Curative medical treatment is clearly a
blessing and we are fortunate to live in a time when many illnesses are treatable and
curable. There comes a time, however, when the end of life is inevitable. No cure is
possible, no prolongation of life is appropriate beyond the days the body can sustain life
on its own. At that point, the greatest need of the patient is to end his/her life in
dignity and with freedom of pain.
In our great-grandparents time,
birth and death were commonplace in the family home and accepted as natural events. With
time and the advance of medicine, birth and death were transplanted to a new and often
strange environment: the modern hospital, where family members were merely guests and
control rested with unknown health professionals.
Hospice had its roots in the Middle Ages
when shelters called hospices were available to travelers who had nowhere else to stay. It
took the modern Hospice movement and three special women to pioneer new ways of thinking
about death and dealing with the dying.
Saunders, has worked as a nurse, a social worker, and a physician. At age 33 she returned
to medical school to specialize in pain control for the terminally ill. She organized and
became director of the St. Christophers Hospice in London in 1967. Her goal was to
keep patients active, alert, and in charge of decisions about their own care for as long
as possible. Concerned that the needs of terminally ill patients were being ignored
because curative options had been exhausted, Dr. Saunders is quoted as saying, There
is never nothing more that can de done. Her emphasis on palliative care
(comfort-oriented care) and pain management, emotional care and spiritual care enhances
the patients quality of life.
Elizabeth Kubler-Ross has studied
death and dying since the 1960s. She has added much to our knowledge of dying in
America. She says, Taking care of terminally ill patients is a privilege and a gift
which teaches us not only about dying but about living. All of those who have the courage
to care for dying patients will be enriched by this experience. Through her studies,
she developed a comprehensive description of the five stages of denial, anger, bargaining,
depression and acceptance that are all part of the dying experience.
Mother Teresa is best known for her work
among the dying destitute in Calcutta, India. She states, Food, shelter and care are
what the dying need, but even greater is their need for being wanted. What you can do, I
cannot do, and what I can do you cannot do. Together we can do something beautiful for
Bringing death out into the open and
making sickness and loss a time of sharing and remembrance has been difficult. The first
American hospice was started in New Haven, Connecticut in 1974. Since then, hospice has
gone from being a little-known medical alternative to a major option in health care. From
the beginning, the American model stressed hospice as a home service. Over 200,000 people
have chosen to spend the last few days or weeks of their life at home, cared for by their
families, with the support and assistance of a hospice team of professionals (physicians,
nurses, certified nurses aides, clergy, social workers, volunteers, etc.).