The History of Hospice

Hospice is an old concept only recently adopted into mainstream medical practice, rooted in providing comfort and dignity to patients facing the end of life. From its early beginnings in medieval Europe to the modern hospice movement, the mission has remained the same: ensuring quality of life in the final stages. As the field has evolved, so too have the tools and resources supporting it. Real-time solutions play a critical role in empowering hospice teams to deliver timely and personalized care. 

Compassionate Care Through the Centuries 

As far back as the 11th century, places of hospitality nicknamed “hospices” appear in recorded history. The first hospices were Roman Catholic run and provided care for travelers, pilgrims, the sick and the dying. It wasn’t until 1967 that the first modern day hospice was established by Dame Cicely Saunders in the U.K and St. Christopher's was the first medical institution to approach care for the dying the way the rest of the medical community approached care for the sick—with a commitment to education, research and clinical excellence. 

Dame Cicely Saunders was a trained nurse, medical social worker and later physician. It was while working at Archway Hospital in London that she befriended David Tasma, a dying Polish refugee. Their intense friendship facilitated the birth of modern hospice as they discussed the possibility of creating a dedicated home for the dying. Upon David’s death, he bequeathed her 500 pounds with the promise of becoming, “a window in [her] home,” someday. The gesture was personal confirmation that improving end-of-life care was her life’s mission. 

Before the Hospice Movement 

The terminally ill were a severely neglected patient population before the hospice movement. Healthcare providers viewed their incurability with contempt and perceived them as personal failures. Dame Cicely Sanders pushed back against this limited understanding of a healthcare provider’s role and responsibilities. She believed that above all else, they had a duty of care to comfort and reconcile patients to their own mortality. 

Dame Cicely Saunders envisioned a patient-centered, clinical environment that cared holistically for the dying by providing for physical, mental and emotional needs. Instead of curative treatments, she submitted palliative care as the answer. Palliative care promotes symptom relief, including from the emotional and mental distress of living with a progressive illness. Comfort is king, not curing. 

Hospice Care and Medication 

Before the Dame's inspired painkiller research, cancer sufferers rarely received appropriate medication intervention as opioids were considered too addictive and dangerous for pain management. Her research demonstrated that regular painkiller dosing was not just recommended, but necessary for improving quality of life at the end. She also proved the oral route to be a simpler, yet equally effective method for pain relief. Prior to her research, physicians relied on the more labor-intensive intravenous route for administration. 

Hospice vs. Palliative Care 

The distinction between hospice and palliative care is rooted in the evolution of compassionate care that Dame Cicely Saunders championed during the early hospice movement. Hospice care focuses on providing comfort and support for individuals with terminal illnesses, typically in the final months of life, and emphasizes quality over curative treatments. In contrast, palliative care extends these principles of symptom management and holistic support to patients at any stage of a serious illness, working alongside curative efforts. 

Dame Cicely Saunders’ concept of "total pain" not only shaped hospice care but also laid the groundwork for modern palliative care by addressing physical, emotional, social, and spiritual suffering. This holistic approach remains central to both fields, ensuring that patients and their families receive the support they need during challenging times. 

Cultural Sensitivity in Hospice Care 

Recognizing and respecting cultural traditions and values is integral to hospice care. Whether it's accommodating dietary restrictions, spiritual practices, or family rituals, hospice teams strive to honor the unique needs of each patient, ensuring a more personal and meaningful care experience. This approach builds on the historical mission of hospice: to provide comfort, dignity, and respect at the end of life while fostering emotional and spiritual healing. 

Modern Hospice Care: Innovations and Advancements 

The principles of hospice and palliative care have paved the way for advancements in how care is delivered today. Modern hospice care builds on this foundation by integrating innovative tools and technologies that enhance both the patient and caregiver experience. 

Exceptional patient care begins at the bedside. Modern hospice care has embraced innovations that enhance the quality and efficiency of end-of-life support. Advances in real-time technology, enable teams to provide timely medications and improve patient comfort. Additionally, telehealth and data-driven care plans are transforming how hospice teams deliver personalized, compassionate care to patients and their families. 

Our easy-to-use mobile medication ordering tool helps nurses select the best medication options, get them approved, and keep track of their status from start to finish. Want to see BetterRX in action? Schedule a demo today! 

Understanding Hospice Participants 

Businesses who cater to the hospice industry must understand their unique background and mission to provide superior service. All medicine is personal, but hospice is especially intimate due to its unapologetic acceptance of the often ugly and uncomfortable realities inherent to dying. This isn’t to say that end-of-life care is entirely bleak or devoid of joy. In hospice we often witness sublime displays of human tenderness and spiritual healing. It is unwise to ignore the difficulties patients and their families face as they confront weakening bodies and dwindling minds.  

Most hospice participants experience heightened emotions of disappointment, guilt and fear. Business clients must be committed to providing exceptional patient care, simply because there is more at stake than profit loss. When quality of care is compromised, what is meant to be a peaceful passing becomes traumatic for patients and loved ones. Subsequently, all business decisions should be weighed against patient benefit before implementation.  

Speed is an important consideration because of limited life-expectancy. Slow-moving, bureaucratic processes should be cut or eliminated where allowable. Since business clients mostly work with clinical staff and administration it’s crucial that your product or service simplifies rather than complicates workflow. Hospice opts for ease whenever possible because of the gravitas of their work. If your product doesn’t work for staff, it’s unlikely to benefit patients. 

The Founding Vision of Hospice 

In 1963, during a presentation at Yale University to American health care professionals, Dame Cicely Saunders showed powerful before-and-after images of terminally ill cancer patients who had received palliative care. The stark transformation—patients smiling despite their wearied faces—demonstrated the profound impact of compassionate, holistic care. Her vision inspired not only the global hospice movement but also practical steps toward integrating hospice into healthcare systems.  

The establishment of St. Christopher’s Hospice in 1967 laid the groundwork for hospice care as we know it today. In the United States, this vision became a reality with the introduction of the Medicare Hospice Benefit in 1982. This critical legislation made hospice care accessible to millions by covering services like palliative care, medications, and support systems for terminally ill patients. It solidified hospice as a vital part of healthcare policy and ensured that compassionate care could reach more individuals and families during their most vulnerable times. 

Serving the hospice industry impacts patient outcomes, so tread lightly. Hold fast to its founding vision and you can’t go wrong. Patients and their families will be eternally grateful for your commitment to exceptional palliative care during this critical time. 

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Works Cited

“A Brief History of Hospice.” Understand Hospice, 1 Dec. 2016, https://understandhospice.org/brief-history-hospice/.

Baines, Mary. “Pioneering Days of Palliative Care.” European Journal of Palliative Care, 2011, 18(5): 223–227, https://www.stchristophers.org.uk/about/history/pioneeringdays.

Fisher, Nicole. “The History Of Hospice: A Different Kind Of Health Care.” Forbes, Forbes Magazine, 28 June 2018, https://www.forbes.com/sites/nicolefisher/2018/06/22/the-history-of-hospice-a-different-kind-of-health-care/#2e3e4dbb660c.

Oliver, Chris. “Short Biography of Dame Cicely Saunders (1918-2005).” Archives of Dame Cicely Saunders (1918-2005): Cataloguing the Papers of the Modern Hospice Pioneer, 10 Feb. 2013, https://cicelysaundersarchive.wordpress.com/tag/david-tasma/.