Who says the world is not a better place! Michael Denham, Past President of the BGS, now historian and archivist of geriatric medicine, describes the vagaries of growing old in nineteen-fifties Belfast.
Miriam Sargaison, Senior Almoner at the Belfast City Hospital, was sponsored by the Nuffield Provincial Hospital Trust to survey old men living in Belfast common lodging houses. It was published in 1954 and is almost a companion study to that of George Adam’s 1951 ‘Survey of Old People in Northern Ireland’.
Originally lodging houses were designed to accommodate younger labourers who came to town to find work but were unable to travel to and from their own homes. Gradually the population changed to include an increasing proportion of older men, particularly pensioners. The situation was exacerbated by the Health and Welfare Act of 1948 which caused many men to be discharged from ‘infirm’ departments of workhouses and had to move to lodging houses.
The aim of the survey
The aim was to discover why older men preferred life in a lodging house to that in a residential home, to examine the living conditions in the lodging houses, and how these conditions might be modified to improve life for the residents. Seventeen lodging houses, which varied in size from 369 beds to a privately owned house with 8 beds, were surveyed between June and December 1951. 371 men were interviewed with 11 failures due to deafness, outright refusals, extreme confusion or drunkenness.
The lodging houses
The quality, cleanliness and management attitudes of the homes varied widely. One well-appointed warm home with a trim appearance, supplied clean bedding, had spotless living areas and well-scrubbed tables. All its beds were fully occupied. Another well-equipped home placed an emphasis on moral rehabilitation and had helped several social outcasts regain their social status. In yet another home, part of the building was reserved for ex-criminals who proved to be the cleanest men in the building, took showers and seldom got drunk. On the other hand there were others providing poor amenities, lacking adequate bedding, cooking utensils, lockers and washing facilities. They had lower occupancy rates due to residents ‘voting with their feet’. The majority of homes did not provide showers or baths but had sinks for washing. Persuading elderly men to take a bath sometimes proved a great problem but, on occasion, provided a great metamorphosis! Sheets were usually changed weekly or fortnightly but sometimes the frequency of change was uncertain. Verminous residents had their bedding sprayed with DDT.
Meal arrangements differed. Most homes did not provide meals but did provide limited cooking facilities such as a gas ring or stove, although in one home the gas stove was so old it was almost useless. Where breakfast was provided it might consist only of bread, jam and tea with a ‘fry up’ on Sundays. Dinner might be more substantial but few residents could afford fresh vegetables. In very poor homes food lockers were unhygienic and often broken into by rats. Ex-labouring old men liked small lodging houses with the warm squalor of the communal back kitchen and the companionship in smoke laden air.
Some homes had broken down furniture. Improvised lockers were made from upturned orange boxes and old dried milk tins used as urinals. The bed cubicles were more like large cupboards with wire netting reaching to the ceiling to prevent thieving. Bedding might consist of ex-army stretchers or had the filthy mattresses with protruding stuffing. In these homes bed wetting was rife and the bedding itself dirty and inadequate. The toilets were not always pleasant. In one case the WC was outside in the yard, had no door and lacked several planks from its walls.
Homes might be dark due to lighting problems. Some either lacked electricity or the system was so defective that candles were used for general lighting. The situation could be exacerbated by boarded up windows. Sargaison described one such home as resembling a Hogarthian print on dark evenings when the ragged occupants were gathered round an inadequate fire lit by a flickering gas jet.
The opening hours differed. Some houses remained open throughout the day but others operated a ‘lock out’ system during the day light hours. In this latter situation potential residents were forced to wander around the community trying to keep warm, which often led them to visit libraries. Where the home was open all day, seasoned residents tended to form small groups to launder clothing, make a basic soup, organise rations or visits to the post office.
Several wardens commented on the difficulty of arranging hospital admission for elderly residents when they became ill because they were not registered with a GP. Admission in winter was often a Godsend to some because they were cleaned up and received regular meals. Since the introduction of the NHS the medical officer of health has reduced responsibility in the management of lodging houses.
