In the years preceding the height of deinstitutionalization of public psychiatric hospitals, twenty-eight percent of the residents were elderly. As the deinstitutionalization movement gained momentum, many elderly residents were either transinstitutionalized to nursing homes or released into the community. For a time, the percentage of elderly people in psychiatric hospitals dropped dramatically, but many elderly people remained confined involuntarily in state and county psychiatric hospitals. As the numbers of elderly people admitted to a hospital for the first time increased, the percentage of psychiatric hospital residents who are elderly rose to the point where over a quarter of all residents currently in public psychiatric hospitals are elderly. Thus despite three decades of deinstitutionalization, long-term care of elderly people remains one of the primary functions of the state hospital.

Elderly people constitute the most rapidly growing segment of our population. Largely because of fluctuating birth rates and advances in medicine which have effectively eliminated early deaths due to contagious diseases, the number of people over sixty-five has increased threefold in the past decade alone. Not only has the absolute number of elderly individuals increased dramatically in recent years, but their proportion of the general population has increased as well. In 1900, only three million people, or four percent of the population, was over sixty-five; in 1990, over thirty-one million people, or almost thirteen percent of the population, was over the age of sixty-five; and by the year 2000, that number is expected to climb to approximately thirty-five million people or one quarter of the population will be over sixty-five as the “baby boom” generation enters old age. Not only are more people growing old today, but once they reach old age, they are living longer. In 1950 the average life expectancy was 68.2 years. In 1985 the average life expectancy increased to 74.9 years, and by the middle of the twenty-first century, it is estimated that sixteen million Americans, or slightly over five percent of the total population, will be 85 or over.