In the 19th century, terminally ill people were generally cared for at home. People suffering from advanced cancer or tuberculosis were not welcome in hospitals, which wanted to be seen as places that cured sickness. Some cancer patients without family support ended up in institutions for the elderly.
The first New Zealand home specifically for the terminally ill was St Joseph’s Home for Incurables in Buckle Street, Wellington, which opened in 1899. Run by the Sisters of Compassion, the home cared for the dying, and for chronically ill and disabled people of all ages. Nursing and religious consolation were part of the care offered. Another Roman Catholic order, the Sisters of Mercy, established hospice wards for the dying adjacent to Mater Misericordiae Hospital in Auckland in 1952. Like similar establishments in other countries, these anticipated the modern hospice movement, which developed in the 1960s.
The first modern hospice, St Christopher’s Hospice, opened in London in 1967. Using an interdisciplinary approach, it provided a blend of medical, nursing, social and spiritual care, and comfort for the dying, acknowledging the importance of family and friends in the process. Unlike older hospices, which were widely seen as places where people went to die, modern hospices emphasised maintaining and enhancing quality of life for the dying, while supporting their families. They also confronted the widespread fear of dying and attempted to dispel some of the myths and mysteries surrounding it. New Zealand’s first hospice, Mary Potter Hospice, was opened in Wellington in 1979 by a Catholic order, the Little Company of Mary.
New Zealand hospice movement
Hospices were subsequently established around New Zealand, not all with a religious basis. At first hospices emphasised inpatient care, but they later began offering home-based services. Some hospices now offer specialist services for children and young people suffering from life-limiting illnesses.
A home away from home
Coralee Grantham's husband Mark was diagnosed with a brain tumour in 2012 and died 16 months later at 52. During that time the Mary Potter Hospice was a bit like a revolving door for Mark. Time in the hospice was often focused on getting him well enough to go home. Coralee said that ‘I really felt he was happy when he was there and it became a bit like a home away from home. You can even bring in your animals. It’s like a calm oasis in the midst of all this turmoil that’s going on in your life.’1
In 1986 a national coordinating body, Hospice New Zealand, was established. In 2016 there were 35 hospice services throughout New Zealand. Hospice care is partly funded by the government, but hospices rely heavily on public donations.
The term palliative care, coined in 1975, describes the kind of holistic care offered in hospices. It includes nursing, symptom control, physiotherapy and counselling. Central to it is the idea that pain relief for the dying is both a science and an art, and needs to take into account each person’s individual circumstances, including their cultural preferences. It is now offered through hospitals as well as hospices.