Chapter XXXI: Part VI: The Residuum of Relief: the Aged, the Infirm, and the Handicapped (2)

To put the case from the financial point of view, $1,389 was given to 18 men; $620 has made seven of them possibly self-supporting, and $769 was expended upon 11 who failed. Those who were not found at the address given may be self-supporting as they have not drifted back to the Rehabilitation Committee. A single fact is sufficient to explain the success of one group and the failure of the other. The seven successful ones averaged fifty years of age, while omitting the exceptional case of the young seaman 10 of the 11 averaged sixty-seven years. Again, the occupations of the unsuccessful are seen to be unskilled and common labor. Incompetence, physical or mental, added to age in most instances, brought these men to Ingleside.

Twelve of the 17 women who applied for business rehabilitation were given aid. One of these, a lodging-house keeper who expected to receive $2,500 in insurance, was granted only $75. When the insurance was received it amounted to but $700, and as she invested in a large rooming house, heavy debts were incurred. Though she was running behind she may not have failed. She blamed the Rehabilitation Committee for not having given aid sufficient to insure success. Two milliners, each about forty years of age, together received $699 and had not re-established themselves. One, however, had had typhoid fever after the fire, and never fully recovered. Both were doing a little casual work. Five others who were given grants amounting to $560 were dependent. None of these had given much promise of self-support but were given the full benefit of the doubt. One of them, later in the Relief Home, lost $100 in the fire, which she had painfully saved for proper burial. The Rehabilitation Committee replaced this money for funeral expenses.

One of the five women who were denied business rehabilitation was refused because she owned real estate which when sold would provide sufficient capital.

HOUSEHOLD REHABILITATION. The records of application for household relief by single or widowed inmates present quite another aspect of the relief situation than that exhibited by the data regarding business rehabilitation. The 43 people in this group[274] asked for very little more than the two essentials--furniture and clothing. Clothing had been given in quantities immediately after the fire, and these applicants, aged and infirm people, re-applied months later when winter was coming on. The heavier part of their demand was, however, for furniture to start bachelor housekeeping. Before the fire San Francisco abounded in furnished lodgings at all prices; but afterward there were almost none to be had at prices within the means of those whose age and incapacity prevented them from earning more than minimum wages. Furniture for the shacks, cottages, and tenements was necessary, but because of the dearth of second-hand stuff, the prices of new pieces, even of the meanest sort, were very high. The average grant of $59 per person, therefore, was not too much with which to buy a bed and bedding, a table, chairs, and cooking utensils, and, in some cases, to pay the first month’s rent. A visitor of much experience, in commenting on such cases, said, “It is appalling to think that mere beds and tables may make the difference between pauperism and independence.” Grants were refused to three applicants; two of them drank to excess, and the third was in need of permanent care.

[274] See Table 120, p. 344.

When one considers that these applicants above sixty years of age were sewing women, charwomen and cleaners, cannery workers, peddlers, and laborers who must regain their patrons or find new work, the results are very encouraging. One-third only were in 1909 found to be dependent on charity; another third were living with relatives or had died or been lost to view; while the last third were presumably self-supporting.

TRANSPORTATION. The 27 persons who applied for transportation were rather more homogeneous than those of any other group. In 15 cases transportation was granted. These 15 individuals were maintained for months at Ingleside until assurance was obtained that they would have proper care if transported; and yet, the experiment was not always successful. For instance, an old nurse was sent to Chicago where her nephews and nieces, although poor, had offered her a home which was visited and approved by the Chicago Bureau of Charities. After some months in Chicago the exacting old woman became so burdensome that the relatives could not care for her. With the advice of the Bureau of Charities she was sent back to San Francisco and placed in the home for the aged. In a few cases careful plans came to nothing, because erratic old people would not consent to be transported.

The case of an old woman of 97 is very pathetic. She had formerly lived in San Francisco and had stored her furniture when she went away. She happened to be visiting in the city on April 18, 1906, in the district burned. The step-daughter to whom she went first abused her and then sent her to Ingleside. The poor old woman while waiting to be given transportation to join her husband in Utah fell ill and just after the coveted transportation was given “died of disappointment.” No judgment can be formed as to whether there was unnecessary delay on the part of the visitor of the Rehabilitation Committee but after the shock of the earthquake, “disappointment” can scarcely be regarded as the chief cause of death.

The war veterans, four of whom were transportation cases and not less than a dozen of whom were at Ingleside, gave trouble quite disproportionate to the hoped-for results. They were traveling paupers each of whom had either been discharged for bad conduct from some soldiers’ home or more probably had left because of restless and vicious habits. Two were given transportation to Washington, District of Columbia, where they belonged, but neither ever arrived. Two others were refused transportation because they belonged in a veterans’ home in California.

