Institutionalising senile dementia in 19th‐century Britain

Abstract

This article explains how old, poor people living with dementia came to be institutionalised in 19th-century Britain (with a focus on London), and how they were responded to by the people who ran those institutions. The institutions in question are lunatic asylums, workhouses and charitable homes. Old people with dementia were admitted to lunatic asylums, workhouses and charitable homes, but were not welcome there. Using the records of Hanwell lunatic asylum, published texts of psychiatric theory, and the administrative records that all of these institutions generated at local and national levels, this article argues that 'the senile' were a perpetual classificatory residuum in the bureaucracy of 19th-century health and welfare. They were too weak and unresponsive to adhere to the norms of the asylum regime, yet too challenging in their behaviour to conform to that of the workhouse, or the charitable home. Across all of these institutions, old people with dementia were represented as an intractable burden, many decades before the 'ageing society' became a demographic reality.

Renegotiating relationships: Theorising shared experiences of dementia within the dyadic career

“…In their place, carers were commonly viewed as proxies for people with dementia (Dewing, 2002, p. 158). Carers were considered the victims of dementia (Andrews, 2017, pp. 248–249; Woods, Keady, & Seddon, 2008, pp.…”

“…This individualism partially explains the contemporary reconceptualisation of dyads within person-centredness. Whereas the ‘carer as victim’ concept positioned people with dementia as causes of burden (Andrews, 2017, pp. 248–249; Beard, Knauss, & Moyer, 2009, p. 227), person-centredness has cast people with dementia as victims of carers’ ‘malignant social psychology’ (Flicker, 1999, p. 880; Higgs & Gilleard, 2016, pp.…”

Re-thinking the nature of day programs for people with dementia: Implications for research

“…Like many other forms of care in the community for people with dementia, day programs are not an intervention designed specifically for people with dementia and their families. Instead over time, they have been adapted from use with other populations to serve a population that has been historically difficult to fit within existing services (Andrews, 2017). Day programs began as a form of care in the community with the early deinstitutionalization trends of the 1940s for people with psychiatric illness or disabilities.…”

Older people in hospitals for the insane in New South Wales, Australia, 1849–1905

“…The institutionalization of older people with senile dementia in nineteenth-century British lunatic asylums, workhouses and charitable homes was examined, with troublesome and unmanageable behaviour being frequently cited by families as the reason for admission to Hanwell Lunatic Asylum (Andrews, 2017). Over the second half of the nineteenth century, asylums in Britain became overcrowded as admissions across all age groups and mental disorders increased and more chronic refractory patients remained in the asylums (p. 244).…”

“…From the 1870s, this influenced lunatic asylum administrators in Britain to argue that this 'natural decay' of ageing should exclude older people with senile dementia from admission, but this had little effect as there was a 78 per cent increase of senile dementia admissions between 1880 and 1900. Andrews (2017) concluded that older people with dementia were not welcomed in any of the institutions, being unable to adhere to lunatic asylum norms and having behaviour too challenging for workhouses and charitable homes.…”