kingdom, the Judicature Acts merged the courts of equity with the courts of common law, as a result the concept of fiduciary duty became applicable in common law courts; when a fiduciary duty is imposed, equity requires a different, stricter standard of behavior than the comparable tortious duty of care in common law. The fiduciary has a duty not to be in a situation where personal interests and fiduciary duty conflict, not to be in a situation where his fiduciary duty conflicts with another fiduciary duty, a duty not to profit from his fiduciary position without knowledge and consent. A fiduciary ideally would not have a conflict of interest, it has been said that fiduciaries must conduct themselves "at a level higher than that trodden by the crowd" and that "he distinguishing or overriding duty of a fiduciary is the obligation of undivided loyalty". Different jurisdictions regard fiduciary duties in different lights.
Canadian law, for example, has developed a more expansive view of fiduciary obligation than American law, while Australian law and British law have developed more conservative approaches than either the United States or Canada. In Australia, it has been found that there is no comprehensive list of criteria by which to establish a fiduciary relationship. Courts have so far refused to define the concept of a fiduciary, instead preferring to develop the law on a case-by-case basis and by way of analogy. Fiduciary relationships are of different types and carry different obligations so that a test appropriate to determine whether a fiduciary relationship exists for one purpose might be inappropriate for another:In 2014 the Law Commission reviewed the fiduciary duties of investment intermediaries, looking at the duties on pension trustees, they commented. Fiduciary duties cannot be understood in isolation. Instead they are better viewed as ‘legal polyfilla’, molding themselves flexibly around other legal structures, sometimes filling the gaps.
The question of, a fiduciary is a "notoriously intractable" question and this was the first of many questions. In SEC v. Chenery Corporation, Frankfurter J said, The law expressed here follows the general body of elementary fiduciary law found in most common law jurisdictions; this is true in the area of Labor and Employment law. In Canada a fiduciary has obligations to the employer after the employment relationship is terminated, whereas in the United States the employment and fiduciary relationships terminate together; the corporate law of Delaware is the most influential in the United States, as more than 50% of publicly traded companies in the United States, including 64% of the Fortune 500, have chosen to incorporate in that State. Under Delaware law, officers and other control persons of corporations and other entities owe three primary fiduciary duties, the duty of care, the duty of loyalty and the duty of good faith; the duty of care requires control persons to act on an informed basis after due consideration of all information.
The duty includes a requirement that such persons reasonably inform
Elder abuse is "a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person." This definition has been adopted by the World Health Organization from a definition put forward by Action on Elder Abuse in the UK. Laws protecting the elderly from abuse are similar to and related to, laws protecting dependent adults from abuse, it includes harms by people the older person knows, or has a relationship with, such as a spouse, partner, or family member. Many forms of elder abuse are recognized as types of domestic violence or family violence since they are committed by family members. Paid caregivers have been known to prey on their elderly patients. While a variety of circumstances are considered elder abuse, it does not include general criminal activity against older persons, such as home break-ins, "muggings" in the street, or "distraction burglary", where a stranger distracts an older person at the doorstep while another person enters the property to steal.
The abuse of elders by caregivers is a worldwide issue. In 2002, WHO brought international attention to the issue of elder abuse. Over the years, government agencies and community professional groups, have specified elder abuse as a social problem. In 2006 the International Network for Prevention of Elder Abuse designated June 15 as World Elder Abuse Awareness Day, an increasing number of events are held across the globe on this day to raise awareness of elder abuse and highlight ways to challenge such abuse. Although elders who have dementia or mental illness make false accusations of theft and other forms of abuse by caregivers or family members, all reports of abuse must be investigated. Although there are common themes of elder abuse across nations, there are unique manifestations based upon history, economic strength, societal perceptions of older people within nations themselves; the fundamental common denominator is the use of power and control by one individual to affect the well-being and status of another, individual.
There are several types of abuse of older people that are recognized as being elder abuse, including: Physical: e.g. hitting, slapping, pushing, restraining, false imprisonment/confinement, or giving excessive or improper medication as well as withholding treatment and medication. Psychological/Emotional: e.g. humiliating a person. A common theme is a perpetrator who identifies something that matters to an older person and uses it to coerce an older person into a particular action, it may take verbal forms such as yelling, name-calling, ridiculing criticizing, blaming, or nonverbal forms such as ignoring, shunning or withdrawing affection. Elder financial abuse: known as financial exploitation, involving misappropriation of financial resources by family members, caregivers, or strangers, or the use of financial means to control the person or facilitate other types of abuse. Failure to pay financial support to impoverished elders in jurisdictions which have filial responsibility laws, such as France and most of the United States.
