How It All Began


The term “hospice” can be traced back to medieval times when it was referred to as a place of shelter and rest for the weary or ill travelers on a long journey. (1) In today’s world, “hospice” was initially applied to specialized care for dying patients by a British physician named Dame Cicely Saunders.

Saunders began her career in medicine as a registered nurse, but her continuing health issues forced her to pursue a career in medical social work.  In her new role, she developed a relationship with a dying Polish refugee who helped her decide that her ideas that terminally ill patients needed compassionate care to help address their fears and concerns was needed.  After the refugee passed away, she began volunteering at St. Luke’s Home for the Dying Poor, where a physician told her that she could best influence the treatment of the terminally ill as a physician.  Saunders soon entered medical school and received her degree.  (2)

Saunders always 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 and continually included the needs of the patient’s family. (3)

Saunders introduced the idea of specialized care for the dying to the United States during a visit with Yale University.  Her lecture, given to medical students, nurses, social workers, and chaplains explained the concept of holistic hospice care.  (4)

According to, Saunders founded St. Christopher’s Hospice in London, which was the first hospice for terminally ill patients in the United Kingdom.

Dr. Patricia Wald, Dean of the Yale School of Nursing, took a sabbatical to work at St. Christopher’s to experience hospice first hand. (5)

Dr. Elisabeth Kubler-Ross published her groundbreaking book, “On Death and Dying,” which contains more than 500 interviews with dying patients. In this book, Dr. Kubler-Ross emphasizes the benefits of home care over treatment in an institutional setting for terminally ill patients, and argues that everyone deserves the right to decide about their end-of-life care. (6)

Wald, two pediatricians, and a chaplain founded the first hospice in the US—Connecticut Hospice in Branford, CT. That same year, Senators Frank Church and Frank E. Moss introduced legislation to provide federal funds for hospice programs. The legislation didn’t pass. (7)

Congress included a provision to create a Medicare Hospice Benefit as part of the Tax Equity and Fiscal Responsibility Act, but it contained a sundown provision for 1986. (8)

The Medicare Hospice Benefit was enacted, and states were given the option to include hospice in their Medicaid programs. Hospice care was also made available to terminally ill nursing home residents. (9)

For the next three decades, legislation was passed, funding was improved, and Medicare reimbursement rates were increased.  (10)

The number of Americans who received hospice services exceeded one million for the first time and, in 2005, the number of hospice providers in the US exceeded 4,000. (11)

40 years after the opening of Connecticut Hospice, the National Hospice and Palliative Care Organization (NHPCO) and its affiliates celebrated four decades of providing hospice care in the US. (12)

Hospice Care began with a woman wanting to create a better life for those dealing with a terminal illness; a woman who wanted to completely focus on the patient, not the disease.   Homeland Hospice thanks you, Dr. Saunders, for improving the quality of life of countless individuals and their families.  Your dedication and compassion are unmatched.


Cited Sources

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