To summarize the 15 cases to whom about $1,000 was given in transportation and money, four in 1909 were still, in spite of what seems to have been reasonable precaution, dependent on the charity of San Francisco and one on the charity of Philadelphia. The burden of the other 10 was transferred to relatives or to communities to whom it rightly belonged and San Francisco was relieved from a possible future obligation greater than that represented by the $1,000 expended.

Transportation was not given in 12 cases. The principal reason for the refusal of transportation was the lack of assurance that the persons applying would not become charges on the communities to which they wished to go. Six are now in homes for the aged, one died shortly after applying, two may have returned to the soldiers’ homes where they belonged, and three are possibly self-supporting. Their circumstances and condition are shown by the following transcript from the records.

GRANT REFUSED:

Night clerk; age 61. Applied for transportation to San Diego.
Recommendations not sufficient. Got job as watchman. In Relief Home.

Watchman; age 43. Applied for transportation to Los Angeles.
Physically incapacitated. In Relief Home.

Hotel runner; age 47. Asked for transportation to family in Spokane.
Able to work.

Peddler and war veteran; age 80. Applied for transportation to
brothers in New York with whom he had quarreled long ago. Had left
Veterans’ Home in 1904. Got work.

Ship joiner; age 75. New York relatives refused to receive him because
of his vicious habits, but would pay for him in Relief Home, where he
remained.

Chiropodist and war veteran; age 83. Son in New York surprised that he
had left Soldiers’ Home. Would receive him if fare was paid.

French cook; age 68. Asked for transportation to brother in France,
but brother did not reply to letters. Went to work.

Longshoreman; age 57. Wished to go to Los Angeles. Had been in
hospital for weeks, unable to care for himself. Died shortly afterward
in camp.

Teamster (Negro); age 65. Applied for transportation to wife in
Washington, D. C. No reply from wife. In Relief Home for third time.

Carpenter; age 57. Wished to go to Seattle to collect debt of $50. Was
advised to write. In Relief Home.

GRANT CANCELED:

Car builder; age 69. Granted $100 and transportation to sister in
Northern California. Went to Iowa instead. Check for $100 cancelled.

NO ACTION:

Cigar clerk; age 69. Applied for transportation to sister in Kansas.
Could not be found by visitor. Later, in Relief Home.

SPECIAL RELIEF. The 38 single or widowed inmates whose applications fall under the head of “Special Relief” were nearly all in need of special medical or surgical attention, or of convalescent care.

From the standpoint of restoration to self-support this group, as shown by the abstract given below, is discouraging, but it is doubtful if the Rehabilitation Committee in granting the special relief, expected the recipients to regain economic independence. Owing to the crowded condition of the hospitals in 1906 and 1907 it was necessary to avoid sending to them persons who could be provided for otherwise. The yet greater overcrowding in the institutions for the aged and infirm made it compulsory, until the Relief Home was completed, to give some outdoor relief to those who did not imperatively require institutional care.

Those still independent three years after the grant was made averaged twelve years younger than those then receiving relief. The financial showing is not so discouraging as the social. The 29 persons received grants amounting to $2,955, an average of $102 each. This sum would have paid for keep in an institution, if there had been room, for not more than seven months. The average time that elapsed before each became dependent is, in the known cases, considerably more than seven months. The money therefore was not wasted. Moreover, those objecting, as most of them did, to going to an institution, had the comfort of attempting self-support.

GRANT MADE:[275]

(a) Not Dependent (probably):

Domestic servant; age 68. Granted $150. No information could be
obtained in 1909.

Domestic servant; age 35. Granted $75 for an operation.
Self-supporting.

Cook; age 66. Granted $50. No information could be obtained in 1909.

Housewife; age 50. Granted $75 for washing machine. Ejected from
Ingleside. Small amount for current expenses.

Cannery clerk; age 61. Granted $20, and later $75, to go to hospital
and then to the country. Now with friends.

Plasterer; age 56. Granted $50. Later arrested and in jail three
months.

Peddler; age 54. Granted $60 and a free license. No information
obtained in 1909.

Carpenter; age 32. Tuberculous. Granted $300 to go a warmer climate.
Now recovering.

(b) Dependent:

Cook; age 61. Living on savings before fire. Granted $100. Later
assisted by A. C. In Relief Home.

Seamstress; age 59. Granted $100. Assisted by private charity.

Bookkeeper; age 65. Granted $100. In Home for the Aged.

Janitress; age 50. Granted $50. Sent to hospital.

Domestic servant; age 38. Granted $75. Partially self-supporting; in
and out of Relief Home.

Nurse; age 78. Granted $200. Went to niece. Assisted by several
charities.

