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THE PREAMBLE to almshouses is the act of almsgiving, a gift of charity to the less fortunate in the form of money, property, or bequest. It arises from the basic impulse of humans to help those who cannot help themselves. While practiced by many religions including Buddhism and Islam, almsgiving is especially important in Judaic and Christian religions where it is seen as an obligation.

The giving of alms became increasingly important with the rise of Christianity and the formalization of church structure. The collection and administration of alms were the responsibility of the local deacon reporting to the bishop, and the early recipients of alms were travelers, slaves, and prisoners. In this and later contexts, alms were a form of outdoor relief and were disbursed from the monasteries (or almshouses).

Increased religiousness, coupled with a growing sense of obligation, led individuals to greater charitable acts. These culminated in endowments for the creation of residential almshouses for the indigent, usually attached to a particular monastic order or parish. Such almshouses were based on the Christian hospitals that were founded in the 4th century and are among other religious charitable institutions such as orphanages and schools. In England and Europe, almshouses for the aged, poor, and infirm were established in the 10th and 11th centuries. By the early 14th century, the endowment of almshouses had become a common charitable bequest. In England, the number of almshouses grew after the Reformation.

Contrary to popular notion, the intention of the almshouse was not to offer care to all those in need. Residents were selected according to the particular standards and religious practices of the almshouse and were expected to follow certain rules and participate in obligatory activities such as attendance at church or chapel. The creation of almshouses was part of the movement toward the institutionalization and control of the poor, elderly, and infirm. In Europe, changes in attitudes toward the poor began in the 14th century and included provisions such as the control of begging and the issuing of badges for licensed beggars. This attitude was cemented in England with the Poor Law of 1531, which provided for punitive measures for able-bodied beggars who did not work and were seen as a threat. In some regions, almshouses became synonymous with workhouses for the able-bodied poor. The creation and management of institutions such as almshouses moved from the exclusively religious domain toward secularization through civic charity and the work of lay confraternities.

Jails and almshouses were two institutions that migrated from England to colonial America. Throughout the early 19th century, almshouses provided some level of care and shelter to a wide variety of individuals including orphans, unwed mothers, the infirm, and mental defectives. A move to separate people into groups by age and infirmity began in the latter part of the century, resulting in specific institutions for orphans, the destitute aged, the tubercular, the feeble-minded, and the crippled. Throughout this period, almshouses evolved from institutions containing a mix of ages and infirmities into homes for the aged. By 1923, those over the age of 60 accounted for approximately two-thirds of all almshouse residents in the United States, compared with one-third in 1880. This trend is reflected in the U.S. Census of 1940 where the classification of almshouse changed to “home for the aged.” Almshouses had clearly moved away from their religious roots, as these newly named institutions were eligible for subsidization under the federal welfare program of Old Age Assistance. However, some exceptions to the secularization of this period exist, such as the work of the Society of St. Vincent de Paul and other religious groups, catering to the needs of specific religions.

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