The History of Hospice

“How are you?” asks Dr. Cicely Sanders. Then, “And how are you within?”

Hospice focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching  the end-of-life. It can refer to a place where people go to be cared for as they die, such as a ‘Hospice House’ or ward in a hospital. It could also refer to an organization, such as the Campbell River Hospice Society, which provides compassionate support to individuals facing the end-of-life, their families, and the bereaved.

Hospice first came to Canada in 1974 with the creation of palliative care units at the St Boniface General Hospital in Winnipeg. But the practice started well before that.

The Celts have an especially rich history, dating back thousands of years. At their core was a remarkable set of teachings, passed from one generation to the next, from those who called themselves the midwives of the dying. They were so skilled in relieving pain, both physical and emotional, that patients travelled across the European continent for their services, and their wisdom spread.

During the Crusades many hospices were found in monasteries. These were often at crossroads, and were available not just to the dying, but to the hungry traveller, the woman in labour, the needy poor, the orphan, the leper, and the sick. The goal was hospitality in its true sense; protection, refreshment, and fellowship.

The most remarkable of these was in the village of Beaune, France, in the 15th century. In one of the most difficult times of history, a noble named Nicholas of Rolin founded the l’Hotel-Dieu, or God’s Hotel. Nicholas wrote, “The only measure of a society’s greatness depends upon how it cares for the poorest of its poor at the end of life.” The architecture and elegance of this ‘palace for the poor’ rivaled the cathedrals and palaces of the time. It was built over a river, with a glass floor underneath the patient’s beds. In the ceiling above them was written the mantra of the ancient hospice movement; “Ars sacra moriendi, ars sacra vivendi”. The sacred art of dying is the sacred art of living.

During the next several centuries, significant advancements in medicine and technology were made. The emphasis shifted to finding more ways to keep people alive, until dying became viewed as a medical failure.

Many people made contributions to the modern hospice movement, but appreciable changes didn’t occur until the 1950’s, with the work of Cicely Saunders. In 1938, Cicely originally set out to study politics, philosophy, and economics at Oxford University. In 1940, she left to become a student nurse. After a back injury she went back to school, graduating as a medical social worker.

In 1948 Cicely fell in love with one of her patients, David, a Polish-Jewish refugee dying of cancer. Together they dreamed of a future where nobody had to die alone or with pain untreated. David left Cicely 500 pounds, dedicating it for, “a window in your hospice home”.

Cicely Saunders went back to school, and graduated as a physician. She then worked at St. Joseph’s Hospice for the next seven years, where she researched and made great advancements in pain control.

In 1967 Dr. Saunders founded St. Christopher’s Hospice in London, the world’s first purpose-built hospice, where patients could garden, write, talk, and visit with family and friends. Here the entire patient was treated – physical, social, psychological and spiritual. In the entrance is a plain sheet of glass, in recognition of David’s contribution 20 years earlier.

Countries all over the world used St. Christopher’s as a model, and the hospice movement spread quickly. Hospice is about living well, right to the end.

Written by Margaret Verschuur