My mother-in-law, Nancy, died in Ty Watson House embraced by in loving, home-like care. She enjoyed home-cooked meals; visited regularly with friends and extended family by the fireplace in the cozy living-room; and received the medications she needed to control her pain when she needed them. She felt deeply respected as an individual who still had a lot of living left in her even as she was slowly approaching the conclusion of her life. Hockey Night in Canada remained a highlight of her week to the very end! Treatment Nancy received under the hospice palliative care umbrella is a fairly recent phenomenon.
The modern hospice philosophy can be traced back to Dame Cicely Saunders, a London,
England physician dedicated to improving life for the dying. Beginning her career as a nurse, because of her own health issues, she focused on medical social work - much of it with dying patients. She developed a strong belief that the final journey of life should be one of comfort…the dying should live relatively free of any kind of pain: physical, psychological, social or emotional.
Realizing she could have more impact as a physician, Cicely became one and immediately opened the first modern hospice in London in 1967 – St. Christopher’s. With treatment focused on the patient rather than the disease, opiates were used to make the patient comfortable and able to function more fully. The family of the patient was welcomed into the circle of care. Spiritual needs were addressed.
Hospices had been common in Europe in the Middle Ages as refuges for the traveling Crusaders and the very ill. The concept continued through to the 19th century, with hospices mostly run by religious orders.
In the late 1800’s, however, the rise of modern medicine gave way to the medicalization of the dying process. By the mid-20th century nearly 80 % of the population of the western world died in a nursing home or a hospital, treated much the same as those in acute care.
Saunders’ vision and practice attracted a great deal of attention in North America and she was sought after as a mentor in the United States and Canada. It is in Montreal, that a devoted follower of Cicely Saunders, Dr. Balfour Mount, who headed the first hospice-like care wing in a hospital in Canada (1975), coined the term “palliative care” that is now widely used in hospice settings.
A contemporary of Dr. Saunders, the Swiss psychiatrist Elisabeth Kubler-Ross published her book On Death and Dying in 1969. She perceived the dying process as proceeding through stages of denial, anger, bargaining, depression and acceptance. While today we understand that the stages are not static or orderly, (nor confined only to the dying process), Kubler-Ross’ work opened the door world-wide to greater understanding of the psychological needs of the dying and the need for changes to be made in their treatment.
It is upon the shoulders of these great pioneers, that Alberni Valley Hospice Society and Ty Watson House stand today.