Of the 350 homes from which data were obtained, 193 require relinquishment of all property or income at the time of entering the institution, 3 require that part of the property or income shall be given up, and 5 that the possessions (in 1 case personal effects only) shall revert to the home upon the death of the resident. Of these, however, 75 pay the resident the income from or a specified rate of interest upon all property in excess of the entrance fee.

Other requirements. Five homes admit only citizens of the United States, 63" Americans" only, 23 white people only, 14 negroes only, 1 admits all nationalities and races except Mexicans and dark races, and 1 all but negroes, 1 white Americans only, 1 home each gives preference to French, Dutch, or English people, and 1 home each admits only Gentiles, English-speaking persons, Jews, and Germans. Only 74 homes have religious requirements. Of these, 65 require that the applicant be a Protestant, 2 that he be a Christian, and 1 each that he be a Baptist, Catholic, Jew, Lutheran, Presbyterian, or member of a specified local church. One home specifically excludes Christian Scientists and Catholics.

Residence requirements are fairly common. Fifty-two homes require residence in the city for specified periods ranging from 1 to 20 years; 13, residence in the county from 1 to 10 years; and 5, residence in the State from 1 to 10 years. One home each requires that the applicant be a citizen of the city, State, or city or county, and 1 that he shall have resided in the city or county for 10 years.

Duties of Residents

SOME SERVICE is required of the residents in 212 of these private homes. Light duties, or such tasks as the inmates are able to perform, are required in 107 homes; in 68 homes the residents must care for their own rooms, if possible (in one case mending also). One home requires that they iron their own clothes, one that they do any errands necessary, one that they set the tables for meals. "Reasonable" services are required in one home; another requires that the residents do whatever is necessary (but in practice they are seldom asked to do anything), and another that they do "whatever they can do" to help. In one home a few residents have special duties assigned to them, in another duties in kitchen or garden, and in two homes about 4 hours' assistance a day is required from those who are able, one of these paying therefor at the rate of 10 cents an hour. One home reports that its inmates are all too infirm to be of service around the building. There are no service requirements in 116 institutions, but in 24 of these the old people are allowed to help in such ways as they desire.

Among the requirements of one home is that its residents refrain from religious discussions. "They shall not obtrude their religious ideas upon nor in the presence of any other member who does not care to hear them or is annoyed thereby."

Benefits Provided

BOARD, room, clothing, laundry, etc., are almost universally provided. (Exceptions were noted above.)

Medical care. While most homes require that the applicant be of good health at the time of admission, medical care and nursing are usually provided in case the resident becomes ill after admission. Thus of the 350 homes, 328 provide the necessary medical care and another does so if the entrance fee is all paid. In some instances the home engages the services of a physician by the year and he visits the home regularly; in other cases he comes only when called. In some places the physicians donate their services, and there are instances where the home has a panel of physicians all of whom donate their services. Thirty-three homes have one or more resident physicians (one has 2 and one 5 resident physicians). In 229 homes there are one or more resident nurses (30 have two nurses, 16 have three, 4 have four, 1 has five, 1 has six, 1 seven, 1 eight, and 1 "several "). One home usually has a resident nurse and 1 expects to have one in the future. In three homes the matron is a nurse. In 12 homes a nurse is called in whenever her services are necessary.

Nine homes have a regular hospital or infirmary department in connection with the home. One of these, a home which cares for more than 100 persons, reports that its hospital is "fully equipped and regularly operated," that it has an operating room, clinic, 4 sixbed wards, and 14 private rooms.

It is, as already stated, an almost universal requirement of homes for the aged that at the time of admission the applicant shall be in a fair state of health, having regard to his advanced years, so as not to require constant care. One Massachusetts home, however, admits persons "of either sex who may be afflicted with incurable malady, and who have no relatives responsible for their support," provided the malady is not "malignant, mental, or contagious.' Another home, in New York, restricted to professional and scientific men, also takes invalids.

