Assessing the Needs of the Pediatric Palliative Care Nurse: History of Palliative Care
The concept of palliative care originally evolved from the hospice philosophy of meeting gaps in care for seriously ill and dying patients. The Latin word palliate means “conceal or alleviate symptoms without curing” (Romesburg, 2007). The earliest recording of the word palliate can be traced to the late 14th century, where it originated in Elizabethan and Indo-European traditions (Morris, 1998). In 1967, Dame Cicely Saunders founded the first modern hospice program in the United Kingdom, which emphasized the importance of compassion and medical science (Georges, Grypdonck, & Dierckx de Casterle, 2002). Florence Wald, Dean of Yale University, invited Saunders to the U.S. to learn about her experiences, and in 1974, she founded the first home hospice program based in New Haven, Connecticut. In 1975, St. Luke’s Hospice in New York was the first hospice in the U.S. incorporated into an existing medical center. In 1982, the first children’s hospice center opened in England (Foster, 2007). Despite growth in hospice initiatives, researchers have only just begun to explore the unique aspects of pediatric palliative care.
Palliative care was first introduced in 1990 by the World Health Organization (WHO) (2004) and is currently defined as “an approach to care which improves quality of life of patients and their families facing life-threatening illness through prevention, assessment, and treatment of pain and other physical, psychological, and spiritual problems.” WHO (2004) further describes palliative care for children as the active total care of the child’s body, mind, and spirit, as well as a means of providing support to the family.
To provide this type of palliative care today, hospitals throughout the U.S. have increased initiatives to meet the unique needs of both adults and children. Although there are some commonalities, pediatric palliative care differs from adult palliative care in several ways that preclude the extension of existing adult services into the pediatric world (Sumner, 2003).