PLACERVILLE, Ca. JOSEPH CHOI - 07/21/23 10:06 AM ET
Many assumed the 98-year-old former president was on his deathbed, but his family says he has continued to enjoy ice cream and stay up to date on the work of the Carter Center.
Ben Marcantonio, interim CEO of the National Hospice and Palliative Care Organization, told The Hill this week that the belief that hospice care is a short-term situation “can be a very common understanding.”
“The main marker identified in the benefit [of hospice care] is six months or less,” Marcantonio said. “Yet it also says that’s if the course of the illness or illnesses run their normal course. And so, it’s not like a definitive marker.”
The average length of hospice care is roughly 90 days, which Marcantonio notes includes situations where it only lasts a few days or less. So, while some people may be surprised by how long Carter has been in hospice, his situation falls within the norms of what many patients experience.
Those who work in the hospice realm say Carter has really opened up the conversation for a general population reluctant to think about issues surrounding death and end-of-life care.
“I don’t think we can understate the significance of someone as prominent and well-respected as Jimmy Carter … openly and publicly making that decision,” said Davis Baird, director of government affairs for hospice at the National Association for Home Care & Hospice.
Carter’s decision to publicly disclose his choice to go into hospice has served to highlight the multitude of benefits that patients enjoy, Baird said.
“Just the positive experience he’s having is, I think, really important for the public to have that model,” he said. “These things often happen behind closed doors. Other celebrities that use hospice — you know, whether it’s an old movie star, a sports star or someone — you often find out after they passed away that they were on hospice, and the journey isn’t articulated.”
While the Carter Center is not providing any additional information about the former president’s health and declined to comment for this story, the rare anecdotes from family members have brought attention to the purpose of hospice care, which is to ensure a higher quality of life after a patient has decided to no longer pursue medical treatment.
At the time Carter entered hospice, it was shared that the decision had been made following a series of short hospital stays for an undisclosed condition. According to hospice experts, this is a common course of action among patients who get tired of constantly going in and out of hospitals.
Marcantonio said the thought process for many patients is: “We don’t want to keep on this cycle of returning to hospitals or to seek some sort of other medical interventions to prolong life. Rather, we want to focus on quality of life and alleviating any discomfort, pain, any sorts of emotional challenges that might come with this process.”
Apart from the duration of hospice stay, Baird said another common misconception is that the process involves a precipitous decline in a person’s health. In fact, many patients stabilize after leaving the “ringer” of the health care system, he said.
Baird noted that treatment for terminal illnesses can be extremely depressing for an individual who would rather be doing more enjoyable things with their time. Transitioning to a space where their goals and desires are prioritized over treatment can result in the patient and their family feeling better.
As Carter, the longest-lived U.S. president in history, completes his fifth month in hospice care, he nears a significant milestone for many patients like him. After six months — 180 days — in hospice, patients on Medicare will have to go through a recertification process to see if they still meet the criteria for coverage.
Many people continue to live past the six-month mark, at which point a hospice medical director or hospice doctor will need to recertify them for Medicare to continue covering the cost of care.
These evaluations can sometimes result in grim outcomes for patients.
