Hospice is a particular type of care and even more than that it is a care philosophy that focuses on the palliation of a terminal ill individual’s symptoms. The symptoms can include anything from emotional, social, physical and social symptoms and they can vary from patient to patient. The physical and philosophical concept has started evolving in the 11th century. Back then, hospices were the places where the sick, the wounded and the dying patients were gathered so that specialists could take care of them at the same time. Moreover, a hospice in those times would also accommodate travelers and pilgrims. The modern concept of hospice includes palliative care for the individuals who had been diagnosed with incurable condition and it is commonly given in institutions such as hospitals or nursing homes. Some patients prefer being provided with this type of care at home as they would rather like to die in their own homes. The modern concept of hospice evolved in the 17th century but most of the principles on which modern hospice services operate have been founded in the 1959s by Dame Cicely Saunders. Initially, the movement was received with a significant resistance, yet the concept managed to expand quite quickly in the United Kingdom, then in the US and afterwards in other places of the world.
The pioneer of the hospice movement, Dame Cicely Saunders was a British nurse who was herself chronically ill, suffering from heart problems. Her health situation forced her to follow a career in medical social work and her principles are thought to have evolved during the special relationship that she had developed with a terminally ill Polish patient. She then discovered that terminally ill individuals need more compassionate care to help address their fears and that they also need palliative comfort for various physical symptoms. Following the death of the Polish refugee, Saunders began working for St Luke’s Home for the Dying Poor where she had been told that the best way to influence the treatment of a terminally ill patient was as a physician. She then went to medical school which she graduated in 1957 and remained working as a physician for the same care institution.
Her main ideas were based on the fact that treatment should rather be emphasized on the patient and not so much on the disease. She was the one who had introduced the notion of total pain which included psychological, emotional and spiritual pain as well as physical pain. She experimented with various opioids to control the physical pain but she recognized the need of the patient’s family at the same time.
In the late 1960s, another significant discovery was made in the field by Dr. Kubler-Ross, the author of the five stages of grief model.