Old men
The age of the 371 residents ranged from 60 to over 80 years peaking at 70-75 years. Over eight in ten were single or widowed. Nearly half were unskilled workers but over a third were skilled. More than half were satisfied with their lodging house way of living while a quarter were indifferent to their surroundings. The vast majority were considered mentally alert and only 6% had defective memory. Most derived their income from their old age pension and National Assistance Board allowances. Many would have been happy to return to work to improve finances and provide companionship. However some appeared too lazy to find a job.
The men were not examined medically. However their general appearance ranged from the majority who were considered clean to a third who looked neglected or filthy. This latter assessment was based on the entire absence of any visible effort to achieve cleanliness coupled with an unpleasant smell. The main medical problems were bronchitis, ‘rheumatics’, poor eyesight, skin complaints and visible deformities such as amputations. Some had painful feet with boots cut away to accommodate corns or bunions. However most residents were reasonably mobile and could manage stairs. A few appeared to be sufficiency ill to require medical attention. Many showed very poor dental care and discoloured filthy teeth.
The motives for entering lodging houses were diverse. These included release from the workhouse, destitution, loss of employment, death of a family member and unhappy home circumstances. A number admitted that drink had alienated them from their families and caused them to leave home. Ex-residents of the workhouse had a particularly difficult time coping with complex life outside and the altered value of money. Some began lodging house life after demobilisation from the First World War having found that their family had emigrated. Others found they had nowhere to live when they lost their ‘tied’ accommodation on retirement.
The population of lodging houses is often viewed as a floating one and while this might apply to the younger residents it was not true of the older ones. The majority of elderly men had lived as residents for 1 to 4 years but one 70 year old man had lived in a lodging house for fifty years. The desire to retain independence emerged as the key reason why so many would not contemplate life in a residential home.
Although it was impossible to assess the extent of incontinence among the lodgers a visit to the dormitories gave an indication. Some men admitted difficulty in finding their way to the toilet at night and were helped if given a bed nearby. ‘Malicious’ incontinence occurred from time to time and was associated with drunkenness, laziness and poor hygiene. Where the problem was persistent the warden would usually contact the man’s general practitioner.
Overcoming boredom was a major concern especially for those locked out. Some haunted their previous place of employment, others potted around the markets. The public library was popular because it was warm and there were newspapers to read. Unhappily a few men were illiterate. Other methods of keeping warm involved using layers of newspapers as underwear. The vast majority found solace in smoking, seen as a universal panacea, and/or drinking although usually only one such indulgence could be afforded. Sadly residents knew that, while they had a past, they had no future and just lived from day to day.
Summary
For older lodgers the paramount attraction of living in a lodging house was maintaining their independence, although they might have to do their own cooking, keeping warm, replacing clothing, coping with illnesses and avoiding boredom. They preferred small lodging houses with proper lockers for their possessions to prevent stealing, convivial atmospheres, a degree of privacy and adequate bathing facilities. In many ways the old Poor Law system was kinder to them because the ‘Relieving Officer’ acting like a ‘Dutch uncle’. For the future a residential community centre, with accommodation midway between that provided by a residential home and a lodging house, or clubs with chiropody services would benefit these older men. Ideally lodging houses required improvement although the costs would be high. Abolition of compulsory retirement age, which could increase income and provide companionship, would solve many men’s problems.
Post script
The poor conditions in common lodging houses, doss-houses and hostels awakened the interest of the Victorian philanthropist, Lord Rowton, a former secretary of Disraeli. He built a chain of very large well designed hostels, known as Rowton Houses, with literally hundreds of single cubicles, lockers, bathrooms, foot baths, a library, smoking, sitting and dining rooms. Most were in London but the concept was much copied with similar facilities in Liverpool, Birmingham, Sheffield, Vienna, Milan and Paris. The first was built 1892 and the last in 1905. Charges were moderate. George Orwell, who wrote Down and Out in Paris and London in 1933, praised Rowton Houses for the high quality of their accommodation although he had some reservations about their discipline.
When I worked at the now demolished St. Stephens Hospital in Chelsea, patients told me that they stopped their medication just before Christmas to precipitate admission to hospital over the festive period. Why: because admission provided warmth, companionship and regular meals. One lady was a well-known character and had ‘organised’ admission for many years: just like someone out of Doctor in the House.
Michael Denham