A History of Care
250 Years of American Need, Service, and Hope

For July 4th, 2026 and Ahead

Originally published as a 25-part series in Hospice & Palliative Care Today
and partnering with Composing Life Out of Loss as a downloadable E-Book
for all helping professionals, with focused relevance for today’s hospice and palliative care.

PRELUDE

Partnering with H ospice & Palliative Care Today, Composing Life Out of Loss honored our 250th anniversary of the United States by celebrating a different kind of story: the long, uneven history of how Americans have responded to suffering. We invite you to explore how across war, epidemic disease, poverty, injustice, disability, serious illness, dying, and grief, the story of our country is also a story of service—of people who nursed, advocated, reformed, comforted, and widened the circle of care.

This series of 25 decades traces a history marked by struggle and courage, by failures that demanded truth-telling and by acts of compassion that opened new possibilities for healing—not a straight-line tale of progress, nor a simple chronicle of harm. Reflect with us on how the past shapes the hospice and palliative care we provide today—and the chapters we are called to write next. ~ Text and graphics authored by Joy S. Berger, Founder & CEO of Composing Life; Editor in Chief for Hospice & Palliative Care Today

The Eras You Will Travel

Explore our Table of Contents for a big picture overview and specific entry titles.
Our history’s 25 decades are grouped into these overlapping eras:

Each decade includes several entries with a description, “Historical context,” relevance to “Today’s hospice and palliative care,” and key sources.
Together, these eras invite us to see suffering and compassion anew.

Additional content includes:

For Conferences and Leadership Teams

This 250-year history can serve as a frame for conference keynotes, plenaries, retreats, and leadership gatherings that want to place today’s urgent questions in a larger historical and moral context. It is especially suited for discussions and plans about serious illness, hospice, palliative care, grief, equity, workforce strain, ethics, policy, and the meaning of presence under pressure.

Dr. Joy Berger brings three decades of hospice, palliative, and grief care leadership–with prolific national presentations–and serves as Editor in Chief of Hospice & Palliative Care Today, a daily national newsletter for hospice and palliative care executives. She now offers A History of Care: 250 Years of American Need, Service and Hope as a frame for keynotes and leadership workshops that connect current decisions with the longer American story of suffering, care, and hope.

Ways to Use this History

“O’ say can we see” more clearly what this history reveals?

How can we use our history to better navigate the future?
- Notice what jumps out at you. What does it connect to within you, within your more personal and professional history?
- Identify news headlines from the past that are repeating themselves today. What do you learn from others failures? Successes?
- Use specific segments in your leadership moments of communication, discussion, and strategic planning.
- Cultivate your empathy by diving into this history’s deeply personal stories, and by inviting your colleagues’ diverse reflections.
- Develop dialogue and action via a keynote presentation, a facilitated leadership workgroup, a CE education session, or something else.

How can we refrain from repeating ill-will and intentionally improve care with clarity and courage?

For now, dive into the history. Together, let’s learn. Let’s explore. Let’s discern what matters, who matters, and what we can do.

Walking with you through this time,

A History of Care 250 Years of American Need, Service, and Hope