both the old and the poor. In 1867, Jean Martin Charcot, known
primarily for his work with the institutionalized insane, did a systematic study of old age. The population he studied was old women in a public hospital in Paris—female, old, poor, urban.
Since that time, many psychological and sociological generalizations about the old have been framed as if the population under discussion were male, even when it was exclusively female as in
Charcot’s study. Many observations about the old were made by
professional men about poor women. As if to signal both the symbolic and actual relationship between old age and women, the first person in the United States to receive a Social Security check after
the passage of the Social Security Act in 1935 was a woman, Ida
M. Fuller. Now in the United States, when there is no doubt
whatsoever that the old are primarily female, that the poor are prim arily female, that those on welfare are primarily female, that those in nursing homes are primarily female, that those in mental
institutions are primarily female, there is still no recognition that
the condition of poverty is significantly related to the condition of
women; or that the status of old people, for instance, is what it is
because the bulk of the old are women. “Indeed, ” writes one writer
on old age, “relatively recent trends in the aging of America may
have changed the status of older Americans. It is conceivable, for
instance, that the elderly have become a much larger burden to
society since World War I. After all, women, very old persons,
and those ‘stuck’ in deteriorating locations now constitute a greater
proportion of the aged population than ever before. ” 3 Women,
very old persons, and those “stuck” in deteriorating locations:
women, women, and women. “After all, ” women, women, and
women “now constitute a greater proportion of the aged population
than ever before”—the status of the old has changed, gone down;
they are more of a burden; “after a ll, ” they are women. In 1930,
there were more men over sixty-five than women; by 1940, there
were more women. In 1970, there were 100 women to 72 men over
sixty-five. In 1990, for every 100 women there w ill “only” be 68
men (as the experts put it). The situation is getting worse: because
the more women there are, the fewer men, the worse the situation
gets. Old women do not have babies; they have outlived their husbands; there is no reason to value them. T hey live in poverty because the society that has no use for them has sentenced them to death. Their tenacity in holding on to life is held against them.
Cuts in Social Security and food programs for the old directly issue
from the willingness of the U . S. government to watch useless
females go hungry, live in viciously degrading poverty, and die in
squalor. On the television news, social workers tell us several times
a week that old people are going hungry: “they have just enough
food to keep them alive, ” one said, “but they never eat enough to
stop them from being hungry. ” Then we see the interviews with
old people, the cafeterias where old people who can walk go to get
their one meal of the day. T hey are mostly women. T hey say they
are hungry. We can observe, if we care to, that they are female and
hungry.
W ithin this population of the old, there are the people in nursing
homes. “There are more than 17, 000 nursing homes in the United
States— as opposed to roughly 7, 000 general hospitals— and their
aggregate revenues exceed $12 billion a year, ” writes Bruce C.
Vladeck in U nloving Care: The N ursing Home Tragedy. “T hey have
been described as ‘Houses of Death, ’ ‘concentration cam ps, ’ ‘warehouses for the d yin g. ’ It is a documented fact that nursing home residents tend to deteriorate, physically and psychologically, after
being placed in what are presumably therapeutic institutions. The
overuse of potent medications in nursing homes is a scandal in itself. Thousands of facilities in every state of the nation fail to meet minimal government standards of sanitation, staffing, or patient
care. The best governmental estimate is that roughly half the na
tion’s nursing homes are ‘substandard. ’”4 In 1978, according to
Vladeck, there were still nursing homes “with green meat and
maggots in the kitchen, narcotics in unlocked cabinets, and disconnected sprinklers in nonfire-resistant structures. ” 5 Over 72 percent of the nursing home population is female. Women in nursing
homes are generally widows or never married, white, poorer than
most of their peers (70 percent having incomes under $3000 a year
consisting mainly of Social Security benefits), and have several
chronic diseases. According to The New York Times (October 14,
1979), the average age of the person in such an institution is 82 and
50 percent have no family, get no visitors, and are supported by
government money. Conditions are most terrible in nursing homes
supported by government funding of patient care: nursing homes
for the destitute, for those on Medicaid. The policy of the United
States government is that old people must become paupers: * spend
any money of their own that they have, after which the government takes over; the paupers are unable to defend themselves
*See “Loose Laws Make Care of Aged Costly, ” by Gertrude Dubrovsky,
The New York Times, October 21, 1979. In a subsection called “How the
Programs W ork, ” Dubrovsky explains:
“As of April 1977, the last period for which such figures were available,
a nursing-home patient under Medicaid could not have an income greater
than $533. 39 a month. However, should this same person want to remain
at home and receive community-based health-related services, his monthly
income must be less than $200.
“Thus, Medicaid laws are biased in favor of institutional care.
“Morever, Medicaid imposes strict personal-asset limits of $ 1 , 500 for a
single person or $ 2 , 500 for a couple.
“To be accepted by a nursing home under Medicaid, a person must sell
his home, liquidate his assets and turn them over to Medicaid as a gift, in
which case he stays on Medicaid.
“Or, he may give the funds directly to the nursing home as a private
payment until the money falls below the allowable level. When that happens, the patient reapplies for Medicaid, but may be put on a waiting list. ”