Centenary of the woman who revolutionised care for the dying

In the twentieth century, doctors often perceived patient death as a failure, and not an active field of medicine. However, St Thomas' graduate Dame Cicely Saunders revolutionised end-of-life care in the 1960s, opening a ground-breaking hospice in 1967.

Early Career

During the Second World War, in spite of parental disapproval, Saunders trained at the Nightingale School of Nursing at London’s St Thomas’ Hospital, now part of King’s Faculty of Nursing, Midwifery & Palliative Care. She then became a hospital almoner – the equivalent of a social worker today – and met a Polish man who changed the course of her life.

Patient David Tasma was a Jewish refugee from the Warsaw ghetto, and was dying of cancer. Towards the end of his life, he and Saunders discussed the creation of a home-like environment, offering hope and comfort to dying patients. When David passed away, he left Saunders a sum of money to Saunders, to help make their vision a reality.

Saunders developed the concept that end-of-life environments should pay attention to people’s social, emotional, psychological and spiritual needs, achieved by "a team who work together to relieve where they cannot heal, to keep the patient's own struggle within his compass and to bring hope and consolation to the end".

She also advocated a systematic approach to symptom control, contradicting contemporary hospital practice of inadequate, infrequent morphine injections, leaving many patients in uncontrolled pain.

The birth of the modern hospice

Saunders planned, fundraised and built her own hospice, taking time out to complete a medical degree at St Thomas', admitting the first patients to St Christopher's in south-east London in 1967. The hospice combined clinical research and expert pain and symptom relief with holistic care, and support for patients, their families and friends, and is widely recognised as the birth of the modern hospice movement.

It was a place where patients could garden, write, talk and get their hair done – very different from any other hospital or hospice setting at the time.

Throughout her career, Saunders continued researching, evaluating and innovating new approaches to care. She carried out studies demonstrating that, with the right dose and interval, morphine could provide constant pain relief without addiction. In 1969, she also oversaw the development of the first service delivering care to patients in their own homes, and further worked to have palliative medicine recognised as a speciality by the Royal College of Physicians.

When Dame Saunders passed away in 2005, the UK had some 200 hospices, with similar programmes in 115 countries across the world - demonstrating significant progress towards her aim for "death must not be seen as a failure, but as part of life."

Cicely Saunders Institute

Dame Saunders' vision is continued today through the work of King’s Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation.

The Institute provides end-of-life care, but has expanded it's mission to helping people live well, and improving quality of life for those facing problems associated with complex and life-threatening images.

You can find out more here.