Sarah Grace
Hospice Care
The modern-day concept of hospice as an end-of-life care setting was pioneered by Dr. Cicely Saunders in the United Kingdom. Driven by a commitment to compassionate care for the terminally ill, she founded St. Christopher’s Hospice in London in 1967, establishing a model that emphasized dignity and comfort at the end of life (Lowey, 2020). In the United States, hospice care took root in the 1970s, led by Florence Wald, a former dean of the Yale School of Nursing. Inspired by Saunders’ work, Wald collaborated with colleagues to establish the first hospice in the U.S., Connecticut Hospice, in 1974 (Connor, 2007; NHPCO, 2021). This groundbreaking institution marked the beginning of a broader hospice movement in the country, focusing on providing compassionate, multidisciplinary care for those nearing the end of life.
Dame Cicely Saunders https://www.stchristophers.org.uk/about/damecicelysaunders/
Today, hospice care is available across the United States, typically offered in patients’ homes, dedicated hospice facilities, or as units within hospitals. Services are delivered by interdisciplinary teams that include doctors, nurses, social workers, and spiritual counselors, aiming to improve the quality of life for patients and provide support to their families (NHPCO, 2021).
Hospice care aligns closely with Erikson’s Psychosocial Development Theory, specifically the final stage of integrity vs. despair. According to Erikson, individuals in this life stage reflect on their lives, seeking a sense of completeness and acceptance (Erikson, 1982). Hospice care supports this psychological need by offering dignity-preserving interventions, such as life review activities, spiritual counseling, and legacy-building efforts. These services allow patients to experience a sense of integrity and closure, reducing the potential for despair and enhancing emotional well-being as they approach the end of life.
Hospice care is both a type and a philosophy of care, focused on the needs of the terminally ill, including pain and symptom management and psychosocial needs (Lowey, 2020; Powell, 2015). By aligning with Erikson’s theory, hospice care helps patients confront mortality while preserving dignity and reinforcing a sense of meaning, enhancing quality of life in this critical stage.
Similarities between Hospice and Palliative Care:
- Provides specialized care and support for individuals living with serious illnesses.
- Main goal is to improve the quality of life of patients via interventions that focus on improving comfort and reducing the complications associated with illness.
- Programs are family-oriented.
- Uses a team approach, typically a physician, nurse, and social worker.
- Can occur at home, in an assisted living facility, nursing home, hospital, or hospice residential facility.
(Lowey, 2020; National Institute on Aging, 2021)
Differences between Hospice and Palliative Care:
- Hospice requires patients to forgo all medical treatments that are life-sustaining or curative. The focus shifts completely to comfort-oriented care. In contrast, with palliative care, patients can receive life-sustaining or curative treatments alongside palliative care.
- Hospice is usually reserved for people who have a prognosis of 6 months or less to live, whereas there are no time limits with palliative care.
Click the link below to learn more about palliative care:
10 Myths About Palliative Care
Click the link below to read a detailed explanation of what to expect at the end of life:
References
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- Erikson, E. H. (1982). The life cycle completed. W.W. Norton.
- Lowey, S. E. (2020). Palliative care and end-of-life care. Elsevier.
- National Hospice and Palliative Care Organization (NHPCO). (2021). History of hospice care. Retrieved from https://www.nhpco.org