Housewife; age 95. Granted $25 and later $125. In Home for the Aged.

Rooming-house keeper; age 72. Granted $75. Went to hospital. Assisted
by private charity.

Nurse; age 65. Granted $100. In Relief Home.

Cloak maker; age 65. Granted $100. Assisted by charity. In Relief
Home.

Housewife; age 81. Granted $140 in instalments. In Relief Home.

Dressmaker; age 57. Granted $100 and sewing machines. In Relief Home.

House worker; age 60. Granted $100 and truss. In Relief Home.

Seamstress; age 65. Granted $125 and sewing machine. In Relief Home.

Peddler; age 60. Granted $20. In Relief Home.

(c) Dead:

Seamstress; age 75. Granted $150 in instalments. Died September, 1907.

Nurse; age 79. Granted $100 “till well enough to work.” Died April,
1908.

Janitor; age 58. Granted $50 for stove and bedding. Died February,
1907.

Lecturer on psychology; age 70. Granted $75 and transportation to San
Diego. In Relief Home. Died 1908.

Housewife; age 67. Granted $150. Went to relatives. Died 1907.

GRANT REFUSED:

Seamstress; age 36. Because earning $12 per week.

Nurse; age 64. In need of permanent care. Died in Relief Home June,
1909.

Chambermaid; age 70. In need of permanent care.

Children’s nurse; age 73. In need of permanent care. In Relief Home.

Domestic servant; age 70. Asked for money to pursue invalid claim to
property.

NO ACTION--CHECK CANCELED:

Housewife; age 55. Could not be found by visitor.

Dressmaker; age 73. Granted $100 and sewing machine. Could not be
found.

Cannery worker; age 40. Granted $75. Could not be found by visitor.
Assisted later by Associated Charities to go to the country.

Maker of knitted articles; age 68. Granted $100 and sewing machine.
Drank to excess. In Relief Home.

[275] No information is available as to occupation, age, or present
status of one of the 29 persons to whom grants were made.

HOSPITAL CARE. The small group of 11 persons who applied for hospital care, were of the same general character. Illnesses of a serious nature required special treatment either at Ingleside or other institution. Two of the 11 were sent to an insane asylum, two died at Ingleside, and five were in homes for the infirm. Two became self-supporting.

GENERAL RELIEF. There remains a heterogeneous group of applicants for general relief, most of whom asked for money for living expenses, or for such inexpensive things as false teeth, trusses, and spectacles. Of the 50 persons who applied for general relief, 20 were refused. The total amount paid out in grants to the remaining 30 was $1,735.70.

Three years after the grants were made 10 of these persons, five of whom received less than $25 each, were believed to be independent, 15 were in the Relief Home, one was dependent on other charity, and four were dead.

* * * * *

2. Between April, 1907, and April, 1909, 68 persons who had been at Ingleside Model Camp at some time, in addition to the 14 persons in the seven families already considered in Table 119 and on page 342, applied to the Associated Charities.[276] Since these 68 persons did not apply to the Corporation during the first year after the fire they must either have gone from Ingleside to friends or must have expected to be self-supporting. More than half of them were over fifty years of age and nearly all were more or less incapacitated; in short, they do not seem to have differed from those who before the fire found their way to the almshouse. On April 18, 1909, 39 of these were in the Relief Home, four were in asylums or hospitals, four had left the city, and three were self-supporting. With regard to 18 persons of this group no information could be obtained.

[276] See Table 119, p. 336.

* * * * *

3. The most conspicuous thing about those who did not apply for rehabilitation, both men and women, is their high proportion of disabilities, a proportion even higher than that of the applicants. Of the 585 non-applicants among the single or widowed men and women,[277] no less than 330, 56 per cent, were infirm or crippled, or needed special care for some reason. Table 121 shows the nature of their disabilities.

[277] See Table 119, p. 336.

TABLE 121.--DISABLED SINGLE AND WIDOWED INMATES OF INGLESIDE MODEL CAMP WHO DID NOT APPLY FOR REHABILITATION, BY SEX AND NATURE OF DISABILITY

