I Am an Advocate or Policy Maker

The BCHPCA will strive to integrate hospice palliative care services into the wider healthcare system in order to guarantee its accessibility and acknowledgement as an essential component of health.

This entails fostering partnerships with policymakers, educational institutions, and healthcare providers to advance hospice palliative care education and training, establish uniformity in practices, and incorporate these services into primary care, hospital, and community health environments. The objective is to establish an uninterrupted chain of care that provides assistance to individuals at every stage along their illness progression, thereby enhancing health outcomes and quality of life.

All forms of grief and bereavement support are important, and it is essential that there are mechanisms to ensure these are accessible, timely, evidence based, and sufficient to support a population health based approach to care.

While policies commonly focus on the provision of specialized professional support, it is also vitally important to build the capacity of the informal and community support networks where most help is provided, and most grieving is undertaken. It is important not to underestimate what family, friends and community (which translates to a compassionate community) can bring to many grieving and bereaved people. Hospice societies are uniquely positioned to provide support and education and broaden the community reach in supporting those needing support in community.

This will involve targeted campaigns to raise public and governmental awareness about the importance of a health-approach to palliative care, emphasizing its role in enhancing overall health system efficiency and patient well-being.

a. Culturally Sensitive Care Initiatives:

BCHPCA aims to enhance palliative care services through culturally sensitive initiatives. This involves training healthcare providers to understand and respect the cultural, spiritual, and social needs of diverse populations, including BIPOC and 2SLGBTQIA+ communities. By fostering a healthcare environment that values and integrates patients' diverse backgrounds, BCHPCA seeks to ensure equitable and accessible palliative care for all.

b. Outreach to Underserved Populations:

BCHPCA plans to expand hospice and palliative care services to underserved and vulnerable populations, such as the structurally unhoused, homeless, remote areas, those with diverse neurodiverse and physical abilities.

Initiatives include targeted outreach programs, mobile palliative care units, and partnerships with local community organizations to address healthcare disparities. By focusing on these areas, BCHPCA aims to eliminate inequities in palliative care access and provide compassionate care to all residents, promoting equity and inclusivity across the province.

Through policy engagement and expert guidance, BCHPCA strives to advocate for the integration of palliative care and grief support within the broader healthcare framework.

The word hospice comes from the Latin hospes, meaning both “guest” and “host.” Since the 11th century, hospices were places of shelter for travellers, pilgrims, and those who were sick or dying. The idea of offering hospitality and compassion to people at the end of life continued through centuries, largely in religious communities across Europe.

The Modern Hospice Movement

In the 20th century, a British physician named Dame Cicely Saunders transformed the concept of hospice into a modern model of specialized care for the dying. Working with terminally ill patients in London in the 1950s, she saw that pain and emotional suffering could be eased through interdisciplinary care.

The Idea Reaches North America

Inspired by Saunders, Dr. Florence Wald, Dean of Yale School of Nursing, founded Connecticut Hospice in 1974, the first hospice in the United States. Around the same time, Dr. Elisabeth Kübler-Ross’s groundbreaking work On Death and Dying (1969) deepened public understanding of end-of-life experiences and the need for compassionate, person-centred care.

Early Leadership

Canada’s hospice and palliative care movement began in the 1970s. After visiting St. Christopher’s Hospice, Dr. Balfour Mount, a Montreal surgeon, introduced the approach at the Royal Victoria Hospital in 1974, founding one of North America’s first hospital-based palliative care units.
He coined the term “palliative care”, from the Latin palliare, meaning “to cloak” or “to alleviate”, to better reflect the philosophy in bilingual Canada and avoid the then-narrow interpretation of “hospice” as a place rather than a philosophy.

In 1989, the World Health Organization (WHO) formally recognized palliative care as a distinct field of medicine focused on improving quality of life for patients and families facing life-limiting illness. This acknowledgment legitimized palliative care as an essential component of health systems worldwide and influenced national frameworks, including those developed in Canada. The WHO’s definition emphasized holistic, person-centred care—addressing physical, emotional, social, and spiritual needs—which became foundational to Canadian hospice and palliative care philosophy.

National Growth

• Late 1970s – 1980s: Dedicated palliative care units were established in Winnipeg, Montreal, and Toronto. Community hospice programs began forming across provinces.
  

• 1991: The Canadian Palliative Care Association (now the Canadian Hospice Palliative Care Association, CHPCA) was created to coordinate national efforts.
  

• 2002:The CHPCA released A Model to Guide Hospice Palliative Care in Canada, defining core principles for quality end-of-life care nationwide.

• 2000s – 2010s: Federal and provincial frameworks integrated palliative care into home and community settings, including Compassionate Care Benefits (2004) and the Framework on Palliative Care in Canada Act (2017).

• Today: Canada recognizes hospice palliative care as an essential component of health services, though access and funding remain uneven across provinces.

British Columbia was one of the earliest provinces to adopt and expand hospice palliative care, combining medical expertise with community compassion.

