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Many of the medieval almshouses in England were established with the aim of benefiting the soul of the founder or their family, and they usually incorporated a chapel.As a result, most were regarded as chantries and were dissolved during the Reformation, under an act of 1547.
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To many, religion is less important now than it was in Medieval times, and the Christian side of almshouses no longer applies to all voluntary sector housing, though some maintain a Christian tradition.
Almshouses tend to be characterised by their charitable status and by the aim of supporting the continued independence of their residents.
The Maryland legislature created almshouses in Anne Arundel County, financed by property taxes on landowners throughout the state.
Massachusetts also had a long tradition of almshouses.
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There is an important delineation between almshouses and other forms of sheltered housing in that almshouse residents have no security of tenure, being solely dependent upon the goodwill of the administering trustees.
In physical form, and owing in part to the antiquity of their formation, almshouses are often very dated buildings comprising multiple small terraced houses or apartments, and providing accommodation for small numbers of residents; some 2,600 almshouses continue to be operated in the UK, providing 30,000 dwellings for 36,000 people.
In the United States, aid tended to be limited to the elderly and disabled, and children had to sleep in the same rooms as adults.
Almshouses have been created throughout the period since the 10th century, up to the present day.
In the Netherlands, a number of hofjes are still functioning as accommodation for elderly people (mostly women).