The History of Hospice and Palliative Care
Section snippets
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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Cited by (43)
Chatbot Performance in Defining and Differentiating Palliative Care, Supportive Care, Hospice Care
2024, Journal of Pain and Symptom ManagementPalliative Care
2023, Avery's Diseases of the NewbornA qualitative study exploring nursing students' perspectives on and attitudes towards hospice care in China
2022, Nurse Education TodayCitation Excerpt :The core concept of hospice care is a humanistic care service to improve the quality of the end of life for patients and alleviate the grief experienced by family members, so that patients can die comfortably and calmly (Tatum and Mills, 2020; Zhang et al., 2021). Hospice care originated in western countries, with St. Christopher's Hospice in the United Kingdom (UK) being the first modern hospice institution in the world (Lutz, 2011). Some studies have demonstrated that the major benefits of hospice care include improvement in quality of life with less emotional distress, decreased hospital stays, reduced medical costs, and more support for the family (Currow et al., 2020; Huang et al., 2020b; Yen et al., 2021).
Deception, honesty, and professionalism: A persistent challenge in modern medicine
2022, Current Opinion in PsychologyCitation Excerpt :This was a 40-year study in which government clinicians withheld evidence-based, available, and curative therapies from approximately 400 Black men with syphilis without their knowledge or consent [9]. During this same period, the emergence of palliative and supportive care led to an evolution in the approach to serious illness care that was not solely focused on cure but also on patients’ psychosocial well-being [10]. In a complete reversal, by 1979, over 90% physicians supported full disclosure of the same bad news [6].
Delivery models of neuropalliative care
2022, Handbook of Clinical NeurologyCitation Excerpt :The Crusaders eventually converted these shelters into homes for the incurably ill. Centuries passed and similar facilities offering care for the dying were founded by various religious organizations in Europe (Lutz, 2011). Individuals with limited resources, those with no family and people suffering from tuberculosis and cancer occupied the early hospices.
Palliative Care?! But This Child's Not Dying: The Burgeoning Partnership Between Pediatric Cardiology and Palliative Care
2020, Canadian Journal of CardiologyCitation Excerpt :Saunders championed the concept of addressing a patient’s “total pain”—physical symptoms, mental distress, social problems, and emotional difficulties. The term “palliative care” was coined by Dr Balfour Mount, a surgeon in Montréal, in the 1970s.18 Mount sought training with Saunders after becoming aware of the poor state in which patients were dying within his own institution.