NASW Foundation National Programs
NASW Social Work Pioneers®
Zelda Foster (1934 - 2006)
Mrs. Foster applied principals of hospice care to patients in her charge at a Veterans Administration hospital long before such practices became widespread. She was largely successful at spreading those ideas throughout the nation's hospitals, particularly in the VA hospital network. Starting as a caseworker in the late 1950's, and eventually as a supervisor at hospitals in Brooklyn, Mrs. Foster pressed hospitals to address the psychological needs, along with the medical ones, of the terminally ill. She was unable to ignore her growing discomfort with the way dying patients were treated, the lack of information from their doctors, the Sense of separation from their families, their silent submission to their fate.
In her 1965 article, in the Journal of the National Association of Social Workers, she wrote of her experiences as supervisor of social work at the Veterans Administration Medical Center in Brooklyn and of the hospital's efforts to reform its treatment of the terminally ill. For the first time, she wrote, "the majority of patients were considered capable of understanding the nature of their diseases." "The good patient was no longer one who silently submitted to his fate," Mrs. Foster wrote. "Patients were able to view the doctor more realistically and had less of a need to invest him with magical, omnipotent powers." Dr. Susan Gerbino, a professor at the New York University School of Social Work, said: "She was way ahead of her time. And that was long before anybody was talking about patient autonomy and informed consent."
Zelda Phyllis Leader was born on Aug. 8, 1934, a daughter of Nathan and Ida Leader, the owners of a candy store in the Hell's Kitchen section of Manhattan. Mrs. Foster graduated from Brooklyn College in 1955 and earned a master's degree from the Columbia University School of Social Work three years later. By then, she was already a caseworker at Maimonides Medical Center in Brooklyn. She started work at the Brooklyn VA hospital in 1959.
In May 1966, eight months after Mrs. Foster's article sent ripple through the social work field, an international conference on hospice care was held at the Yale University School of Nursing. The keynote speaker, Dr. Cicely Saunders, requested that Mrs. Foster be invited. From then on they were both considered leaders of the movement. Dr. Saunders is credited with starting the hospice movement in England in the late 1940's. By the early 1960's, the patients' rights movement had taken a foothold in the United States.
Dr. Florence S. Wald, the dean of the Yale School of Nursing at the time, said Mrs. Foster was instrumental in persuading hospitals to adopt the principles of hospice care. "She focused on the organization, from the top down," Dr. Wald said. "Not only hospices, but hospitals must make room for family members to stay overnight, not just during visiting hours; that they be able, to feed their dying family members; that the minister or the rabbi be part of the decision-making process."
Mrs. Foster taught at the Columbia School of Social Work and was director of mental health for the Children's Aid Society. She was also the first president of the New York State Hospice Association. After working at the Brooklyn VA hospital from 1959 to 1971, she returned in 1979, serving as chief of social work until her retirement in 1998. Dr. Gerbino, of N.Y.U., said Mrs. Foster also "trained hundreds of social workers in leadership for end-of-life care."
"There are many mini-Zeldas that she inspired, myself included," Dr. Gerbino said.