Several homes, one of which is a Chicago home with an emergency room and dormitory for ill residents but no hospital of its own, provide that "any member of the home family who requires a major surgical operation, or treatment or detention in a general or special hospital, may be removed to such hospital, as the case may be, and may there be given required surgical or medical treatment without expense to the member."

One home points out that a large part of the cost of operation of the home is due to the cost of nursing service, "which a fourth of our number receive, and which often covers a period of many years in each case."

The difficulties encountered along this line by one home and the way these are met are described as follows:

Illness among our beneficiaries has imposed a heavy burden on the workers and has added greatly to the expense. Sixteen of our men have been in hospitals, some of whom, discharged as incurable, were removed in ambulances. For others, who could not be admitted, because they were incurable, even though emergently sick, care outside a hospital had to be planned. Twelve men died during the year, many of whom were long bedridden.

Though some homes limit the laundry work to a specified number of pieces per person per week.

It is probably more difficult to obtain proper care for the helpless aged in a home with right standards than for any other class of the sick. Prices are prohibitive, and many nursing homes refuse to consider the patient who requires night and day care. Early in the year the problem became so acute that the home visitor, a trained nurse, prevailed upon a young woman with some hospital experience to use, for our old men, her home, established for well, paying guests. The first patient was brought to her from the hospital on a stretcher. Now we have seven patients in this house, where they are surrounded by brightness and warmth and where they receive kindly, intelligent care. This home, however, could not be maintained if the visitor did not stand back of it, ready to respond to any emergency and to help ease the burden should it become too great.

Helpless age presents, on the whole, too great a problem for the nursing home or for family care. Homes have been disorganized and families exhausted in the effort to care for these bedridden ones. Yet not one hospital in Boston, even in the group caring for chronics, will admit a man helpless merely from old age or with palsy or an old hemiplegia. For all other age groups there is hospital accommodation, even though inadequate to meet the need, but for these there is no place. Although in the days of their youth and strength they may have done their part in the community, establishing homes and firesides of their own; yet brought to dependency by illness and loss of kindred, there awaits them only the almshouse, ever dreaded, isolated, and far from their friends and all their old associations.

One of the most beautiful homes studied, which was established in 1917 under the terms of a will, makes the following statement:

The home is absolutely free. No admission fee is required. Any member who has not sufficient income to provide for his clothing and personal expenses will be furnished with sufficient funds therefor. The home provides for each member a single bedroom and lavatory, together with board and laundry service. He also has the use of the public rooms, consisting of lounge, library, smoking room, billiard room, and recreation rooms. The services of a nurse and visiting physician are furnished to members without charge.

Recreation. An attempt to provide entertainment for the aged guests is made in 244 homes by either the home officials or by various outside groups, such as churches, clubs, etc., which have become interested in the home. The kinds of entertainment vary from the simplest sort of recreation afforded by the home grounds, porches, etc., to an elaborate program of entertainment. Radio programs form a very popular recreation; 28 homes specify these as one of the amusements of the residents. Music from other sources-by piano, victrola, graphophone, etc.--is a recreation feature mentioned. in 18 reports; 2 homes give regular concerts and 1 gives musicales. In 42 homes special entertainments are given for the enjoyment of the old people. Automobile or carriage rides are furnished in 16 homes, outings in 2, and occasional trips in one.

Games of various sorts, such as card games, billiards, pool, croquet, quoits, etc., form part of the recreation in 11 homes, while 1 home gives card parties for the old people. The recreations furnished by one include receptions, concerts, lectures, garden parties, and even an annual ball, and those of another pool, billiards, and other games, a good library, and motion pictures. In one home the recreations include plays given at the home for the old people.

One large home, which also takes children, has a community building in which the social life of the residents centers. Here in the theater or the gymnasium are given motion pictures once a week, frequent concerts, plays by the children, entertainments by the children's band and orchestra, and basketball and other games. The superintendent states that the activities in this building have "prac