Until the end of the 19th century, care for the elderly and infirm was primarily the responsibility of their family members. Those who had no descendants or relatives could buy into monastic communities or even hospitals and hospices. Destitute people were housed in poorhouses or workhouses. From the middle of the 19th century, various denominational and private associations and foundations took care of those affected. Private foundations played a decisive role in the development of care for the elderly; they were often aimed at single women.

The first institution to provide special care for the elderly in Wiesbaden was the Zimmermann Foundation, established in 1852. The siblings Elise and Philipp Zimmermann each donated 1,000 fl as well as the furnishing of a room for this purpose. The Katharinenstift retirement and nursing home in ➞ Biebrich was also established through a foundation. Katharina Schneider instructed her daughter Louise to use her parents' inheritance for social purposes after her death. As a result, an after-work home was opened in the former canning factory "Am Schlosspark" in 1893, which was transferred to EVIM (Ev. Verein für Innere Mission in Hessen und Nassau) in 1901 and given the name "Katharinenstift".

Another foundation went back to the publishing bookseller Christian Wilhelm Kreidel, who in 1890 named the "Versorgungshaus für alte Leute" (care home for the elderly) as one of his heirs in his will. Another well-known benefactor was Eugenia ➞ Kreitz. In 1908, she donated her villa with outbuildings and garden to the Catholic Herz-Jesu-Gemeinde in Biebrich in order to set up a nursing home (now the "Herz-Jesu-Heim") for elderly ladies. Around 1910, the Paulinenstift, the ➞ Hospiz zum heiligen Geist and the Catholic Brüderhaus, among others, were also looking after elderly people in need of care. The municipal workhouse for the poor in Mainzer Landstraße (built in 1893-97), which could accommodate 120 people, also housed so-called old people who did not require special care, alongside younger unemployed and homeless people.

In the 20th century, increased life expectancy and social changes made it necessary to set up additional care facilities. For example, the number of families in which several generations lived under one roof decreased and more and more older people lived alone.

In 1921, the first retirement home funded by the city of Wiesbaden opened its doors. The former hotel and bathhouse ➞ Schützenhof was able to accommodate "impecunious or less well-off single people of both sexes". The accommodation in the Schützenhof was closed again at the beginning of 1927 due to renovation work, but another home was created in the ➞ Dietenmühle, where 92 people were accommodated in 1928. In 1923, the Nassauische Blindenfürsorge e.V. set up a home for single blind people, in which older people also lived. Other municipal facilities included a home in Schwarzenbergstraße and the infirmary of the Biebrich municipal hospital.

In the mid-1930s, private homes, which were run by church organizations or welfare associations and received financial support from the city, provided the majority of care for the elderly. In 1936, 561 "people in need of help" lived in homes in and around Wiesbaden.

In 1938, the Biebrich hospital in Breslauer Straße, which dated back to 1888, was converted into a retirement home and a home for the chronically ill (now the Toni-Sender-Haus). At the same time, EVIM opened a retirement home with 50 beds in the Ludwig-Eibach-Haus, originally a Protestant rescue home from 1853 for "morally neglected children". Between 1939 and 1956, the number of residents rose to 84, and demand was particularly high during the war years.

The housing shortage after the Second World War, the high number of single women and the decreasing willingness of younger people to live with older people were the reasons for the further increase in demand for places in homes. Private homes and foundations attempted to remedy this situation. Existing buildings were converted into retirement and nursing homes with limited financial resources. In 1949, a retirement home was also built on the site of the ➞ Antoniusheim. From 1964, plans were made to build a retirement home here, the first construction phase of which was opened in 1970. Also in 1949, the "von Zedlitz-Heim" with ten single and four double rooms was opened at Alwinenstraße 22. The home had to be closed in 1979 as it was no longer being used to capacity and was in need of renovation.

At the end of the 1950s, the new profession of geriatric nurse was created. In Hesse, the first training courses were held in Darmstadt in 1958; in Wiesbaden, the first course started in May 1964 in the Lorenz-Werthmann-Heim in Kohlheck with eleven women.

Wiesbaden's particular population structure exacerbated the lack of housing suitable for the elderly. In the 1960s, the proportion of senior citizens in the population was far above the average for the Federal Republic of Germany, and by 1966 it was already 15.3%. In the 1960s, the city of Wiesbaden therefore declared the construction of retirement homes and apartments for the elderly to be a priority of its social policy. Private and church sponsors also set up further retirement and nursing homes. In 1961 and 1964, for example, EVIM built a home on the Geisberg with 104 places.

New forms of living and care emerged: in 1965, Wiesbaden had ten day care centers for the elderly (two municipal and eight day care centers run by independent providers), by the end of 1976 there were already 39 (five of which were municipal). In 1968, the first apartments suitable for the elderly were built in Wiesbaden. In 1969, a further 155 apartments for the elderly were built in the new district of Klarenthal, and in the same year the "Feierabendhaus Simeonhaus Wiesbaden" on Langendellschlag, which had been under construction since 1966, was completed.

In the mid-1970s, there were almost 1,200 places in retirement and nursing homes in Wiesbaden, but there were still long waiting lists. In the following 20 years, a change took place: many places in the old people's homes were converted into nursing places, as more people only came to the homes in old age and in the face of serious illnesses, and nursing wards were set up. One of these homes for the elderly opened its doors in 1984 in the building of the former eye clinic in Kapellenstraße.

At the beginning of the 1990s, Wiesbaden was dominated by facilities that offered both apartments suitable for the elderly and places in retirement and nursing homes. Of the 4,591 places, 2,400 were in these multi-unit homes. They include the "Hilda-Stift" of the Gemeinschaft Deutsche Altenhilfe (GDA), which opened in 1984 and in which residents are expected to live as independently as possible in 1-, 2- or 3-room apartments.

In 2015, there were around 30 retirement and nursing homes of various operators and sizes with over 2,000 places in Wiesbaden. In addition to the city and private companies, the operators are charitable organizations, including Caritas Altenwohn- und Pflegegesellschaft, EVIM, ➞ Arbeiterwohlfahrt, the German Red Cross and Nassauische Blindenfürsorge. Some of the retirement and nursing homes that still exist today, such as the Katharinenstift and the Herz-Jesu-Heim, date back to private foundations around 1900.