The lives of today's elderly population have deep historical precedents by which we can better understand current social policies, health care, and retirement. The history of old age in America is more complex and varied than most people realize. This history has been shaped largely by the search for economic security. In the agricultural economy of preindustrial America, few individuals saved sufficient resources for their declining years, and most elderly people either continued to work or lived in dependent poverty. More than any other factor, the lack of family members willing or able to provide for an elderly relative resulted in the relative moving to the dreaded poorhouse. Passage of Medicare and Medicaid legislation resulted in the rapid development of commercial nursing homes, accelerating the trend away from nonprofit and government facilities. However, serious deficiencies in care have continued to occur, prompting additional federal legislation. Knowledge of the history of aging in America can provide a useful touchstone: it can expose past problems that could happen again, identify what is worth preserving from the past, and help us avoid relearning painful lessons.