History of Hospice and Grace Hospice

by Sarah Van Winkle

The concept of Hospice has been evolving in Europe since the 11th century. The first modern hospice care was created by Cicely Sounders in 1967. Dame Cicely Saunders was a British registered nurse whose is often thought of as the founder of the modern Hospice Movement. Her relationship with a dying Polish refuge helped solidify her ideas that terminally ill patients needed compassionate care to help address their fears and concerns as well as palliative comfort for physical symptoms. Her vision was brought to the United States and a grassroots movement began, faith based nonprofit organizations embraced the hospice movement. These organizations through donors and volunteers began to provide hospice care in the community providing spiritual, emotional and physical care to those at end of life. These services supported the wishes of our patients to die where they chose, generally not in cold sterile hospitals.

As the founder of Grace Hospice I was able to experience the pure grassroots movement and original vision of hospice care in the United States before Medicare made it a benefit. Because the grassroots movement was so well received and the outcomes were excellent Hospice became a Medicare benefit.

Medicare wanted to be sure the pure vision of hospice and the outstanding outcomes translated in the new benefit. In the grassroots hospice programs volunteers were vital to the comprehensive care of the patients in hospice, so it was written in the rules that hospice agencies had volunteers that provided at a minimum of 5% of direct patient care. In that same vein spiritual care was such an essential part of the care of the whole person, Medicare in its rules stated that a spiritual assessment be completed on every person. Specific rules were written on emotional support and nursing support mirroring the original hospice vision seen during the early years before Medicare. Grace Hospice models its program and cares to that of the original vision of the grassroots movement.

Through this Blog I hope to continue to share the vision of Hospice care and make you the readers ambassadors for hospice care, here are a few things to know:

  • Hospice is a philosophy of care, not a place. It is something you do, not somewhere you go.
  • Hospice looks at the total person, providing spiritual, emotional and physical care.
  • Hospice is a team oriented approach tailored to each person’s individual needs and wishes.
  • Hospice believes the quality of life to be as important as length of life.
  • Hospice cares for not only the patient but the family/loved ones that surround them.
  • Hospice Medicare benefit allows for patient/family choice, you have a choice on who provides your end of life care.

Sarah Van Winkle is the executive director and president of Grace Hospice, a faith-based nonprofit agency. She has more than 35 years experience as an RN in public health, with extensive experience in hospice and palliative care.


weaving care, peace, and grace