=============================+========================
|NON-APPLICANTS WITH EACH
| SPECIFIED DISABILITY
Nature of disability +-------+--------+-------
| Men | Women | Total
-----------------------------+-------+--------+-------
Infirm or crippled persons: | | |
Too infirm to work | 33 | .. | 33
Lame or crippled | 19 | 11 | 30
Feeble | .. | 21 | 21
Without one leg or one arm | 19 | .. | 19
Blind or very deaf | 9 | 6 | 15
Paralyzed | 11 | 1 | 12
Bed-ridden | .. | 3 | 3
-----------------------------+-------+--------+-------
Total | =91= | =42= | =133=
-----------------------------+-------+--------+-------
Persons needing special care:| | |
Sick | 44 | 23 | 67
Normally convalescent | 31 | 17 | 48
Injured in accidents | 33 | 2 | 35
Senile or demented | 16 | .. | 16
Severely rheumatic | 15 | 4 | 19
Tubercular | 4 | 8 | 12
-----------------------------+-------+--------+-------
Total | =143= | =54= | =197=
-----------------------------+-------+--------+-------
Grand total | =234= | =96= | =330=
-----------------------------+-------+--------+-------

Four-fifths of the 585 non-applicants were over fifty years of age. Nevertheless, they applied for no relief other than shelter for a longer or shorter time at Ingleside. Their neglect to make application for rehabilitation may be set down in a great measure to the want of initiative due to infirmity (more than one-seventh of the number have since died), and to the apathy that comes to the inevitable institution inmate. In 1909 one-third of this group were in the Relief Home or in some other charitable refuge. But the margin of over one-third of the remainder whose condition was known, who went to work or to friends and were not as yet dependent on charity, is surprisingly large.

Table 122 shows what became of the non-applicants as far as the facts are known.

TABLE 122.--SUBSEQUENT HISTORY OF SINGLE AND WIDOWED INMATES OF INGLESIDE MODEL CAMP, WHO DID NOT APPLY FOR REHABILITATION BY SEX

=================================================+=================
Subsequent history | INMATES WHOSE
| HISTORY WAS AS
| SPECIFIED
-------------------------------------------------+-----+-----+-----
| Men |Women|Total
-------------------------------------------------+-----+-----+-----
Died within one year of admission to Ingleside | 31 | 16 | 47
Died within three years of admission to Ingleside| 33 | 11 | 44
Went to work or to friends or relatives | 83 | 25 | 108
Now in charitable institutions | 124 | 70 | 194
No information available | 154 | 38 | 192
-------------------------------------------------+-----+-----+-----
Total | 425 | 160 | 585
-------------------------------------------------+-----+-----+-----

It is highly suggestive that a very large proportion of those who went to work or to friends or relatives left in January, 1908, when Ingleside was about to be closed and all the inmates removed to the Relief Home. When the final alternative was presented to go permanently to an institution or to find some other home, they were able to make the latter choice. Most of them belonged to the wandering labor classes which find no hardship so great as the monotonous, comfortable life of an orderly institution where thorough discipline is maintained. The Relief Home was, fortunately, located beyond the city a mile from any car line. It was far removed from the bustle and the sensational diversions which were so pleasantly accessible to the lazy and the semi-vicious at Ingleside. The mere limitation of the right to go in and out freely was so irksome that many chose to take their chance in the world again rather than go where they must ask for a pass.

(c) APPLICANTS WHO HAD NEVER BEEN AT INGLESIDE

Mention has already been made, page 325, of the fact that between 100 and 200 persons left the almshouse shortly after the fire, most of them presumably going to the camps and posing as refugees. Besides these there were 27 applicants for relief who, although not in the almshouse at the time of the fire, had been there one or more times, one of them 16 times, in the eight years previous. In most instances the Rehabilitation Committee had no means of knowing that these people were former almshouse inmates, and the grants were made merely on the ground of old age. The more important details concerning this group of 27, none of whom were at Ingleside, are as follows:

To 13 persons relief was granted in sums ranging from $15 to $125, and six of these were believed to be non-dependent in 1909, while seven were in the Relief Home. Grants were refused to nine applicants; eight of these required such care and supervision as that provided in the Relief Home, and the ninth, who was an opium taker, was aided by a sister. Checks were canceled in three cases: one, because other relief was given; another, because the applicant was found to be a drunkard; and the third, because the money had been paid to the wrong person. In the two remaining cases of the 27 no action was taken.

It is surprising to find that the 13 cases in which relief was granted average ten years younger than the Ingleside cases. They were either persons who had gone in former years to the almshouse to convalesce after illness, as was customary with those discharged from the City and County hospital, or persons who had some physical or mental disability that made it difficult to keep employment. Most of the others who were not in the Relief Home in April, 1909, if they live will probably come back there. Of the 14 applicants who did not receive aid, nine were in the Relief Home three years after the disaster or had died there.

One last group of the aged and handicapped remains to be mentioned,--35 applicants who had been neither in the almshouse nor at Ingleside, but who arrived at the Relief Home between April, 1908, and April, 1909. These had been able to hold out until then against the ravages of age, disease, incapacity, and misfortune. A few, a very few, were again independent of relief three years after the grant was made, but of the remainder, 21 were still in the Relief Home or other charitable institutions, and nine had either left the city or had died.

