The History Behind Hospice and Palliative Care

Hospice care has a long history reaching back to at least the 11th century. 

Early hospices were set up to provide care for pilgrims who were on their way to or back from the Holy Land, and who were sick or near death. Hospices existed throughout the Middle Ages but petered out following changes to the religious communities that supported them. 

In the mid-1800s, France began opening up hospices, with other countries, such as Australia, Ireland, and the US, following suit by the end of the century. 

Modern hospice care got its start in the 1950s and was pioneered by Cicely Saunders, a British nurse. In the course of her work caring for terminally ill people, she developed a connection with a cancer patient. It was this bond that inspired her to start thinking about palliative care and how to create an end-of-life experience that focused on caring for the patient and their family, rather than on the disease. Her view of care sought to address "total pain," a phrase she coined to describe the physical, emotional, social and spiritual turmoil that can affect people who are terminally ill. 

Wanting to be able to provide more care, she went on to become a physician and presented her findings to Yale University. She showed the difference that hospice care made by showing pictures of patients before and after they received hospice care.

Dr. Saunders’ results were so powerful that they laid the groundwork for hospice care in the US. 

At around the same time, Dr. Elisabeth Kubler-Ross released her groundbreaking book, On Death and Dying, that shed new light on the end of life and how to approach it with care, dignity, and respect. The book featured interviews with people who were dying and highlighted the benefits of home care versus hospitalization for patients who were terminally ill. The book emphasized patients’ rights to have their wishes respected around their own care and death. 

Dr. Saunders’ and Dr. Kubler-Ross’ work constituted major shifts in how the medical establishment viewed hospice and palliative care. It would still take concerted effort to secure government funding for hospice care, but by the mid-1980s, the ball was rolling and over the next few decades, hospice and palliative care grew and developed into its current form we have today.