When it comes down to bringing comforting care to the dying, palliative and hospice are very similar. Both have the bedrock belief that people have the right to die with dignity. Both try hard to alleviate patients’ pain — often with powerful analgesics like morphine — and other symptoms of their illness. Both focus on improving patients’ quality of life.
Palliative care, in fact, has its roots in hospice. And hospice goes back to the fourth century as a resting place for wary travelers. By the 19th century, hospices for the dying were established by religious orders in Ireland and England.
But modern-day hospice didn’t begin until 1967. That’s when Dame Cicely Saunders — a physician who had been working with the terminally ill since the late 1940s — opened up St. Christopher’s Hospice in London. During a visit to Yale University, she introduced the idea of having specialized care for the dying there.
In 1974, Florence Wald, dean of the Yale School of Nursing, founded Connecticut Hospice in Branford, Connecticut, with two pediatricians and a chaplain. Four years later, the U.S. Department of Health, Education and Welfare reported that hospice care for the terminally ill and their families was a viable health care option “which holds out a means of providing more humane care for Americans dying of terminal illness while possibly reducing costs. As such, it is the proper subject of federal support.”
In the late 1980s, the first hospital-based palliative care programs began at the Cleveland Clinic, Medical College of Wisconsin and a handful of other U.S. institutions. Today more than 80 percent of U.S. hospitals with more than 300 beds have a palliative program.
Some 90 million Americans are living with cancer, heart disease, dementia and other serious illnesses. As baby boomers reach old age, that number is expected to double. And most will need palliative and hospice care.
