Hospice is a thoroughly modern concept of care that derives its name from the Latin word “hospes,” which means “to be both host and guest.”

Dr. Cecily Saunders is generally credited with establishing the modern hospice movement in Great Britain in the 1960s. The basic concept, care in a special facility that addressed the physical, social, emotional, and spiritual needs of the dying, was readily received and gratefully embraced by those it sought to serve.

It was not long before the hospice concept spread to the United States. It was largely a grass roots movement that developed outside the conventional health care delivery system. These early hospices survived on shoestring budgets and were almost entirely dependent on charitable contributions and volunteer staff to provide the intensive and personalized care central to the hospice concept.

Hospice developed in this country as a concept of care rather than a place for care, from the beginning the focus has been care in the patient’s own home. During the 1970s, hospice leaders began meeting regularly to formulate model standards for guiding development of hospice care. Creation of the National Hospice Organization (NHO) in 1978 provided a national forum for discussion, education, and support of quality standards for hospices.

In 1983, Congress expanded Medicare coverage to include hospice. Many private insurers, recognizing not only the compassion associated with hospice care, but also its cost effectiveness, began offering hospice benefits. Many states now provide hospice benefits under Medicaid.
The availability of reimbursement for hospice care has had a dramatic impact. There has been a steady increase in the number of hospices, and existing hospices have increased numbers of patients they care for and the services they provide. In 1991, NHO statistics show 1,830 hospice programs in the United States serving over 212,000 patients and families.

Today, the basic concept of hospice remains essentially unchanged form its earliest days. The intent is to foster a setting where patients can get relief from pain and suffering, and their families can find support and care to enhance comfort and improve the quality of life. Dying peacefully and with dignity is not only possible, but also supported by a caring community.

Hospice has earned a place in the mainstream health care and social services in our country. Hospice’s compassionate and personal character, plus its consummate expertise in the control of pain and symptoms make it a viable choice for those individuals who not only wish to die with dignity, but also want to live until they die.