By Dr. Saul Ebema- Resident writer. (Dr. Ebema is an expert in End of life care. He has done extensive study and research on spiritual care and meaning making in the final stages of life)

More people in America today die under hospice care at home compared to fifty years ago where many people died in a hospital setting. A hospice is a program of healthcare which provides physical, psychological, social and spiritual care for the dying and their families.

The hope of hospice is that through care and availability of a community sensitive to the needs of dying patients, both the patient and their families will be able to satisfactorily prepare mentally, emotionally and spiritually for the impending death.

The origins of hospice are somewhat unclear, “it is thought that the establishment of ‘safe houses’ in Biblical times where travelers could find safety, rest, and refuge from bandits is the earliest evidence of what has grown into the modern day hospice concept.”[1]

“In fourth-century Rome, the concept of hospice as a place to care for the sick and dying first came into being under the direction of Fabiola, a member of the Roman patrician class, who was well-known in her day as a generous provider of care and comfort to the sick and dying. Over the next Several centuries, the Roman Catholic Church continued to provide care to the poor and the sick, especially to the soldiers returning from the crusades.[2]

Jeanne Garnier is said to have established the first place to be known as a hospice facility in France in 1842. This hospice facility was set up to care primarily for the dying. The name hospice, ‘a resting place for travelers or pilgrims’ was chosen because this was a place between a hospital and a home. The goal was to help individuals with terminal illness to live comfortably until they died. Not long after this, “an order of nuns known as the Irish Sisters of Charity started a hospice in Ireland in 1879.

In 1885, the Sisters of Charity expanded their work in hospice to England.”[3]  In the ensuing years, “other homes for the dying were established not only in England but also in several other European countries.”[4]

The advancement of the current model for hospice in the United States is credited to British physician Dame Cicely Saunders, who, “in 1963, came to Yale University to lecture on the concept of hospice care to medical, nursing, social work, and chaplaincy students.[5]” Her teachings on hospice care “as it was being provided at St. Christopher’s inpatient hospice in London resulted in a series of events leading to the advancement of hospice care as it is today.”[6] The first Hospice in the United States was started in 1974 in Branford, Connecticut. Using St. Christopher’s hospice in England as a model, The Connecticut Hospice Inc, services were meant to:

• Provide medical care for the continuing control of symptoms such as pain, nausea, anorexia, etc.
• Concentrate on bedside nursing to provide comfort, close attention to easing physical distress, slow lengthy encounters that allow for patient’s care, interpersonal interactions and emotional support.
• Focus on the family unit and allow the patient and family to use the assets of their life style to cope with the situation.
• Provide spiritual and emotional support to the patients, families and staff.

The success of the Connecticut Hospice Inc. led to the growth of hospice services nationwide.

Sources

1. Janet E. Neigh, “Hospice: A Historical Perspective.” http://www.nahc.org/haa/history/ (accessed February 20, 2015).
2. Thomas J. Simms, “A Perspective on End of Life: Hospice Care.” http://www.medscape.com/viewarticle/549702 (accessed February 15, 2015).
3.  Clare Humphrey, “Waiting for the Last Summons: The Establishment of the First Hospices in England 1878–1914.” Mortality Journal 2 (2001): 146–166.
4.  Neigh, Hospice: A Historical Perspective, 1.
5.  Cathy Siebold, The Hospice Movement (New York: Twayne, 1992), 23.
6.  Simms, A Perspective on End of Life, 2.