By Fredrick P. Niemann, Esq. a New Jersey Hospice Attorney
There are more than 3,000 hospice programs that serve communities in New Jersey today and throughout the United States. In 2012, hospice programs are treating more than one million dying Americans, according to the National Hospice and Palliative Care Organization. According to that organization, about 70 percent of American hospice programs are not-for-profit, 27 percent are for-profit and 3 percent are government owned.
Today’s hospices are patterned after the first modern program, St. Christopher’s Hospice, which physician Dame Cicely Saunders established it in the London suburbs in 1967. She originated the term “hospice” to describe the program of specialized care for dying patients. Hospice derives from the Latin word for guesthouse, hospitium. In Medieval times, the word “hospice” referred to a sheltered rest stop—a place of comfort—for ill or tired travelers returning from religious pilgrimages. Modern hospice also offers comfort to those on a different kind of journey.
Dr. Saunders introduced her concept in the United States in a lecture to medical students, nurses, social workers and chaplains at Yale University in 1963. She returned to Yale as a visiting faculty member in 1965. Three years later, Florence Wald, dean of the Yale School of Nursing, took a sabbatical to work at St. Christopher’s.
Interest in care for dying patients increased on both sides of the Atlantic in 1969, when Dr. Elizabeth Kubler-Ross published On Death and Dying, an international best-seller. The book defined five stages of dying gleaned from Dr. Kubler-Ross’s interviews with more than 500 terminally ill patients. An important feature of the book was the author’s recommendation that patients with terminal illness be allowed to participate in decisions about their medical treatment and be offered the choice of continuing treatment at home instead of in an institutional setting.
Three years later, Dr. Kubler-Ross told the U.S. Senate Special Committee on Aging, “We should not institutionalize people. We can give families more help with home care and visiting nurses, giving the families and the patients the spiritual, emotional and financial help in order to facilitate the final care at home.”
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