III

RESULTS

The final important question to be considered in this study of relief of the aged and infirm is: What proportion of the aged and infirm persons in the Relief Home in April, 1909, were there solely because of the earthquake and fire of April 18, 1906? To answer this question one must know the proportion between the total population of San Francisco and the aged and infirm in the almshouse for some time previous to 1906.

TABLE 123.--PROPORTION OF ALMSHOUSE INMATES AND OF ALMSHOUSE ADMISSIONS TO TOTAL POPULATION, SAN FRANCISCO, 1890, 1900, 1905, AND 1909

====+=============+=========+===========+============+============
Year| Population | Average | Almshouse | Admission | Admissions
| of city and |number of|inmates per|to almshouse|to almshouse
|county of San|almshouse| 1,000 of | during |per 1,000 of
| Francisco | inmates |population | year | population
----+-------------+---------+-----------+------------+------------
1890| 298,997 | 736 | 2.5 | 560 | 1.9
1900| 342,782 | 947 | 2.8 | 670 | 2.0
1905| 379,847[278]| 890 | 2.3 | 773 | 2.0
1909| 409,499[278]| 1,295 | 3.2 | 816 | 2.0
----+-------------+---------+-----------+------------+------------

[278] Estimated.

It seems fair to assume that the disaster was responsible, at least in part, for the increase of the proportion of almshouse inmates in the population from 2.3 per 1,000 in 1905 to 3.2 per 1,000 in 1909. The fact that in 1909 the number of admissions was not higher indicates that already as regards this class the abnormal conditions resulting from the fire were passing away. The high death rate would shortly reduce the Relief Home population almost to its normal proportion.[279]

[279] Between 1900 and 1905 the inmates of the almshouse went in and
out much more freely than they do now at the Relief Home, but the
effect on the average number present is impossible to calculate.

The increase, from 1904-05 to 1909, in the relative number of almshouse inmates in the population must not be attributed wholly to the disaster. The condemnation of the unsanitary City and County Hospital threw a part of the burden of its chronic cases on the Relief Home. The shock of the disaster to highly nervous and ill-balanced persons doubtless produced insanity in a number of cases. As the state insane hospitals were already overcrowded, the least troublesome found refuge in the Relief Home. But perhaps the most important factor in producing this charitable burden was the general disorganization of industry in the years 1907-08, due to a street-car strike in San Francisco and to the financial panic. The slow recovery of certain industries caused by the exorbitant cost of building was perceptibly checked. The result was that only young and able-bodied men could get work. Old and semi-able men who would in normal times have continued for several years to make a bare living, could find no work after the brick cleaning was done. This economic stagnation accounts for the failure of some who were given tools, or small grants to set up little shops or buy stock to peddle. The buying capacity of the laboring class, their prospective patrons, was greatly diminished.

Finally, the number of the aged and the infirm in the Relief Home was increased by those sent from a number of the private charities whose buildings were burned or whose funds were lessened. The private charitable agencies were the more inclined to disburden themselves as the new institution was so attractive. As one of the employes put it: “If the city furnishes clean steam-heated rooms, three hot meals a day, electric lights, and every convenience, the place will always be full. Lots of people in the Relief Home never had so much before.” The new institution at its dedication was advertised to set a high standard of care. The maintenance of this standard by the superintendent drew to it, undoubtedly, some who formerly would not have applied for admission.

Since the variations in the numbers of the old almshouse inmates registered the increase due to the industrial stagnation following the labor agitation and the panic of 1893, it is reasonable to conclude that the several circumstances described above had increased the number of the inmates in the Relief Home as much as had the disaster of April 18, 1906.

An interesting question, growing out of the coalescence in the Relief Home of the Ingleside refugee group with the old almshouse population, is the comparative social standing of the two groups. Were the Ingleside inmates potential almshouse inmates or were they such as would not have arrived there but for a great and wholly impersonal misfortune? The “refugees” maintained in the Relief Home a class identity and were particular to insist that they were not like “the old almshouse people.” It has been pointed out[280] that there was a group at Ingleside whose occupations and general history marked them as belonging to a somewhat more skilful and resourceful class than the rest. Such of these as went to the Relief Home continued to be superior and exceptional, but far the larger number were precisely of the same human stuff as the interminable procession that had for forty years been entering the almshouse. On this point the testimony of employes who were in charge at Ingleside and later at the Relief Home was nearly unanimous and quite conclusive. They agreed that three-fourths of these refugees were “almshouse types” and would have reached an almshouse in a few years; and that some of the others, of rather better education and character, would have been cared for in private charitable institutions, or by children and relatives who because of the fire were too poor to take them. It is pointed out that these last if they shared the poverty of their kindred would have been far less comfortable than in the Home.