Sexual: e.g. forcing a person to take part in any sexual activity without his or her consent, including forcing them to participate in conversations of a sexual nature against their will. Neglect: e.g. depriving a person of proper medical treatment, heat, clothing or comfort or essential medication and depriving a person of needed services to force certain kinds of actions and otherwise. Neglect can include leaving an at-risk elder person unattended; the deprivation may happen out of lack of knowledge or resources. In addition, some U. S. state laws recognize the following as elder abuse: Abandonment: deserting a dependent person with the intent to abandon them or leave them unattended at a place for such a time period as may be to endanger their health or welfare. Rights abuse: denying the civil and constitutional rights of a person, old, but not declared by court to be mentally incapacitated; this is an aspect of elder abuse, being recognized and adopted by nations. Self-neglect: any persons neglecting themselves by not caring about their own health, well-being or safety.
Self-neglect is treated as conceptually different than abuse. Elder self-neglect can lead to illness, injury, or death. Common needs that older adults may deny themselves, or ignore are the following: Sustenance. Self-neglect is created by an individual's declining mental awareness or capability; some older adults may choose to deny themselves some health or safety benefits, which may not be self-neglect. This may be their personal choice. Caregivers and other responsible individuals must honor these choices if the older adult is sound of mind. In other instances, the older adult may lack the needed resources, as a result of poverty, or other social condition; this is not considered as "self-neglect". Institutional abuse refers to physical or psychological harms, as well as rights violations in settings where care and assist
A tax is a mandatory financial charge or some other type of levy imposed upon a taxpayer by a governmental organization in order to fund various public expenditures. A failure to pay, along with resistance to taxation, is punishable by law. Taxes may be paid in money or as its labour equivalent. Most countries have a tax system in place to pay for public, common or agreed national needs and government functions; some levy a flat percentage rate of taxation on personal annual income, but most scale taxes based on annual income amounts. Most countries charge a tax both on corporate income and dividends. Countries or subunits also impose wealth taxes, property taxes, sales taxes, value-added taxes, payroll taxes or tarrifs; the legal definition, the economic definition of taxes differ in some ways such as economists do not regard many transfers to governments as taxes. For example, some transfers to the public sector are comparable to prices. Examples include, tuition at public universities, fees for utilities provided by local governments.
Governments obtain resources by "creating" money and coins, through voluntary gifts, by imposing penalties, by borrowing, by confiscating wealth. From the view of economists, a tax is a non-penal, yet compulsory transfer of resources from the private to the public sector, levied on a basis of predetermined criteria and without reference to specific benefit received. In modern taxation systems, governments levy taxes in money; the method of taxation and the government expenditure of taxes raised is highly debated in politics and economics. Tax collection is performed by a government agency such as the Ghana Revenue Authority, Canada Revenue Agency, the Internal Revenue Service in the United States, Her Majesty's Revenue and Customs in the United Kingdom or Federal Tax Service in Russia; when taxes are not paid, the state may impose civil penalties or criminal penalties on the non-paying entity or individual. The levying of taxes aims to raise revenue to fund governing or to alter prices in order to affect demand.
States and their functional equivalents throughout history have used money provided by taxation to carry out many functions. Some of these include expenditures on economic infrastructure, scientific research and the arts, public works, data collection and dissemination, public insurance, the operation of government itself. A government's ability to raise taxes is called its fiscal capacity; when expenditures exceed tax revenue, a government accumulates debt. A portion of taxes may be used to service past debts. Governments use taxes to fund welfare and public services; these services can include education systems, pensions for the elderly, unemployment benefits, public transportation. Energy and waste management systems are common public utilities. According to the proponents of the chartalist theory of money creation, taxes are not needed for government revenue, as long as the government in question is able to issue fiat money. According to this view, the purpose of taxation is to maintain the stability of the currency, express public policy regarding the distribution of wealth, subsidizing certain industries or population groups or isolating the costs of certain benefits, such as highways or social security.
Effects can be divided in two fundamental categories: Taxes cause an income effect because they reduce purchasing power to taxpayers. Taxes cause a substitution effect when taxation causes a substitution between taxed goods and untaxed goods. If we consider, for instance, two normal goods, x and y, whose prices are px and py and an individual budget constraint given by the equation xpx + ypy = Y, where Y is the income, the slope of the budget constraint, in a graph where is represented good x on the vertical axis and good y on the horizontal axes, is equal to -py/px; the initial equilibrium is in the point, in which budget constraint and indifference curve are tangent, introducing an ad valorem tax on the y good, the budget constraint's slope becomes equal to -py/px. The new equilibrium is now in the tangent point with a lower indifferent curve; as can be noticed the tax's introduction causes two consequences: It changes the consumers' real income It raises the relative price of y good. The income effect shows the variation of y good quantity given by the change of real income.
