Hospice is a type of care and a philosophy of care
which focuses on the alleviating the symptoms of a terminally ill patient. These symptoms can be physical, emotional, spiritual or social in nature.
The concept of hospice has been
evolving since the 11th century. Hospices were places of hospitality for the sick, wounded, or dying, as well as those for travelers and pilgrims. The modern concept of hospice includes
palliative care for the incurably ill given in hospitals or nursing homes, but also care provided to those who would rather die in their own homes. It began to emerge in the 17th century,
but many of the foundational principles by which modern hospice services operate were pioneered in the 1950s by Dame Cicely Saunders.
Linguistically, the word "hospice" is
derived from the Latin hospes, a word which served double-duty in referring both to guests and hosts. The first hospices are believed to have originated in the 11th century, around
1065, when for the first time the incurably ill were permitted into places dedicated to treatment by Crusaders. Among the more influential early developers of Hospice were the Irish
Religious Sisters of Charity, who opened Our Lady's Hospice in Harold's Cross, Dublin, Ireland in 1879. In 1905, they opened St Joseph's Hospice in London. It was there in the 1950s
that Cicely Saunders developed many of the foundational principles of modern hospice care.
Saunders emphasized focusing on the patient rather than the disease and introduced the notion
of 'total pain', which included psychological and spiritual as well as the physical aspects. She experimented with a wide range of opioids for controlling physical pain but included
also the needs of the patient's family.
The concept of hospice care has faced resistance springing from various factors, including professional or cultural taboos against open communication
about death among physicians or the wider population, discomfort with unfamiliar medical techniques, and professional callousness towards the terminally ill. Nevertheless, the movement
has spread throughout the world.