The hospice care movement itself started as an innovation in medicine, with the term hospice derived from the word hospitality, the term initially referring to a shelter during the Middle Ages for weary or ill travelers.
The practice came to the attention of U.S. medical professionals when British physician and hospice movement founder Dame Cicely Saunders, who for more than a decade had been working with patients who had terminal illnesses, delivered a lecture on the concept of holistic hospice care in 1963 to Yale University medical students, nurses, social workers, and chaplains.
“You matter because you are you, and you matter to the end of your life,” Saunders is quoted as saying. “We will do all we can, not only to help you die peacefully, but also live until you die.”
Her message found a captive audience at the Ivy League school. Two years later Florence Wald, the dean of Yale School of Nursing, invited Saunders back to the campus in New Haven, Conn., as a visiting professor. Then, in 1967 Saunders founded St. Christopher Hospice in London.
The following year, Wald took a sabbatical from Yale and moved to London to work with Saunders at St. Christopher and learn about hospice care. In 1974, Wald, along with two pediatricians and a chaplain, founded a hospice in the town of Branford, Conn.
From there the hospice movement gained traction rather quickly among health care providers and within the halls of the U.S. Congress. After a few years of Capitol Hill debate on the merits of hospice care, lawmakers, in 1982, authorized a temporary hospice benefit for Medicare beneficiaries.
Four years later, Congress permanently established hospice care payment for Medicare enrollees and extended the benefit to patients with terminal illnesses living in nursing centers. There are now more than 5,800 hospice care programs across the United States.
Inclusivity The Goal
“During the early days we wanted to make sure that hospice care was available to anybody that needed it no matter where they lived in the country,” says Judi Lund Person, vice president of compliance and regulatory leadership at the National Hospice and Palliative Care Organization.
As president and chief executive officer of the Carolinas Center for Hospice and End of Life Care, back in the 1980s, Person helped shape the legislation authorizing the Medicare hospice benefit.
“I would not say that we have 100 percent of coverage in the country, but we have excellent coverage for hospice care in rural as well as urban areas,” Person says.