[280] See Part VI, p. 333.

One clear distinction between the almshouse people and the refugees is a difference of temper. During the relief period the refugees got the idea that there were “millions for relief,” in which they had a “just and equal share,” and that as the Relief Home was built for them they had exceptional rights in it as victims of misfortune. They were, therefore,--the women especially,--more exacting, lazy, and termagant than the old-time inmates. Ingleside has been described as “one long vacation picnic” where they had varied and abundant food, very little work and, to satisfy their gregarious instincts, continuous gossip. Those who had become accustomed to the freedom of the camps were consequently more incorrigible as well as more able-bodied than the almshouse inmates, and were never bound by such necessary rules of labor and discipline as existed there.

It has already been demonstrated[281] that so far as age, proportion of the sexes, marital condition, and nativity are concerned, at least four-fifths of the refugees at Ingleside did not differ essentially from the inmates of the San Francisco almshouse. Collateral information corroborates this conclusion. The rents they had paid and the wages they had received before the fire were rarely above those common to the unskilled laboring classes, while the streets they had lived in were in the districts familiar to charity visitor and settlement worker. It may be concluded upon these facts that not more than one-sixth of the Ingleside refugees, at most 200 persons, were of the more fortunate and resourceful sort who but for some extraordinary disaster would never have become dependent.

[281] See Tables 114-116, pp. 329-331.

Before undertaking to estimate the work of the Rehabilitation Committee in relation to the aged and infirm it is imperative to make clear the characteristics of the different classes with which they had to deal. The problems of the helpless, the very old, and the very young, stand apart. But the destiny of old people cannot, like that of children, be determined solely by the will of others, for self-will increases rather than diminishes with the approach of senility. So long as the old are on their feet in the world, whatever plans are made, whatever relief is proposed, may be set at naught. They cannot be imprisoned unless positively vicious, nor be refused relief, because the humane standard requires that age, however unlovely, shall be kindly treated.

There were at Ingleside 70[282] unruly, immoral, drunken people, who had to be ejected but who returned again and again by way of the jail and the hospital to ask assistance. To such as these only food and shelter could safely be given. In the Relief Home they were relegated to “The Last Chance,” the name given by the residents to the building for senile incorrigibles. Some were in their second infancy and behaved like filthy animals, others had senile dementia and “imagined violence like children,” accusing the nurses of stealing from them and of starving them, yet it would have been impossible to get them committed for insanity. Still others who came and went from Ingleside and who went in and out of the Relief Home as often as permitted, became insane with rage whenever they were crossed. Angry at some trifle, they would rave by the hour; but if locked up or deprived of some privilege they would gradually recover self-control and be quiet for weeks until crossed again. It would have been impossible for them to live in a family even of their own relatives. It was all but impossible to care for them in the institution until their vigor was depleted enough to make them stationary.

[282] See Part VI, p. 325.

Another class is the wanderers, in all stages of senile dementia. Some were intelligent enough to apply for relief but wandered from Ingleside, could not be found by the visitors, and turned up later in the Relief Home. A few were promised grants but never claimed the checks. Those in the Relief Home got lost, could not remember where their rooms were, or now and then climbed the barbed-wire fence and ran away. Although for their proper care the same precautions were needed as at a prison, neither Ingleside Model Camp nor the Relief Home could be so organized. Every person had the legal right to come and go from the Relief Home at will. Some of the relatively able-bodied would go out to visit acquaintances or relatives, to beg a little, to work a little, or even to pawn their clothes, and after drinking up the money obtained, return exhausted or filthy to recuperate in the Home. The same may be said of the one-third of the inmates who were entered in the records as drinking or drunkards. Many of them combined with intemperance some other infirmity. For our purpose, however, it is immaterial whether they began to drink as a result of physical debility or whether they were sick because of drunkenness. In either case, it was very nearly hopeless to give them money for rehabilitation. A number are known to have wasted their grants in drink.

“PORTALS OF THE PAST”

This beautiful arch was found practically uninjured in the midst of the ruins at the summit of Nob Hill. Mr. James D. Phelan had it removed to the banks of a little lake in Golden Gate Park, where it stands as a memorial to the devastated city.]

The Ingleside population affords a painful study in isolation. Among a thousand refugees over fifty years of age, a majority would be expected to have children or relatives and the hasty inference would be that family care should be given to a number that were in the Relief Home. Filial obligation is, indeed, too little emphasized; but frequent migration weakens the family tie. An examination of these cases does not show many in which the refugees were dependent because of wilful neglect by relatives. The superintendent of the Relief Home in the year 1909 carefully investigated all cases about which there was rumor of property concealed or relatives able to give support. The result was that only a very few of either were discovered. In the case of those who had hidden savings, or an inheritance, the city compelled the payment of $15 a month for board and lodging or the leaving of the institution. In the case of most children who had been well-to-do, a payment was agreed on rather than the return to relatives.

