Palliative nursing and managed care

The origins of modern palliative nursing lay in social changes during the 1950s and 1960s. In Europe and North America, pioneers in the social sciences cracked open the cultural silence about death and dying which was pervasive at that time. Pioneers in clinical practice fostered the establishment of the hospice as a service to humanise the experience of terminal illness and treat the distressing symptoms of painful dying. Both efforts were part of a social movement to improve the health and wellbeing of vulnerable people isolated from effective care by cultural norms and taboos about death.