Florence S. Wald, American Pioneer in End-of-Life Care, Is Dead at 91

Published: November 14, 2008
Florence S. Wald, whose vision of bringing the terminally ill peace of mind and, to whatever extent possible, freedom from pain led to the opening of the first palliative care hospice in the United States, died on Saturday at her home in Branford, Conn. She was 91. Her death was confirmed by her son, Joel.

Michael Okoniewski/Associated Press

Mrs. Wald, who was dean of the Yale University School of Nursing from 1959 to 1966, was the prime mover, in 1974, in starting the Connecticut Hospice, the nation’s first home-care program for the terminally ill. Six years later, a 44-patient hospice — where the dying could be comforted by their loved ones around the clock and where the staff would do what it could to alleviate suffering — opened in Branford.

“This hospice became a model for hospice care in the United States and abroad,” the publication Yale Nursing Matters said this week, adding that Mrs. Wald’s role “in reshaping nursing education to focus on patients and their families has changed the perception of care for the dying in this country.”

There are now more than 3,000 hospice programs in the United States, serving about 900,000 patients a year.

In recent years, Mrs. Wald had concentrated on extending the hospice care model to dying prison inmates.

“People on the outside don’t understand this world at all,” Mrs. Wald told The New York Times in 1998. “Most people in prison have had a rough time in life and haven’t had any kind of education in how to take care of their health.”

And, she added, “There is the shame factor, the feeling that dying in prison is the ultimate failure.”

Part of Mrs. Wald’s solution was to train inmate volunteers to care for the dying. Besides comforting the terminally ill, she said, the program would save taxpayers’ money and “have rehabilitative qualities for these volunteers.”

More than 150 inmate volunteers in Connecticut prisons have since been trained, and the model is now being molded for residents of veterans’ homes in the state.

Mrs. Wald’s work brought her many honors. In 1998, she was inducted into the National Women’s Hall of Fame in Seneca Falls, N.Y., along with Madeleine K. Albright, Maya Angelou and Beverly Sills. She was also named a Living Legend by the American Academy of Nursing, and received the Founder’s Award of the American Hospice Association.

Florence Sophie Schorske was born in the Bronx on April 19, 1917, one of two children of Theodore and Gertrude Goldschmidt Schorske. Her husband, Henry Wald, died in 2000. In addition to her son, she is survived by a daughter, Shari Vogler; a brother, Carl Schorske, a Pulitzer Prize-winning historian; and five grandchildren.

As a child, Mrs. Wald was often hospitalized because of a chronic respiratory ailment. The care she received, she said, inspired her to go into nursing. After graduating from Mount Holyoke College in 1938, she received a master’s degree in nursing from Yale in 1941. During World War II, while working as a research technician for the Army Signal Corps, she met a young engineering student — Mr. Wald. Soon after, she turned down his marriage proposal.

She returned to Yale, earned a master’s degree in mental health nursing, and became an instructor in the nursing program. In 1958, at 41, she was appointed dean of the school of nursing.

Mr. Wald, by then a widower, read of her appointment in the newspaper. He got in touch, they started dating, and a year later, she accepted his new proposal.

Four years later, in 1963, a friend at Yale persuaded Mrs. Wald to attend a lecture by Dame Cicely Saunders, a British physician who was then planning to open the world’s first hospice, in Sydenham, south of London. Inspired, Mrs. Wald soon resigned as dean of the Yale nursing school to work on creating a similar center in the United States. She was troubled by a medical ethic that insisted on procedure after procedure.

“In those days, terminally ill patients went through hell, and the family was never involved,” she said. “No one accepted that life cannot go on ad infinitum.”

Dr. Saunders’s hospice, St. Christopher’s, opened in 1967, and Mrs. Wald went there to work and learn. After returning, she and several Yale colleagues joined forces to establish an American hospice. In 1971, Mr. Wald left his engineering firm and returned to Columbia University to earn a degree in hospital planning. His master’s thesis became the proposal for the Connecticut Hospice.

When Mrs. Wald received an honorary doctorate from Yale in 1996, she was introduced as “the mother of the American hospice movement.”

“That’s a completely incorrect description,” she said. “There were many, many people in those days who were just as inspired and motivated as I was.”