A cursory glance at the Ingleside records would give the impression that all the mutilated, semi-blind, deaf, rheumatic, and disabled old people in the countryside; the one-legged and one-armed men and the men with no legs at all; the partly paralyzed and otherwise crippled, had been gathered there,--a forlorn company more than half of whom added to other defects the slowness of old age. The problem was not merely the relief of the aged, but the relief of the handicapped. The crippled had been for the most part self-supporting before the fire; some were elevator men, some were watchmen, many had sold notions or papers on the streets or peddled goods in the country roundabout. The peddlers on the whole did very well with their grants, perhaps because a physical mutilation is an asset to a peddler, or because no definite patronage had to be regained. A person with a physical defect but accustomed to unusual or skilled occupation, as for instance, the printing and distributing of bill-heads or the repairing of musical instruments, is not debarred from self-support as is the man who belongs in the ranks of common labor.

The restoration to self-support of even the able-bodied elderly women was quite as difficult as the rehabilitation of the handicapped. There was after the fire, as always, a considerable demand for cheap general houseworkers. To the casual observer, these sturdy old women at Ingleside ought to have been able at least to earn their lodging and food. But if the observer had attempted to employ one in her own household she would have found it all but impossible to endure her personal peculiarities. More than half were born and had lived in foreign countries, and although to a degree Americanized, were relapsing into the peasant habits of childhood. In cleanliness and decorum a rising standard had left them far behind. To uncleanly and vulgar habits and lack of skill were added a tendency to misrepresent, even when truth-telling would be advantageous, and to be voluble on the subject of chronic grievances or ailments. Women of another type who were both cleanly and competent could not keep in work because they lacked initiative. Someone had to do their thinking for them. In the Relief Home where they had kindly supervision they became excellent helpers capable of earning small wages.

The chief elements in the failure of these old people, men and women, to recover their independence, were lack of adaptability, lack of speed, and poor judgment in business matters. Those who had maintained themselves for years, could not get back into their narrow familiar groove nor find another into which to fit themselves. An old man who was probably as good a cabinet maker as any other in the city, could do barely half the work in a day expected by employers, because of over-conscientiousness and slowness. In a thousand ways the inefficiency due to ignorance, lack of skill, and poor judgment, predestined the refugees of Ingleside to failure, whether they received grants or not, and whether the aid given was great or small.

In some cases the grants seem pitifully inadequate and it may be questioned whether the individuals had a fair chance to re-establish themselves. Remembering the high rents, the cost of materials, the cost of transportation, the dearth of employment, and the lessened consumption, larger sums than those given would seem to have been necessary to afford a prospect of permanent rehabilitation. But the Corporation could not anticipate panic nor exceptional lack of employment. A large proportion of these cases, moreover, had to be decided in August, 1906,[283] when the grants were discontinued or made in small amounts. In the cases of those who received $150 or more, there was no higher proportion of success than where smaller amounts were given. It is impossible to determine from the information we have whether the later dependence of one-third to one-half of the Ingleside refugees was due to the industrial situation or to the deficiencies of the individuals themselves or to inadequate relief. One conclusion we may safely set down: no case of failure was due to any one of these causes alone.

[283] See Part I, p. 99 ff.

Turning from the discussion of these qualifying circumstances to estimate the results of the relief of the aged, the infirm, and the handicapped at Ingleside and in the Relief Home, certain things emerge very definitely. For convenience and clearness they may be set down categorically.

1. _The speculative character_ of relief after disaster, especially in the case of persons over fifty years of age, should be recognized and too much must not be expected from the issue. The recuperative power of aged persons is relatively small under ordinary conditions of life, but when they are thrown out of the groove of years, subjected to shock and hardship, and made to begin over again, it is infinitely smaller. For this reason the element of uncertainty should be reduced to a minimum by the use of records, by the employment of trained investigators, and by the consultation with camp commanders or others who have observed the applicants for some time. During the earlier part of the relief work in San Francisco grants were made after investigation, in lump sums which in a considerable number of cases were squandered or used unwisely. After the Model Camp at Ingleside had been in operation for some months and the camp commander had had time to observe the inmates, the recommendations of visitors were often modified at his suggestion; in some cases the money was placed in the hands of a visitor to be expended for the applicant, and in many others it was given in care of the Associated Charities. These later grants lasted longer and were of more avail in relieving the recipient than those made on less information and with fewer precautions.

