The History of Hospice Care and Palliative Care
According to the NHPCO [National Hospice and Palliative Care Organization], about 1.4 million Medicare beneficiaries were enrolled in hospice care for one day or more in 2015. Most people who have experienced the gradual loss of a loved one are familiar with hospice services (you can visit our hospice care and palliative care links for details and distinctions between the two). Today, hospices are considered the model for quality, compassionate care for life-limiting illnesses. Few of us, however, are aware of how these services got started.
The word “hospice” is derived from the Latin “hospes” which refers to both a host and guest. Wikipedia states that hospice history evolved from 11th century Europe. Rooted in Roman Catholic tradition, hospices were “places of hospitality for the sick, wounded, or dying, as well as those for travelers and pilgrims.” Though hospices flourished in the Middle Ages, they steadily declined until they were revived and further developed by religious charities in the 17th century in France. The first modern hospice, St Christopher’s Hospice, was created by Cicely Saunders in London in 1967.
Through the centuries, the hospice movement has faced cultural taboos shared by doctors, patients and their families. Reservations stemmed from a discomfort in openly discussing death and the application of unfamiliar medical techniques. In 1969 the best-selling book, On Death and Dying, was influential in changing both public and professional perceptions. It was written by Swiss psychiatrist Elisabeth Kübler Ross, based on her observations of inadequate and callous responses to the terminally ill at a Chicago hospital where her physician husband worked.
In the United States, hospice services grew out of a volunteer-led movement to improve care for people dying alone or with limited personal attention in hospitals. In 1982 Congress created the Medicare Hospice Benefit and in 1993 hospice was installed as a guaranteed benefit. Today it is a significant part of the health care system and it plays a role in cutting Medicare costs. Hospice reduces costly emergency room visits and inpatient hospitalization that can often be traumatic for patients and their families. In the U.S over 56% of hospice care is provided in-home, but services are also provided at home-like residences, nursing homes, assisted living facilities, veterans’ facilities, hospitals, and prisons.
A 2006 study found that about half of the countries in the world offer some form of hospice or palliative care service. While it is estimated that there are more than 10,000 international hospice and palliative programs today, it is also estimated that 18 million will still die in unnecessary pain and distress each year.
The WHPCA is a global voice on hospice and palliative care with 250 member organizations in over 90 countries. On the 2nd Saturday of October every year they organize a World Hospice and Palliative Care Day.