The hospice movement promotes care for dying patients, focusing on providing comfort and dignity. End-of-life care under the hospice model transitions from treating the disease with measures intended to be curative or controlling to treating the patient. It can be performed at home, in a specialized hospice facility, or in another environment like a hospital. Members of the movement may join professional organizations, participate in and publish research, and promote standards of care for terminally ill patients to ensure that hospice care is provided consistently and appropriately.
British physician Cicely Saunders is often credited with the birth of the modern hospice movement. Working in the 1960s with dying patients, she identified issues specific to people who were terminally ill. These included not just physical pain and discomfort, but emotional and spiritual pain and distress. She advocated a model of care to address these, providing total comfort to the patient while helping people maintain their dignity.
Internationally, the hospice movement began to spread in the 1960s, and researchers participated in a variety of activities to explore the needs of dying patients. These studies informed the direction of hospice care, where providers may offer pain management, massage and other physical touch for emotional comfort, and spiritual counseling. The treatment is tailored to the needs of the individual, and while medications may be used to alleviate discomfort caused by conditions, the goal is not to cure or control them.
Some members of the hospice movement have been involved in the promotion of standards. These include definitions to clearly determine who should quality for end-of-life care, and who should receive conventional medical treatment. Patients with conditions that might be treatable may not be good candidates, and patients who start to improve while in hospice can be transferred to receive more appropriate treatment. The goal is to avoid situations where patients may avoid necessary care because they’re treated as hospice patients when they might otherwise respond to treatment.
These standards also include ethical practices for members of the hospice movement, such as guidance on working with patients and families. People may work with patients from diverse religious and personal backgrounds and need to be able to provide care in a nonjudgmental and safe environment. In the 1980s, the hospice movement became particularly important for early Acquired Immune Deficiency Syndrome (AIDS) patients on dedicated wards and in their own homes. Care under a hospice model provided these patients with compassionate treatment from friends, nurses, and volunteers.