The substitution effect shows the variation of y good determined by relative prices' variation. This kind of taxation can be considered distortionary. Another example can be the Introduction of an income lump-sum tax, with a parallel shift downward of the budget constraint, can be produced a higher revenue with the same loss of consumers' utility compared with the property tax case, from another point of view, the same revenue can be produced with a lower utility sacrifice; the lower utility or the lower revenue given by a distortionary tax are called excess pressure. The same result, reached with an income lump-sum tax, can be obtained with these following types of taxes (all of them cause only a budget constraint's shift without causi
In regulatory jurisdictions that provide for it, consumer protection is a group of laws and organizations designed to ensure the rights of consumers as well as fair trade and accurate information in the marketplace. The laws are designed to prevent the businesses that engage in fraud or specified unfair practices from gaining an advantage over competitors, they may provide additional protection for those most vulnerable in society. Consumer protection laws are a form of government regulation that aim to protect the rights of consumers. For example, a government may require businesses to disclose detailed information about products—particularly in areas where safety or public health is an issue, such as food. Consumer protection is linked to the idea of consumer rights and to the formation of consumer organizations, which help consumers make better choices in the marketplace and get help with consumer complaints. Other organizations that promote consumer protection include government organizations and self-regulating business organizations such as consumer protection agencies and organizations, the Federal Trade Commission in America and Better Business Bureaus in America and Canada, etc.
A consumer is defined as someone who acquires goods or services for direct use or ownership rather than for resale or use in production and manufacturing. Consumer interests can be protected by promoting competition in the markets which directly and indirectly serve consumers, consistent with economic efficiency, but this topic is treated in competition law. Consumer protection can be asserted via non-government organizations and individuals as consumer activism. Consumer protection law or consumer law is considered as an area of law that regulates private law relationships between individual consumers and the businesses that sell those goods and services. Consumer protection covers a wide range of topics, including but not limited to product liability, privacy rights, unfair business practices, misrepresentation, other consumer/business interactions. It's a way of preventing frauds and scams from service and sales contracts, eligible fraud, bill collector regulation, utility turnoffs, personal loans that may lead to bankruptcy.
The following lists consumer legislation at the nation-state level. In the EU member states Germany and the United Kingdom there is the applicability of law at the EU level to be considered. In Australia, the corresponding agency is the Australian Competition and Consumer Commission or the individual State Consumer Affairs agencies; the Australian Securities and Investments Commission has responsibility for consumer protection regulation of financial services and products. However, in practice, it does so through run EDR schemes such as the Financial Ombudsman Service. In Brazil, consumer protection is regulated by the Consumer's Defense Code, as mandated by the 1988 Constitution of Brazil. Germany, as a member state of the European Union, is bound by the consumer protection directives of the European Union. A minister of the federal cabinet is responsible for protection. In the current cabinet of Angela Merkel, this is Katarina Barley; when issuing public warnings about products and services, the issuing authority has to take into account that this affects the supplier's constitutionally protected economic liberty, see Bundesverwaltungsgericht Case 3 C 34.84, 71 BVerwGE 183).
In India, consumer protection is specified in The Consumer Protection Act, 1986. Under this law, Separate Consumer Dispute Redress Forums have been set up throughout India in each and every district in which a consumer can file his complaint on a simple paper with nominal court fees and his complaint will be decided by the Presiding Officer of the District Level; the complaint can be filed by both the consumer of a goods as well as of the services. An appeal could be filed to the State Consumer Disputes Redress Commissions and after that to the National Consumer Disputes Redressal Commission; the procedures in these tribunals are less formal and more people friendly and they take less time to decide upon a consumer dispute when compared to the years long time taken by the traditional Indian judiciary. In recent years, many effective judgment have been passed by some state and National Consumer Forums. Indian Contract Act, 1872 lays down the conditions in which promises made by parties to a contract will be binding on each other.
