When medieval people lived to old age, most of them had families who cared for them. Some lived in monastic communities, which were well-equipped to care for the aging. A wing of the monastery was always devoted to nursing care; it usually had a sheltered flower garden just outside its door. Some wealthy people who didn’t have family donated to the monastery in exchange for end-of-life care. The poor tended to die wherever they were, however it happened, but some lucky few came to hospitals.
Hospitals had been a Roman tradition, so in Constantinople, the Eastern Rome, they remained well-developed and even included simple surgeries. Benedictine monasteries had started a new tradition of setting aside a wing for sick care for the poor, but Crusades-related travel to Byzantine lands took hospital care out of the Dark Ages. Medieval hospitals were, in fact, the only buildings that tried to keep a light on overnight.
Weirdly, the medieval hospital considered its first duty to be the spiritual care for the sick, so the sick were forced to attend Mass and prayers if they were at all able. Physical care was generally limited to food, water, and heated rooms, with some simple wound care. This was enough help for many people to recover, but it made death a little less miserable for others. Hospitals often took in a cluster of orphans, employing them as errand-boys and keeping a little school. The duties of caring for the poor, the sick, the wounded, the crippled, the aged, and the orphans were all blurred in those days.
Most hospitals were made from repurposed manor halls, donated by owners who were afraid of Hell in their last weeks. Wards were open, without private rooms, simply for that reason. Large barn-like halls could only be partitioned and organized to a certain point. It was a long time before hospitals were built on purpose. Beds were a motley collection of whatever dying people had left in their wills; most had rope foundations and straw mattresses, but they were a lot better than the poor were used to.
The best hospitals were in Italy; they were funded by city governments and had medical schools attached. The rest of Europe lagged behind; St. Leonard’s in York was the largest and best outside Italy. It used herbal medicine and was staffed by monks with medical training; its 200 beds were dimly lit at night by lanterns in the hallways. As in most hospitals, many nuns and lay sisters were the majority of the staff; gradually they developed uniforms, usually a cross badge.
The medieval hospital system began to break down at the end, first by frank mismanagement of the ordinary modern kind, mostly scams to keep donations rolling in while few patients were in care. But then came the plague. Hospitals were overwhelmed, and their staff died as rapidly as their patients. The whole thing had to be overhauled. In the early modern period, duties became separated: orphanages, almshouses as nursing care for the dying poor, and hospitals for the sick and wounded.