Monday, November 17, 2008

Hospice Pioneer Florence Wald Dies

Florence Wald, a humble pioneer of hospice in the United States died Saturday November 8th at her home. She had been receiving hospice services that she helped found and expand from a single program in Connecticut to the thousands of hospice agencies in the United States today. When she began to be involved with the early hospice movement in the early 70's she had already been dean of the Yale School of Nursing from 1959-1966.

The Yale School of Nursing had two profound quotes from her (italics mine):

"Hospice care for the terminally ill is the end piece of how to care for patients from birth on." Dean Wald wrote. "As more and more people - families of hospice patients and hospice volunteers - are exposed to this new model of how to approach end-of-life care, we are taking what was essentially a hidden scene - death, an unknown, and making it a reality. We are showing people that there are meaningful ways to cope with this very difficult situation."
Her ability to imagine care for the patient to encompass all points of life including dying seems so obvious in the field today it is easy to forget what a breakthrough this was. The second quote demonstrates the need for increased awareness not just for the health care professionals but for the public as well. For her death and dying should not be an afterthought of good medical care.

Her first inspiration for end of life care was during a lecture from Dame Cicely Saunders, founder of St. Christopher's Hospice. The LA Times quotes her saying:
"She blew me away," Wald later said. "Until then, I had thought nurses were the only people troubled by how a terminal illness was treated."
The LA Times also notes that she was in favor of assisted suicide as an option for the terminally ill, although the NHPCO website and the Yale School of Nursing website do not mention that so I am not clear on the primary source. Her latest work was dedicated to improving hospice access and care in correctional facilities. There is a scholarship at Yale in her name for nursing students helping underserved populations.

Another good quote this time from the NY Times article:
“In those days, terminally ill patients went through hell, and the family was never involved,” she said. “No one accepted that life cannot go on ad infinitum.”
When she was once introduced as the 'mother of the American hospice movement' she quickly replied (NYT):
“That’s a completely incorrect description,” she said. “There were many, many people in those days who were just as inspired and motivated as I was.”
Mrs. Wald was also supported directly by her husband in the founding of hospice as the NY Times notes:
In 1971, Mr. Wald left his engineering firm and returned to Columbia University to earn a degree in hospital planning. His master’s thesis became the proposal for the Connecticut Hospice.
Thank you Florence Wald for your foresight, inspiration, and dedication to changing a medical paradigm so that many people could benefit from hospice and palliative care.

LA Times Article

Yale School of Nursing Article
NHPCO Article
NY Times Article
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