It lays down the remedies available to aggregate party if the other party fails to honor his promise. The Sale of Goods Act of 1930 act provides some safeguards to buyers of goods if goods purchased do not fulfill the express or implied conditions and warranties; the Agriculture Produce Act of 1937 act provides grade standards for agricultural commodities and live stock products. It specifies the conditions which govern the use of standards and lays down the procedure for grading and packaging of agricultural produce; the quality mark provided under the act is known as AGMARK-Agricultural Marketing. The Nigerian government has a duty to protect its people from any form of harm to human health through the use and purchase of items to meet daily needs. In light of this, the Nigerian Consumer Protection Council, whose aim is to protect and enhance consumers' interest through information and enforcement of the rights of consumers was established by an Act of Parliament to promote and protect the interest of consumers over all pro
Nursing home care
Nursing homes known as old people's homes, care homes, rest homes, convalescent homes, provide residential care for elderly or disabled people that includes around-the-clock nursing care. These terms have different meanings in the same or different English-speaking countries to indicate that the institutions are public or private or provide assisted living or more or less nursing care and emergency medical care. A nursing home is a place for people who don't need to be in a hospital but can't be cared for at home. Most nursing homes have skilled nurses on hand 24 hours a day; some nursing homes provide short-term rehabilitative stays following surgery, illness, or injury. Services may include occupational therapy, or speech-language therapy. Nursing homes offer other services, such as planned activities and daily housekeeping. Nursing homes may be referred to as convalescent care, skilled nursing or a long-term facility. Nursing homes may offer memory care services. Starting in the 17th century, the concept of poorhouses were brought to America by English settlers.
All orphans, mentally ill and the poor elderly were placed into these living commons. In the twenty-first century, nursing homes have become a standard form of care for the most aged and incapacitated persons. Nearly 6 percent of older adults are sheltered in residential facilities that provide a wide range of care, yet such institutions have not always existed. Before the nineteenth century, no age-restricted institutions existed for long-term care. Rather, elderly individuals who needed shelter because of incapacity, impoverishment, or family isolation ended their days in an almshouse. Placed alongside the insane, the inebriated, or the homeless, they were categorized as part of the community's most needy recipients; these poorhouses gave a place where they could be given daily meals. Poorhouses continued to exist into the early 20th century despite the criticism. Much of the criticism stemmed from the conditions of the poorhouses; the Great Depression overwhelmed the poorhouses as there were a lot of people that needed help and care but not enough space and funding in the poorhouses.
Due to Muck Raking in the 1930s the less than favorable living conditions of the poorhouses were exposed to the public. Poorhouses were replaced with a different type of residential living for the elderly; these new residential living homes were called board-and-care homes or known as convalescent homes. These board-and-care homes would provide basic levels of care and meals in a private setting for a specific fee. Board-and-care homes proved to be a success and by World War 2, the new way of nursing homes began to take shape; as the times continued to change, the government identified the issue of people spending extensive amounts of time in hospitals. To combat these long stays in short-term settings, board-and-care homes began to convert into something more public and permanent, state and federally funded. From this, by 1965 nursing homes were a solid fixture. Nursing homes were a permanent residence where the elderly and disabled could receive any necessary medical care and receive daily meals.
Though nursing homes in the beginning were not perfect, they were a huge step above almshouses and poorhouses in regards to following laws and maintaining cleanliness. From the 1950s through the 1970s the dynamics of nursing homes began changing significantly. Medicare and Medicaid began to make up much of the money that would filter through the homes and the 1965 amendment laws enforced nursing homes to comply with safety codes and required registered nurses to be on hand at all times. Additionally, nursing homes may sue children for the costs of caring for their parents in jurisdictions which have filial responsibility laws. In 1987, the Nursing Reform Act was introduced to begin defining the different types of nursing home services and added the Residents' Bill of Rights. Today nursing homes are different across the board; some nursing homes still resemble a hospital. Nursing home residents can pay for their care out of pocket, others may receive medicare for a short time and some may use long-term insurance plans.
Across the spectrum, most nursing homes will accept medicaid as a source of payment. In most jurisdictions, nursing homes are required to provide enough staff to adequately care for residents. In the U. S. for instance, nursing homes must have at least one registered nurse available for at least 8 straight hours a day throughout the week, at least one licensed practical nurse on duty 24 hours a day. Direct care nursing home employees include registered nurses, licensed practical nurses, certified nursing assistants, physical therapists, amongst others. Nursing homes require that a registered nurse monitor residents; the RN's job duties include implementing care plans, administering medications and maintaining accurate reports for each resident and recording medical changes and providing direction to the nursing assistants and licensed practical nurses. The LPN monitors residents’ well-being and administers treatments and medications, such as dressing wounds and dispensing prescribed drugs. A nursing assistant provides basic care to patients while working directly under a LPN or RN.
These basic care activities referred to as activities of daily living, can include assisting with bathing and dressing residents, helping residents with meals, eit