Authors: Mitsuru Sakitani.
In 1967 Cicely Saunders founded St. Christopher’s Hospice. Then, Saunders’ hospice model of palliative care promoted palliative care movement in the world. World Health Organization (WHO) adopted this hospice model, but WHO has gradually improved palliative care and integrated it into community-based comprehensive care. This review focuses on the recent substantial shift in palliative care from hospice to community and WHO’s leadership in integration of palliative care into primary health care. We summarized Saunders’ hospice model, WHO’s improved model in 2002 and the complemented model proposed by the International Association for Hospice & Palliative Care (IAHPC) in 2019. Then, we delineated the development steps of WHO’s integration of palliative care into primary health care. We also showed integration of supportive care in cancer and existential therapy/care into primary health care. Thus, various limitations of Saunders’ hospice model (palliative care for patients with cancer only at the terminal stage and Christian religious care) have been overcome by WHO’s integrated primary health care model that provides care for noncommunicable (including cancer) and communicable diseases during all the continuity of care. Further education and training of the participants in community-based primary health care are required to address all the needs of patients and families in community.
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