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Long Term Care in the 13th Century

There have been a number of recent efforts to finance long-term care for the elderly. The health reform law, as amended by the Health Care and Education Reconciliation Act of 2010, created a national, voluntary insurance program for purchasing community living services and supports known as the Community Living Assistance Services and Supports program (CLASS Act). In January 2013, however, CLASS was repealed since it was not financially viable.

Caring for sick parents, however, is not a new problem. Consider how the English dealt with this issue in the 13th century according to Francis Fukuyama.

Things were rather different in England, where parents who foolishly passed legal title to their possessions to their children while still alive had no customary residual rights to their property. One medieval poem cites the case of a father who turned over his property to his son, who then began to feel his father was too heavy a burden and started to mistreat him…To avoid situations like this, parents signed maintenance contracts with their children obliging the latter to care for them once they had inherited their parents’ property. “For surrendering the property a couple in Bedfordshire in 1294 were promised, in return, food and drink and a dwelling in the main messuage [house], but if the two couples started to quarrel, then the old couple were to have another house and ‘six quarters of hard corn at Michaelmas, namely three quarters of wheat, a quarter and a half of barley, a quarter and a half of beans and peas, and a quarter of oats’ and all the goods and chattels, movable and immovable, of the said house.”…Putting one’s parents out to pasture in a nursing home has very deep historical roots in Western Europe.



  1. Don’t know how I missed this, Jason – excellent perspective.

    Just updated (and bumped) a recent post I did on the future of LTCi – directing folks here for a rather longer view than we’re accustomed to.

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