Origin and Evolution of Hospice Care

Apr 20

Written By Coastal Home Health & Hospice

Hospice care - or caring for terminally ill individuals and their families during the final stages of life - dates back centuries; however, its modern form first gained momentum in the 1960s. Since then, hospice has changed how we view death and dying, focusing on prioritizing compassion, dignity, and quality of life. It has also changed the conversations had with and among family members during this sensitive time.

Birth of the Contemporary Hospice Model

Cicely Saunders' pioneering work as an English nurse, social worker, and physician can be considered the origins of modern hospice care models. She founded St. Christopher's Hospice near London based on researched principles prioritizing compassionate care over curative treatments for those in their final days.

Revolutionary at the time, she promoted ideas such as providing terminally ill patients with comprehensive medical, spiritual, and emotional care in an effort to limit suffering rather than focusing on throwing every available treatment at a patient, even if those treatments caused extra suffering with minimal results.

Her theories focused on creating an atmosphere filled with peace and human connection. She stressed achieving optimal pain control as part of providing homelike environments to make life as comfortable and fulfilling as possible for her patients.

St. Christopher's quickly established itself as an example of humane end-of-life care. By the 1970s, hospice programs had begun appearing across America and beyond. Since then, they have spread to every major city in the U.S. and are even an important part of the medical system in small towns like our own Crescent City.

Early Hospices in America

Early American hospices followed the principles espoused by St. Christopher's in England, seeking to treat "the person rather than their disease;" provide personalized medical, emotional, and spiritual care; support patients and families as a unit; and care for terminally ill individuals in either their homes or warm, homelike settings rather than cold institutional environments.

As hospice philosophy was more widely publicized through grassroots efforts led by nurses, community leaders, and volunteers, widespread demand was created. Supply soon rose to meet demand, and along with that came efforts to establish standards of care and regulations. In 1983, the federal government granted Medicare waivers reimbursing approved hospices which opened the way for further expansion while setting baseline requirements for hospice providers.

Hospice Access Via Medicare

Medicare Hospice Benefit became permanent in 1986 and opened up hospice access to more Americans. By 2000, approximately 3,000 hospice programs were providing over 500,000 people annually with hospice services; today this market has expanded into nearly 5,000 providers serving over 1.5 million patients and their families each year (2).

Modern hospices continue to evolve from their founding principles decades ago, evolving to meet a variety of end-of-life needs. Specialty programs exist for Alzheimer's, ALS, HIV/AIDS, pediatric hospice, perinatal hospice for infants, and more. Hospice programs exist in hospitals, healthcare facilities, and, of course, right in patient homes via home hospice services like Coastal’s.

Home Hospice Services

Of all the hospice programs currently available, home hospice stands out as having unparalleled and life-altering benefits in its final chapter of life. Over one million patients per year benefit from hospice services provided right in their place of residence - whether that means in a private home, assisted living facility, or long-term care facility.

Terminally ill patients and their loved ones often find the most comfort in their familiar home environment. Home hospice allows loved ones to experience their remaining days together in intimate surroundings full of memories- patients can sleep in their own beds, look out their own windows, be surrounded by beloved items from home, and find peace within the privacy of their own residence.

Almost any necessary medical equipment, supplies, and medications can be delivered directly to the patient’s home while family caregivers receive education from hospice staff members and other healthcare providers about each patient’s unique needs and how they can best be helped. Home hospice teams become an extension of families, offering expert care, compassionate guidance, and respite for caregivers.