Celebrating 50 years of the modern hospice movement
The modern hospice movement has improved the quality of palliative care greatly over the past 50 years and has helped with the research and education in its field. It has achieved this by creating a culture of constantly looking to offer a better service to its patients and their loved ones. A notable figure in the modern hospice movement was Dame Cicely Saunders.
Who was Dame Cicely Saunders?
Dame Cicely Saunders was born in 1918, in Barnet. She was heavily invested in the care of people and during her life was a nurse, a medical social worker and also a physician. She began her work with the terminally ill in 1948, where she gained a determination to improve the care of the dying.
The depth of involvement Dame Cicely Saunders had in pioneering the modern hospice movement is impressive. She “lectured widely on this subject, while writing many articles and contributed to numerous books”. In 1967, she opened St Christopher’s Hospice in South London, which is considered to be the first hospice of this new era in expert palliative care. It brought end of life care together with education and research, excelling in the care of pain, symptom control and compassionate care.
She also helped bring the modern hospice across the pacific to America. Florence Wald (Dean at Yale School of Nursing) invited Dame Cicely to Yale School of Nursing in 1965, where she would be a visiting faculty member for the spring term. Florence Wald then travelled to St Christopher’s Hospice to meet Dame Cicely again in 1968 to learn as much as she could from her. This lead to Florence Wald co-founding Connecticut Hospice (the first modern hospice in America) in 1974, with two paediatricians and a Chaplin.
St Christopher’s Hospice gave Dame Cicely Saunders the platform to circulate her work through teaching and outreach, and radically improve the care of the terminally ill, and also the bereaved. Her Christian faith was a huge influence in her commitment to end of life care and was a factor in the naming of St Christopher’s Hospice. St Christopher was the patron saint of travellers, and this imagery was used in the context of helping people traverse this terrible period in their life.
“Dame Cicely Saunders is recognised as the founder of the modern hospice movement” and has been rewarded for her work on multiple occasions. The awards included:
- 25 honorary degrees
- The British Medical Association Gold Medal for services to medicine
- The Templeton Prize for Progress in Religion
- The Onassis Prize for services to Humanity
- The Raoul Wallenberg Humanitarian Award
- The Franklin D. Roosevelt Four Freedoms for Worship Medal
- Dame of the British Empire in 1979
- Order of Merit in 1989
Dame Cicely Saunders passed away peacefully on the 14th July 2005 at St Christopher’s Hospice.
The introduction of the modern hospice movement
The term hospice is derived from hospitality and dates back to medieval times. These places used to welcome weary or ill travellers on a long journey and offer them shelter. However, the term hospice was first used to describe “specialised care of dying patients” by Dame Cicely Saunders.
Before Dame Cicely Saunders started the modern hospice movement, there were already “hospices”. However, in the healthcare community there was the underlying thought process that patients should be cured, and if they couldn’t it was a failure. Because of this, it was deemed acceptable for terminally ill patients to be misled on their prognosis.
The modern hospice movement abolished that way of thinking and introduced the concept of specialised care of the dying. This meant that patients weren’t left to wait until their painkillers had worn off before they were allowed anymore. It also did away with the notion that opiates shouldn’t be used in pain management of the terminally ill because of their addictive properties.
How has the modern hospice movement improved the care of the dying?
Led by Dame Cicely Saunders, the modern hospice movement introduced the idea of total pain. This encompassed the physical, emotional, social and spiritual dimensions of pain and ensured they were all treated effectively. Until the patient’s death, they were regarded as their own individual and looked after as such, always with care and compassion.
The modern hospice movement has gone from strength to strength, travelling across the globe, ensuring that terminal patients and their loved ones receive quality care, until the very end. Hospices have reversed the trend of people dying in hospitals as the vast majority of palliative care is administered at home, where most patients would prefer to be. This is shown by Hospice UK’s study, that around 80% of hospice care is delivered in a community setting, such as the home, rather than a clinical setting.
Education and research have remained a huge feature of the modern hospice movement throughout its 50 years, with St Christopher’s Hospice having a specialised education centre, where people come from all over the world to take courses in specific areas of healthcare. Bereavement support has also developed from the modern hospice movement, and care of the patients loved ones is seen as equally as important as the care of the patient.
Dame Cicely Saunders and St Christopher’s Hospice were widely seen as the pioneers of the modern hospice movement, but there are now over 200 hospices in the UK, offering expert palliative care, and they have become integral parts of their local communities.
The following quote from Dame Cicely Saunders, best describes the main ethos behind the modern hospice movement –
You matter because you are you and you matter until the last moment of your life.
Facts and Figures from Hospice UK
Hospice UK has some interesting stats on hospices. They show just how important they have become for local communities in the UK.
- Hospices care for an estimated 200,000 people with terminal and life-limiting conditions in the UK each year. This equated to over four out of ten people approximately of those who need expert palliative care.
- 40,000+ people in the UK, each year, receive bereavement support from a hospice.
- Illnesses Hospices deal with include Cancer, motor neurone disease, cardiovascular diseases, dementia, multiple sclerosis and Parkinson’s disease.
- 80% of hospice care is provided in community-based settings. This includes outpatient services, home care and hospice day care.
- 125,000+ volunteer at hospices each year in the UK
- Hospices in the UK will need to raise around £1 billion a year (collectively) to effectively run their services. This amounts to 2.7million per day.
- The number of people aged 85 and over expected to double in the next 20 years