2. _The value of charity records_ as a basis for determining the kind and amount of relief that should be given in an emergency cannot be over-emphasized. The case records of the Associated Charities, of the several benevolent societies of the different nationalities, and of the Catholics and the Hebrews, and the records of the almshouse, all should have afforded a quick means of learning the former dependent or independent position of many applicants. Unfortunately in San Francisco, before the fire, most of these agencies did not sufficiently understand the value of permanent detailed records. The result was that a number of people who previously had been more or less dependent were assisted on the assumption that they were as likely to become self-supporting as those who had never applied for aid. Elderly indigents rarely resort to an alias and they might have been easily identified if the records had been reasonably complete and had been available in one central bureau. Since the disaster, the exchange of case information among the principal charitable agencies is proving invaluable in preventing duplication of relief and in developing unity of plans for constructive charity.

3. _The value of trained investigators_ is distinctly apparent in a comparison of their recommendations with those of amateurs in the Ingleside cases. The inexperienced visitor, “taken in” by some plausible old person, would recommend a grant of several hundred dollars; the committee, mindful of many applicants yet to come and suspicious of the excessive enthusiasm of the visitor, would give half as much carefully guarded. The trained visitor, on the other hand, seized upon the hopeful points as well as the limitations of capacity and formed a balanced judgment which the committee usually accepted in substance and which was generally justified by the subsequent history of the applicant. The business of an investigator is not to harden his sympathies and expose imposture, but to become a trained and sympathetic expert in human nature. Especially in emergency relief, therefore, his judgment should be of the highest value.

4. _The pension and the direct grant_ were both used in providing for two quite different classes of the aged and infirm. A number of feeble persons who had been decent and hardworking before the fire but who, very evidently, could never again be self-supporting, were given grants outright “till they should be able to work again”--as the committee kindly phrased it--or because they were “too nice to go to the almshouse.” A larger number of cases, where it was impossible to determine whether the applicants were still capable of self-support or in need of institutional care, were given the benefit of the doubt. This was, indeed, almost compulsory because institutional facilities were so meager. The intention of these grants must be wholly commended, but the history of the cases treated by the two methods indicates clearly that the money given in instalments in care of a visitor or of the Associated Charities had been much more effectively spent than that given to the applicant in a lump sum. If it be assumed--as it should be--that no decent person of this borderland class should be prematurely relegated to an institution, the results in San Francisco prove that a limited pension in the care of a friendly visitor is both wise and humane. It is, moreover, economical.

5. _The age of possible rehabilitation_ is approximately defined by the results of these cases. The natural period of self-support is between sixteen and sixty; but the capacity of the unskilled laboring classes to keep the pace of modern industry often begins to decline at middle age. As regards health and ability to be self-supporting the decade between fifty and sixty is critical; and the number of those between sixty and seventy who, after such a disruption of their lives as that produced by the earthquake and fire, are able to re-establish themselves even with assistance, will be very small. To conserve the common self-respect and society’s humane instincts, as many as possible should be encouraged to try.

6. _The lack of provision for certain classes_ in San Francisco was well known to charity workers before the fire, but it became a far more serious matter owing to the sudden increase and shifting of these classes of dependents. There were many people set down as “convalescents” at Ingleside who remained permanently in need of institutional care. The hospitals continued to discharge, at the earliest possible moment because of overcrowding, numbers of half-well people who had no homes and little or no resources. Even those who went back to poor homes frequently did not recover fully for want of proper care during the convalescent period. Those without homes must go to the Relief Home, and the increase of this class of inmates became a serious tax on the institution. The medical attention that must be given to the inmates of the Relief Home is greater than had to be given in the old almshouse. The increase in the number of the incurables, due in some measure to the shock and hardships of 1906, makes great demands upon the nursing staff. Although the number of admissions per thousand of the population is now no greater than before the disaster, the permanent burden of refugees will remain proportionately great for some years to come. Certain special classes--the convalescent, the incurable, the advanced tubercular, the chronic alcoholic, have never been adequately provided for in San Francisco. The transition from emergency to permanent provision affords the opportunity for developing the best methods and differentiating the kinds of charitable care.

SOME LESSONS OF THE RELIEF
SURVEY

SOME LESSONS OF THE SURVEY

PAGE
PART I. ORGANIZATION AND THE EMERGENCY PERIOD 369
PART II. REHABILITATION 370
PART III. BUSINESS REHABILITATION 371
PART IV. HOUSING REHABILITATION 371
PART V. AFTER-CARE 372
PART VI. THE AGED AND INFIRM 372

SOME LESSONS OF THE RELIEF SURVEY

What then are some of the lessons to be learned from this review of the San Francisco relief work that may be applied in other great disasters?