A Brief History of Palliative Care
Adapted from Medical Care of the Dying, 4th edition, Victoria Hospice Society, 2006.
Modern hospices or programs of care for the dying began in Britain. The most famous is St. Christopher’s Hospice in London, begun by Dame Cicely Saunders in 1967.
Hundreds of years ago, during the Crusades of the Middle Ages, we know that hospices were often found in monasteries, established not only for the sick and dying, but also for the hungry wayfarer, the woman in labour, the needy poor, the orphan, and the leper. The goal was hospitality in its true sense: protection, refreshment, and fellowship, rather than the demand for a cure.
In the 17th century, a young French priest, St. Vincent de Paul, founded the Sisters of Charity in Paris and opened several houses to care for orphans, the poor, the sick and the dying. In 1900, five of the Irish Sisters of Charity founded St. Joseph’s Convent in the East End of London and started visiting the sick in their homes. In 1902, they opened St. Joseph’s Hospice with 30 beds for the dying poor.
The first hospice programs in Canada opened in 1975 at St. Boniface Hospital in Winnipeg and in Montreal at the Royal Victoria Hospital under Dr. Balfour Mount.
Victoria Hospice was established in 1980. See below for more details on our own local history.
In Montreal, Dr. Mount coined the term “palliative care” (soins palliatif in French) rather than the word “hospice” which, from the early history of Lower Canada, was commonly considered a place of last resort for the poor and derelict. The word “palliative” comes from the Latin word meaning “to cover or cloak”. This unique Canadian use of the term “palliative care” caught on quickly and, in Canada, is used more frequently than “hospice”. An alternative word “home” (maison in French) is also used in Quebec.
The Palliative Care Foundation of Canada was formed in the early 1980s, later replaced by the Canadian Hospice Palliative Care Association.
History of Victoria Hospice
Victoria Hospice had its earliest beginnings in a grassroots movement called the Victoria Association for Care of the Dying (VACD). VACD was formed in 1978 to provide a volunteer program of support for people in our community who were dying.
Two years later, the provincial government’s Ministry of Health initiated Hospice Victoria as the first of two pilot projects in British Columbia (the second was Hospice Vancouver) to develop a model of care for the dying, and to assess its value to the community. This pilot project ended in 1982. After evaluating the great success of the pilot project, the Ministry designated Hospice Victoria as an ongoing essential part of the health care system. VACD, which had been providing volunteers during the pilot project phase, amalgamated with Hospice Victoria when the Victoria Hospice Society (VHS) was created in March 1983. Learn more about the current Victoria Hospice Society board of directors.
The Society received funding from the Ministry of Health to provide seven acute care hospice palliative care beds at Royal Jubilee Hospital’s Bay Pavilion. Some community care services were provided off-site at that time, but limited resources meant long waiting lists for both community and in-patient services. In 1989, with funding from the Victoria Health Project, the Victoria Hospice Palliative Response Team (PRT) was established, offering emergency short-term crisis consultation and treatment for problems that would otherwise require admission to hospital. At this time, Victoria Hospice expanded its working relationships with Home Care Nursing, creating an integrated continuum of hospice palliative care from home to hospital.
In 1994, Victoria Hospice received additional funding from the ‘Closer To Home’ initiative that enabled PRT to expand into a 24-hour service. The following year, the Ministry of Health asked Victoria Hospice to take over management of 10 Long Term Care palliative care beds. In June 1996, the third and fourth floors of the Richmond Pavilion at Royal Jubilee Hospital were developed to accommodate a 17-bed hospice palliative care facility, becoming one of the larger hospital-based programs in Canada. On any given day, Victoria Hospice now has over 320 patients registered on its program of care, with almost 800 deaths annually and an annual operating budget of over $6 million.
In 1997, Victoria Hospice established the Victoria Hospice and Palliative Care Foundation to assume a primary fundraising role, and to provide investment, financial management and stewardship of funds raised for Victoria Hospice operations. The Foundation is registered under the Income Tax Act as a charity. Our charitable registration number is 87440-9964-RR0001.
In 1999, Victoria Hospice formalized its longstanding history of helping others learn how to take better care of the dying when it established the Victoria Hospice Learning Centre for Palliative Care, now known as Victoria Hospice Education Services. This department offer palliative care courses, publications and ongoing training services to professionals and the public, and works with other partner organizations to support and provide the highest standards of hospice palliative care.
In 2006, the VHS Research & Development Office was created to better understand current clinical care and to seek ways to increase the quality of care for all