ABSTRACT
Early History Local Government Contracting for Provision of Care: Outdoor Relief A complete understanding of long-term care (LTC) in the United States must begin with knowledge of its past so as to foster awareness of the roots of current challenges and facilitate the development of innovative responses. In the early years, elder care was not of great concern. With the exception of the Native American population, inhabitants were generally young immigrants who came either on their own accord or involuntarily as slaves. Older people, especially those who were ill, seldom made the arduous oceanic voyage. Th ose who did were likely to die on the trip (Stevenson, 2007). After arrival, in the colonies, people often experienced cycles of poverty and disease resulting in relatively short life spans.
