History of Hospice
Most people would like their loved
ones to live as well as possible as long as possible even with an
incurable disease. At some point, however, aggressive treatment
of the loved one's disease or diseases may force them to decide
that the burden exceeds the benefit. This frees them to choose quality
over simple length of life.
Treatment of symptoms continues and may include chemotherapy and
anti-biotics, but their purpose is palliative, that is, only to
relieve pain. Care in the last phase of life becomes more comprehensive
rather than less, so that with a new perspective the patient and
family can focus more on maintaining comfort for as long as the
patient has left. This emphasis on quality of life gives them the
opportunity to reconcile both with each other and with God and to
grow in their awareness of deeper spiritual values. By saying good-bye,
grieving together, and offering each other hope for a future together,
they share one of the most important events in the life of the family.
The purpose of hospice is to make this possible.
The hospice movement is considered by some to be a post-modern reaction
to the modernist desacralization of the person and community. The
triumphalist attitude toward the conquest of nature and disease
has brought improvement in standards of living but has undermined
the traditionalist reverence for the human transition from this
life to the next. All the world religions at their core have viewed
death as a natural phase of life, as something that should be accepted
without fear and even as the greatest moment of one's life.
The hospice movement to avoid the prolongation of suffering from
useless effort to conquer death or from the opposite extreme of
ignoring the dying was not invented thirty years ago in America.
The culture of accepting the inevitable in order to focus on easing
the path from one phase of life to another has roots extending back
centuries and even millennia to periods when dedicated spiritual
leaders gave nurturing refuge to those in need because God loves
every person and because hospice is a beautiful means for care givers
to return this love. This ancient tradition has now been revived
in the modern hospice movement in which caring for the dying is
not considered to be so much of a burden as an opportunity to ease
the path of one's fellow beings from this world to the next.
The modern revival of the hospice concept came to fruition during
the cultural turmoil of the 1960s, when Dr. Cicely Saunders defined
and pioneered a hospice program in 1968 at St. Christopher's Hospital
in London, and when the next year Elisabeth Kubler-Ross published
her On Death and Dying in America, which now ranks with Rachel Carson's
book, The Silent Spring, from the same era as a classic in developing
new perspectives on life and death.
Both of these seminal thinkers focused on the power of new technologies
and chemical processes in modern civilization. At the time, the
greatest frontier in medicine was cancer research, and Dr. Saunders
began her career by improving methods of pain control in terminally
ill cancer patients. This developed into the concept of "sheltering"
the dying from pain by new techniques of palliative care, which
then expanded naturally into the idea of holistic treatment of all
terminal pain, including the psycho-social and the spiritual.
The profound teaching of Dame Cicely Saunders throughout her active
professional life is indicated by her often quoted insight: "The
community needs the dying to make it think of eternal issues. We
are indebted to those who can make us learn such things such as
to be gentle and to approach others with true affection and respect."
She had returned full circle to the original concept of hospice
that has existed in all cultures since the beginning of human life.
The concept and practice of hospice care as a new, holistic discipline
is a permanent part of modern life, because it is an important response
to changing cultural conditions. Perhaps the most important are:
1) a reaction against the impersonal secularization of society and
the accompanying desacralization of life, as discussed above; 2)
the renewal of spirituality in all religions as part of a broader
cultural transformation; 3) greater awareness of the availability
of assisted suicide and of hospice care as a better alternative
at the end of life, similar to the choice between abortion and adoption
at its beginning; 4) organized grass-roots efforts to provide life-affirming
answers to such ethical questions; 5) demographic changes evident
in the burgeoning elderly community, combined with the emergence
of an educated and organized majority demanding better value and
service through alternative methods of care and treatment; 6) the
revolution in all fields of social science toward emphasis on quality
of life; 7) technological and pharmacological advances that make
quality improvement possible; and 8) advances in the health care
delivery system demanded by the tax-payers who want better care
at a fiscally and politically sustainable cost.
The unique purpose of hospice, as distinct from the curative medical
model, is to provide appropriate care and a caring community of
family and hospice team members sensitive to the patient's needs
so that the person cared for may remain in familiar surroundings
and better prepare mentally and spiritually for the major transition
from this life to the next. Maximum Hospice and Palliative Care,
Inc. gives effective Hospice Care services for Dying Patients and
Cancer Patients. Our Hospice care program is specifically designed
to minimize suffering for dying patients, cancer patients and their
family members.
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