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Hospice, a concept of supportive care for the terminally ill Inspired by the hospices of the Middle Ages, the modern movement began with the founding in 1968 of St. Christopher's Hospice in London as an alternative to the imper­sonal nature of hospitals and nursing homes as a place to die. The first Amer­ican hospice was established in New Ha­ven, Connecticut, in 1971. It is estimated that there are now 300 hospice programs established or being planned in the United States. In January 1980, the De­partment of Health and Human Ser­vices announced it would participate for a 30-month period in the continuing de­velopment of hospice care programs.

The hospice concept favors the com­forting setting of home for the dying, cared for by family and friends as well as their doctors. The assistance of community agencies such as the Visiting Nurse Association and volunteers is pro­vided to families, as well as 24-hour tele­phone contact availability. When home care is not possible, institutional – care may be had in specially built facilities or in units associated with or actually within existing hospitals. All provide trained personnel and homelike environments for patients and visitors. Of great importance in hospice care is the management of pain, which can be particularly severe in people dying of cancer. Special mixtures of pain relievers are given at around-the-clock intervals to control pain while keeping the person's mind as clear as possible. All hospice care is geared chiefly to relief of symp­toms – rather than efforts to cure disease and to helping an individual to die with as much dignity and peace and as little discomfort as possible. Psycholog­ical counseling is available to the dying and their families, and work to help sur­vivors handle their grief is the final func­tion of hospice workers.

Plans for the nation's first hospice pro­gram exclusively for terminally ill chil­dren were announced in April, 1980, by St. Mary's, a pediatric hospital in Bay-side, New York. The children will be kept at home as much as possible, in keeping with the hospice concept. Visit­ing medical teams will guide the care given by family and friends and a spe­cially equipped wing will provide hospital care when that becomes necessary. Em­phasis in the hospice facility is to be on a maximum of attentive care and a min­imum of regulations. Counseling to help family members cope with the presence of a dying child will also be important in the program.