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hospice in the U.S.

August 2008 Enterprise article by Mary Odbert

“In 1978, an article on the front page of the New York Times about Hospice in England drew 10,000 inquiries, including mine,” said Nancy Dubois.

As Nancy indicates, the credit for the hospice movement goes to an English doctor, Dame Cicely Saunders. Physician, nurse and social worker, she is credited with founding the first hospice near London in 1967.


In 1974, the first hospice was established in the U.S. in New Haven, Connecticut. Florence Wald, MN, MS, FAAN, is the acknowledged founder of hospice in the United States.
We have our own Wald here in Yolo County. Nancy Dubois is credited with founding Yolo Hospice along with three other devoted members of the community, and humble about the tremendous gift she gave this community.


“If I hadn’t started things here in 1978, somebody else would have done it in 1979,” said Dubois. “It was an idea whose time had come.”

The hospice approach is still much the same -- a team approach to care giving with an emphasis on pain management and compassionate care for those with a life-limiting illness.

Yolo Hospice was among the earliest hospices in the nation, but gradually they were formed all across the United States.

“Because hospice was such a ground-swell in the United States there seems to be some confusion about how we provide services,” said Doug Jena, Yolo Hospice Executive Director. “Hospices are set up similar to hospitals – some are part of groups or systems and some, like Yolo Hospice, are independent and community based.”

Each hospice makes its own decisions and delivers care within the philosophy of hospice and applicable laws, but at their own discretion.

One of the biggest changes to hospice service delivery came in 1983, when Medicare began to pay for hospice services. Prior to that, hospice services in the United States were provided by volunteer nurses and others. The availability of services was completely contingent on those volunteers being available.

The change in Medicare made it possible for more people to have access to hospice care. It also allowed hospices to provide services with consistency and made room for a well-rounded professional staff to deal with the entire person, body, mind and spirit. At Yolo Hospice that staff consists of a:

  • Medical director who serves as consultant to the patient’s physician,
  • Registered nurses who make regular visits to the patient,
  • Home health aides, help with personal care and homemaking tasks,
  • Social workers who provide emotional support and guidance in end-of-life issues,
  • Spiritual counselors who support patients through a broad range of religious and spiritual traditions,
  • Bereavement counselors who provide grief services to patient families and members of the community,
  • Trained volunteers give assistance and support to patients and their families.

“One of the best things Medicare did was to retain the spirit behind the hospice movement – its emphasis on people helping each other and on volunteerism – by requiring 5% of all hours put in by a hospice to be provided by volunteers,” said Jena.

Yolo Hospice has continued to maintain the strong community tie that Nancy and her co-founders gave us. We have over 40 volunteers who actively participate in helping us provide care. In fact, our volunteers provide an average of 9% of the patient care hours we provide.

Because of our continued emphasis on serving our community and our not-for-profit status, we are able to serve those in need but without insurance or other means to pay for hospice care. We are able to do that through the generous and continued support of our community.

Community support began with Nancy Dubois’ efforts. They have continued since her with a long, unbroken line of volunteers and others who’ve provided financial gifts to Yolo Hospice.

No matter what hospice looks like elsewhere, Yolo Hospice will always feel it is people helping each other. We are pleased to provide that help in the form of clinically excellent care delivered in a spirit of loving kindness.

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Quotes

Ted Skiera
"I've worked for 20+ years in cardiovascular and oncology nursing, most recently working as a nurse coordinator in cardiovascular research. My work with Yolo Hospice has enabled me to focus all of my acute clinical experiences into caring for patients, and their loved ones, during a most challenging period of their lives."
~Ted Skiera, RN