Elsevier

Current Problems in Cancer

Volume 35, Issue 6, November–December 2011, Pages 304-309
Current Problems in Cancer

The History of Hospice and Palliative Care

https://doi.org/10.1016/j.currproblcancer.2011.10.004Get rights and content

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The Roots of End-of-Life Care

The first houses dedicated to the care of the dying were set up to manage care for travelers and crusaders who became ill. Not surprisingly, the term “hospice” therefore has its linguistic origins in the Latin word Hospes, a term that referred to either a traveling guest or a traveler's host.1 Crusaders in the 11th century are believed to have been the first group to have set up homes for the incurably ill.1 The Knights Hospitaller opened a hospice-type facility in the 14th century to both

The Development of Modern Hospice

Cicely Saunders was a 20th century British nurse and social worker who decided early in her career that she wanted to devote her professional life to the care of terminally ill patients.4, 5 She initially volunteered in the St Luke's Home for the Dying Poor in England. Her experiences led her to obtain a medical degree in 1957 to give her an opportunity to achieve her palliative care goals. In the coming decades, Dr Saunders played the predominant role in forming the tenets used in hospices

Formation of the Medicare Hospice Benefit

The first bill suggesting that hospice services be paid for by Medicare was introduced to and rejected by the USA Congress in 1974. Still, a US government task force determined in 1978 that hospice was a viable concept that could both improve end-of-life care and decrease overall Medicare expenses. A subsequent demonstration program, including 26 hospice programs across the country, measured the value of this approach to end-of-life care, and the success of that pilot program led Congress to

Palliative Care as a Medical Specialty

The term palliative care gains its origins from the Latin word palliaire, which means “to cloak.” A Canadian doctor named Balfour Mound has been given credit for first using the term “palliative care” in 1974 in the setting of treatment given with the goal of symptom relief.16, 17 The formal World Health Organization description is that palliative care is “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness,

Current Worldwide Hospice and Palliative Care Efforts

The worldwide adoption of effective hospice and palliative care measures has faced an array of challenges, many of which remain pertinent even today. Those factors have included physician disinterest in dying patients, cultural taboos against openly discussing death, limited resources, heterogeneous access to health care, suspicion about medical methodologies across borders, and simple resistance to change. Still, the need for quality end-of-life care has driven the ongoing increases in

Future Directions

The need for hospice and palliative care services will increase dramatically over the next 20 to 30 years. Developed countries are facing the aging of their populations, as is evidenced by the 78 million American “Baby Boomers,” who have just begun entering the phase of life associated with the peak incidence of cancer, heart disease, and other life-threatening and chronic illnesses. By contrast, continued improvements in the control of trauma and infectious diseases in developing countries

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