History of Hospice
Canadian physician Balfour Mount, who first coined the term "palliative care", was a pioneer in the Canadian hospice movement, which focuses primarily on palliative care in a hospital setting. Having read the work of Kubler-Ross, Mount set out to study the experiences of the terminally ill at Royal Victoria Hospital, Montreal; the "abysmal inadequacy", as he termed it, that he found prompted him to spend a week with Saunders at St. Christopher's. Inspired, Mount decided to adapt Saunders' model for Canada. Given differences in medical funding in Canada, he determined that a hospital-based approach would be more affordable, creating a specialized ward at Royal Victoria in January, 1975. For Canada, whose official languages include English and French, Mount felt the term "palliative care ward" would be more appropriate, as the word hospice was already used in France to refer to nursing homes. Hundreds of palliative care programs followed throughout Canada through the 1970's and 1980's.
However, as of 2004, according to the Canadian Hospice Palliative Care Association (CHPCA), hospice palliative care was only available to 5-15% of Canadians, with available services having decreased with reduced government funding. At that time, Canadians were increasingly expressing a desire to die at home, but only two of Canada's ten provinces were provided medication cost coverage for care provided at home. Only four of the ten identified palliative care as a core health service. At that time, palliative care was not widely taught at nursing schools or universally certified at medical colleges; there were only 175 specialized palliative care physicians in all of Canada.