Dame Cicely Saunders

Abstract

Founder of the modern hospice movement Cicely Saunders founded the first modern hospice and, more than anybody else, was responsible for establishing the discipline and the culture of palliative care. She introduced effective pain management and insisted that dying people needed dignity, compassion, and respect, as well as rigorous scientific methodology in the testing of treatments. St Christopher's Hospice opened in south west London in 1967. It is now one of many but is still the leader in the field. It was her personal achievement and has been imitated all over the world. She raised the funds for the hospice and contributed some of her own money. Saunders introduced the idea of "total pain," which included the physical, emotional, social, and spiritual dimensions of distress. A good listener, she paid systematic attention to patient narratives. One St Christopher's patient, transferred from another hospital, said, "They used to see how long I could go without an injection. I used to be pouring with sweat because of the pain. I couldn't speak to anyone and I was having crying fits. I think I've only cried once since I've been here. .. The biggest difference is feeling so calm. I don't get worked up or upset." Cicely Mary Strode Saunders was born in Barnet, Hertfordshire, in 1918. She was sent to Roedean School when she was 10. Taller than the other girls, she felt she never fitted in, which, she said, gave her a feeling for people who were outsiders. She also suffered from a painful and slightly crooked spine, and was made to lie flat on the floor for 40 minutes a day. Her father disapproved of her desire to be a nurse, and so instead she went to study at Oxford. After the outbreak of the second world war she abandoned her course and defied her parents' advice, enrolling as a student nurse at St Thomas' Hospital in 1944. However, her back was still painful, and she was advised to quit nursing. After returning to Oxford for a year she gained a "war degree" and qualified as a social worker, or what was then called a lady almoner, in 1947. Saunders was originally an agnostic, but, while on holiday in Cornwall with some 238

Heart failure symptom burden in outpatient cardiology: observational cohort study

“…Further evaluation of causative factors is indicated—most patients with end-stage HF are elderly with multiple comorbidities 16 25. Pain management in life-limiting conditions can be challenging, particularly when pain encompasses all of a person’s physical, psychological, social, spiritual and practical struggles26 and requires a multidimensional approach. Palliative care clinicians have a pivotal role in the education and support of non-specialist colleagues managing complex pain in this setting.…”

Cuidados paliativos en Latinoamérica

“…Se espera que, con la nueva resolución de la 73.ª Asamblea Mundial de la Salud, realizada el 18 de mayo de 2020 (41) , la cual adopta la respuesta nacional COVID, e incluye a los CP, como refiere el profesor Radbruch que "facilite la integración de los CP en todos los servicios y para todas las condiciones" (42) . También contribuyen a mejorar la educación y la calidad de atención, las diferentes publicaciones de la OMS, como son la guía clínica publicada de manejo clínico de COVID-19 (43) , donde también se incluyen los CP, la guía sobre CP en la crisis humanitaria de 2018, y la prevención y el manejo de COVID-19 en los servicios de cuidado de larga duración.…”

Cuidados paliativos: conceptos básicos

“…Los avances médicos del siglo XX ignoraron el sufrimiento de los pacientes con enfermedades terminales. Es por esto por lo que entre 1950-1960 surge en Dame Cicely Saunders, enfermera, médica y trabajadora social (11) , la inquietud del cuidado a estos pacientes, lo que cimentó las bases del movimiento moderno del cuidado paliativo y hospicio. Su abordaje del tratamiento del dolor y otros síntomas se basa en el reconocimiento de la dimensión multidimensional del sufrimiento bajo el concepto de "dolor total" y de la necesidad de integrar los aspectos físicos, emocionales y espirituales tanto del enfermo como de su familia.…”