The history of hospice

Until the 1960′s the majority of hospitals worked under the aegis of an unconditional belief in the continuous improvement of medical technology and the model of “aggressive therapy.” It was then that thanatology, the science of death, began developing, addressing questions that are traditionally held taboos, such as death, dying, grief and pain. Thanks to the interviews Swiss psychiatrist Elisabeth Kübler-Ross and her colleagues conducted with dying patients, the public began to understand what the dying think of their fate, and what phases they go through before they reconcile with the idea of death. Homes were set up for the dying, where death was discussed candidly, where people could come to accept it as a meaningful end to a meaningful life, and where the dying were provided conditions worthy of humans, conditions for life and death.

 

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The model for Kübler-Ross was the St. Christopher’s Hospice in London, opened with the directorship of Dr. Cicely Saunders in 1967.

 

“A key figure of the hospice movement, Saunders was originally a nurse looking after seriously ill people, and went on to study for a medical degree with the intention to find relief for acute pain and mental suffering. From the very beginning, Saunders was interested in finding relief for the aggregate pain of cancer patients, their somatic, psychic, social and spiritual suffering. This of course required intimate communication with the patients.

 

The St. Christopher’s Hospice developed a scientific model for the treatment of terminal-phase cancer patients, what they called Tender Loving Care, which involved the participation of patients and their families. The principles worked out here were later adopted by hospices all around the world. Beside Cicely Saunders and Elisabeth Kübler-Ross – the latter founded hospices in the United States –, the third great woman we must count among the founders of thanatology was Mother Theresa of Calcutta, who established an order to care for the forsaken sick on the streets of India.”

 

( Adopted from Katalin Hegedus: Az emberhez méltó halál (Death Worthy of Man). Budapest: Osiris Kiadó, 2000.)

 

By the 1970′s hospice had become a movement. The model of home care had developed, as well as those organizations that represent a combination of in- and outpatient treatments: day sanatoria, outpatient clinics, palliative care support teams (mobile teams) that visit hospitals, support teams for the bereaved, and eventually the national hospice programmes. According to the Hospice Information Service, in 1998 there were 5500 inpatient units and home care teams in 81 countries worldwide.