In BC, hospice care has developed through two interconnected models:

• Health-authority-operated hospice programs, which provide clinical and medical services within the formal health system (for example, inpatient hospice beds and palliative units in hospitals or residential facilities).
  

• Community-based hospice societies are non-profit, charitable organizations deeply rooted in their local communities. They are often named after the community they serve, followed by “Society” or “Association.” These hospices deliver most of the province’s psychosocial, grief and bereavement, volunteer, and caregiver-support services, working in close partnership with their regional health authorities. Their care extends across a variety of settings, including people’s homes, community spaces, and local hospice houses (residential facilities that provide end-of-life support in a home-like environment).

Across the province, more than 70 hospice societies form the backbone of community hospice palliative care, supporting tens of thousands of people every year. Their trained volunteers, counsellors, and staff work alongside clinical teams to ensure that every person and family can receive compassionate, holistic care close to home.

(Note: Throughout the timeline below, the term “hospice society or societies" refers to these community-based non-profits that complement and strengthen health-authority hospice programs.)

1980s: Pioneering Programs

• 1980 – Victoria Hospice Society was established, becoming one of the first comprehensive hospice programs in Canada. It remains a model for integrated clinical, bereavement, and education services.
  

• Volunteer-led hospice societies began forming in communities such as Prince George, Vancouver, Mission, and Kelowna, offering companionship and support for people at home and in hospital.

1990s: Provincial Expansion

• Dozens of local hospice societies were established, often registered as non-profits and supported by donations, volunteers, and small health authority grants. We even saw in 1995 in the Northern region: Prince George Rotary Hospice House, now known as Prince George Hospice Palliative Care Society opens its doors. Widely recognized as B.C.’s first stand-alone hospice house.
  

• 1995 marked a transformational year in children's pediatric care in our nation, Canuck Place Children’s Hospice opened its doors in Vancouver, British Columbia, thefirst free-standing children’s hospice in North America, and one of the earliest worldwide; offering pediatric hospice and respite care, pain and symptom management, and bereavement support for families.
  

• BC became known for its strong community-based hospice model, in which trained volunteers provided emotional, spiritual, and respite support alongside the health system.
  

In the early 1980’ s to early 1990’s, the BC Hospice Palliative Care Association (BCHPCA) was formed to connect societies, share best practices, and represent the sector provincially.

2000s: Integration into Health System Planning

• In 2001, BC reorganized its health system into five regional health authorities, which began embedding palliative care into home and community care.
  

• 2004,  marked Interior’s first hospice house, Kamloops’ Marjorie Willoughby Snowden Hospice Home, operated by Kamloops Hospice Association
  

• 2006 marked Vancouver Coastal Health’s: Richmond’s Salvation Army Rotary Hospice House. The region's first hospice house
  

• In 2006, the Ministry of Health released a Provincial Framework for End-of-Life and Palliative Care, better understanding the role of hospice societies and formalizing regional programs.
  

• BC introduced the Palliative Care Benefits Program, providing access to essential medications, equipment, and supplies for people receiving palliative care at home.

2010s: Building Capacity and Awareness

• Expansion of hospice beds across health authorities improved access to residential hospice care, while many community hospices societies continued serving people outside institutional settings.
  

• 2010 – A First for Fraser Health: The Delta Hospice Society opens the Irene Thomas Hospice, the first free-standing hospice residence in the Fraser Health region. Built adjacent to Delta Hospital, the 10-bed facility marked a major step in integrating community hospice care into the formal health system, paving the way for additional hospice residences across the region
  

• The BC Centre for Palliative Care (BC-CPC) was established in 2013, with core funding from the BC Ministry of Health. Its creation followed growing recognition that BC needed a central body to support consistent standards, research, and innovation across health authorities and community partners.
  

• Education initiatives, such as Advance Care Planning, were introduced through health authorities and hospice societies.
  

• BC hospices societies increased partnerships with Indigenous and culturally diverse communities to improve equity and culturally grounded care.
  

  2020s: Strengthening the Continuum of Care

  • The hospice palliative care sector continues to evolve through provincial collaboration, research, and data collection led by BCHPCA and partners.
    

  • The COVID-19 pandemic (2020–2022) profoundly affected hospice and palliative care across British Columbia and Canada. Many hospice societies experienced significant funding cuts, volunteer shortages, and disruptions to in-person services. At the same time, the need for grief and bereavement support surged as communities faced unprecedented loss and isolation. These challenges exposed systemic weaknesses in the sustainability of community hospice programs and reinforced the importance of integrating grief, bereavement, and palliative supports within the broader health system.
    

  • The integration of grief and bereavement services, a central part of hospice philosophy, has expanded to reach over 120,000 British Columbians annually through community-based programs delivered by hospice societies.
    

  • BC’s hospice societies now play a vital role in supporting caregivers, families, and individuals across the province, embodying the original spirit of hospitality and compassion that defined the earliest hospices centuries ago.