Hospice Facts

The Origins of “Hospice Palliative Care”
Dame Cicely Saunders first conceived of the modern hospice movement in the United Kingdom in the mid 1960s to care for the dying. Dr. Balfour Mount coined the term “palliative care” in 1975 so that one term would be acceptable in both English and French as he brought the movement to Canada (from Latin palliare = to cloak or cover).

Both hospice and palliative care movements have flourished in Canada, and internationally. Palliative care programs developed primarily within larger healthcare institutions, while hospice care developed within the community as free-standing, primarily volunteer programs. Over time, these programs gradually evolved from individual, grass roots efforts to a cohesive movement that aims to relieve suffering and improve quality of life for those who are living with, or dying from, an illness. 

To recognize the convergence of hospice and palliative care into one movement, and their common norms of practice, the term “hospice palliative care” was coined. While hospice palliative care is the nationally accepted term to describe care aimed at relieving suffering and improving quality of life, individual organizations may continue to use “hospice”, “palliative care”, or another similarly acceptable term to describe their organization and the services they are providing. In French Canada, the term “soins palliatifs” (palliative care) is used because of the pejorative connotation of the term hospice.

Definition
Hospice palliative care aims to relieve suffering and improve the quality of living and dying.

Hospice palliative care strives to help patients and families: address physical, psychological, social, spiritual and practical issues, and their associated expectations, needs, hopes and fears prepare for and manage self-determined life closure and the dying process cope with loss and grief during the illness and bereavement.

Hospice palliative care aims to treat all active issues, prevent new issues from occurring, promote opportunities for meaningful and valuable experiences, personal and spiritual growth, and self-actualization.

Hospice palliative care is appropriate for any patient and/or family living with, or at risk of developing, a life-threatening illness due to any diagnosis, with any prognosis, regardless of age, and at any time they have unmet expectations and/or needs, and are prepared to accept care.

Hospice palliative care may complement and enhance disease modifying therapy or it may become the total focus of care. Hospice palliative care is most effectively delivered by an interdisciplinary team of healthcare providers who are both knowledgeable and skilled in all aspects of the caring process related to their discipline of practice. These providers are typically trained by schools or organizations that are governed by educational standards. Once licensed, providers are accountable to standards of professional conduct that are set by licensing bodies and/or professional associations.

Foundational Concepts
Hospice palliative care is based on three foundational concepts:

• effective communication,
• effective group function, and
• the ability to promote and manage change.

The Hospice Philosophy
Today, the word hospice refers not only to an organization of people devoted to caring for the dying but also to the philosophy of care that values quality of life until death. It is a philosophy that intends not only physical care but emotional and spiritual support, and it is a philosophy that puts the client/resident at the centre and in control of his or her own life and care.

Hospices in Ontario
In an age of near-miracles wrought by high-technology medicine, there is still the need for people to have relief from pain, help in bathing, eating and even breathing, and to enjoy simple, honest companionship when it is so desperately needed.

The Ontario Government said as much when it included the following commitment in its 2005 Provincial Budget: “The government intends to improve access to doctors, nurses and other health professionals by … supporting end-of-life care services, including those in residential hospices, for 4,300 adults and children in their communities by investing an additional $39 million this year.” The $39 million is a global budget figure for many services that comprise end-of-life care.

In October 2005, the Ontario government announced $4.4 million in annualized funding available for nursing and personal support for nine residential hospices. In future years, up to 30 approved residential hospices will be funded based on a 10-bed model at approximately $580,000 annually for nursing and personal support services.

The Ontario government also recognized Maison “La Paix” House (MLPH) as a leader in residential palliative care in Sudbury and approved MLPH to receive operational funding for a community residential hospice starting in 2007/08.  Sault Ste. Marie and Thunder Bay will also be receiving residential hospice funding.

Hospices are essential for people living with a life-threatening illness, who can no longer be cared for in their own homes. They offer compassionate and cost effective care for people who do not require the expensive and highly technical care available in an acute care hospital unit. They are designed to meet the needs of a resident and his or her loved ones when the curative approach is no longer achievable.

The Hospice Association of Ontario states that residential hospices are a cost effective way of providing palliative care. For example, it costs $290 a day to manage a bed in a residential hospice compared to $830 in an acute care hospital.