In Early Modern north-western Europe a unique form of charitable foundation developed – almshouses. These were inhabited by elderly men and women, who had led honourable middle-class lives, but had become unable to support themselves. In towns that were rapidly growing through immigration, many elderly people were without income or family support. The masses of the working-class poor had to resort to outdoor relief and other survival strategies or were confined in old people’s homes and hospitals. Almshouses, in which residents could maintain their privacy, autonomy and honour, were a viable middle-class alternative. We argue that this type of provision could rise especially in relatively urbanised, monetised north-western Europe. Here, wage labour was the dominant form of income; nuclear families the prevalent family type, and rich citizens had great interests to invest in building religious and urban communities. Around the North Sea, dependent middle-class elderly could entertain early notions of individualism and privacy, which were not catered for by charitable institutions elsewhere.