Before modern-day senior living facilities, the state's mental hospitals were some of the only options for thousands of elderly people who suffered from what later would be diagnosed as Alzheimer's or other forms of dementia.
“It's hard for you to believe, if you're younger, that there were very few nursing homes for geriatrics,” said the Rev. George DeVille, who worked in the state hospital system for 37 years. “There was just nowhere else to send these people.”
DeVille, 82, began working as a state mental hospital chaplain in the mid-1960s before the term Alzheimer's was readily known and the treatment for it was even more confounding. Just about one-third of the patients who were living in state hospitals were seniors during that time, he said, and many of those patients were thought to have “pre-senility” or “hardening of the arteries,” crude names for a puzzling condition.
“We knew people were senile or had loss of memory, but we didn't name it Alzheimer's,” DeVille said. “Then we were able to name it. We don't use those words anymore.”
DeVille, the pastor of Holy Rosary Parish in Muse, harkened back on his years working at Woodville and Mayview hospitals in Allegheny County. Although his job as hospital chaplain was difficult, he remembered it as the best time of his life – “It was my Camelot,” he fondly says – while trying to help thousands of patients who passed through the system.
“We really didn't sort it out and say, 'This is Alzheimer's,'” DeVille said.
It wasn't until the mid-1970s – a full decade after he began his career working in the mental health system – that Alzheimer's was widely diagnosed and better understood, he said. Without a firm grasp on the disease, the hospital workers did what they could to make patients comfortable and keep them safe.
Some patient rooms had locked doors when DeVille began, until that was deemed inhumane and alarm systems were installed to alert the staff of problems. The biggest concern for the hospital staff was for patients to leave their rooms and wander off the property.
“It wasn't like you see today when you have specialized Alzheimer's wards,” DeVille said. “We didn't have anything like that at the time to treat them.”
But DeVille tried his best as chaplain to help the elderly understand or even remember his Catholic Masses. He created a color-coded missalette to help the patients follow along with the service. He marveled at how many of them still participated in Communion without instructions, most likely because they first learned it as children.
“What you learned first, you remember last,” DeVille said about Alzheimer's.
It was sad to watch people who were pillars in the community whittle away at the state hospitals, DeVille recalls. The advent of better medications was a double-edged sword because it helped the patients live longer, but that just meant more time for the disease to take hold, DeVille said.
“When you have a few cases of this, no one is paying a lot of attention to it,” he said. “As the population starts to grow older, you get people who have more of a chance of getting it.”
Then came Medicare. The federally funded program that insures seniors 65 and older was passed in 1965 and began to have an effect on the state system. Patients who couldn't afford specialized care in nursing homes soon were pushed into private facilities that offered better options.
“There was this 'magic door' we sent them through,” DeVille said of the transfer of patients from state hospitals to senior care homes when they turned 65.
That, along with the improvement of psychiatric medications for those suffering from depression or other mental disorders, ultimately led to the decline of the state hospital system. According to state Department of Public Welfare records, 27,536 patients lived in 24 state hospitals in 1969. That population dropped to 10,573 just 10 years later.
The decline led to the closure of 14 hospitals from 1979 to 2010. DeVille had worked at Woodville State Hospital in Collier Township until 1992, when it closed, and he was transferred to Mayview. He remained at that state hospital located in South Fayette and Upper St. Clair townships until 2000, before it ultimately closed in 2008.
Though still an enigma, more is known about Alzheimer's today than when DeVille first started in the state mental health system. The treatments for the disease were crude, DeVille said, but he's proud of the work the staff did to care for the patients humanely and with respect.
“For what we had, we gave them the best care possible,” DeVille said. “I have great admiration for the state employees that worked there. They loved these patients.”