The hospice movement provides end-of-life care that focuses on patient comfort and dignity, rather than curative measures. It began in the 1960s with British physician Cicely Saunders, who identified the need for total patient comfort. Hospice care can be provided at home, in a specialized hospital setting, or in another setting. Members of the movement promote standards of care to ensure hospice care is provided consistently and appropriately. Ethical practices for working with patients and families are also included in these standards. Hospice care became especially important for patients with early AIDS in the 1980s.
The hospice movement promotes care for dying patients, focusing on providing comfort and dignity. End-of-life care under the hospice model moves from the treatment of illness with measures intended as curative or control to the treatment of the patient. It can be done at home, in a specialized hospital setting, or in another setting such as a hospital. Members of the movement can join professional organizations, participate in and publish research, and promote standards of care for the hospice to ensure hospice care is provided consistently and appropriately.
British physician Cicely Saunders is often credited with birthing the modern hospice movement. Working in the 1960s with dying patients, she identified specific problems for people who were terminally ill. These included not just physical pain and discomfort, but emotional and spiritual pain and anguish. She advocated a model of care to address these issues, providing total patient comfort and helping people maintain their dignity.
Internationally, the hospice movement began to spread in the 1960s and researchers participated in a variety of activities to explore the needs of dying patients. These studies have informed the direction of hospice care, where providers may offer pain management, massage and other physical contact for emotional comfort and spiritual counseling. Treatment is tailored to the individual’s needs, and while medications can be used to ease the discomfort caused by the conditions, the goal is not to cure or control them.
Some members of the hospice movement have been involved in promoting the standards. These include definitions to clearly determine who should be qualified for end-of-life care and who should receive conventional medical care. Patients with conditions that may be treatable may not be good candidates, and patients who begin to improve while in hospice may be transferred to receive more appropriate treatment. The goal is to avoid situations where patients may avoid needed care because they are treated as hospice patients when they might otherwise respond to treatment.
These standards also include ethical practices for members of the hospice movement, such as guidance on working with patients and families. Individuals may work with patients from diverse religious and personal backgrounds and must be able to provide care in a non-judgmental and safe environment. In the 1980s, the hospice movement became especially important for patients with early acquired immunodeficiency syndrome (AIDS) in dedicated wards and in their own homes. Hospice care provided these patients with compassionate treatment from friends, nurses, and volunteers.
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