The History of Hospice Care

The word "hospice" comes from the Latin word "hospes," meaning to host a guest or stranger. As medicine and hospitals developed during the middle ages, ill people were treated in ‘"hospitals," but because germ theory was unknown, disease would often spread and people would die from acquired infections. Families often preferred to keep their loved ones at home, fearing that they would die in "the house of death" as the hospitals were sometimes called. Neighbors would help support the family with food and clothing. The name 'hospice' was first applied to the care of dying patients by Mme Jeanne Garnier who founded the Dames de Calaire in Lyon, France, in 1842.

After WWII, hospitals gained a better reputation as medicine improved and more lives were saved. These early centers of care did not separate curative from palliative (comfort) care. As healthcare became more technologically advanced, prolonging life at any cost prevailed over comfort care.

In 1967, Dame Cicely Saunders started St Christopher’s Hospice after being inspired by a patient who was hospitalized with an inoperable cancer and she, a former nurse, was working as a medical social worker. The two had discussed how she might one day open a place that was better suited to pain control and preparing for death than a busy hospital ward. Since then her ideals have spread around the world, which gave her the reputation of being the founder of the modern hospice movement.

In 1969, a book based on more than 500 interviews with dying patients was written by Dr Elisabeth Kubler-Ross. The book, "On Death and Dying," was revolutionary and challenged the high-tech approach. It became a best seller and took death out of secrecy and into public awareness and discussion for the first time. Kubler-Ross argued that home care was preferable over institutional care and that patients should be able to participate in decisions regarding their treatment. She described stages through which dying people go in coping with the reality of death: denial, anger, bargaining, depression, and acceptance. These still hold true, though they are not experienced by everyone, or in an exact sequence.

Until recently, the focus of modern hospice care has been cancer care. The AIDS epidemic has been a large force in broadening the focus of hospice care. Today, hospice is no longer a place, but rather an approach of care for patients with life-limiting illness, and their loved ones who are facing a difficult journey.