Place: Atlanta, Georgia Date: Oct. 1, 2009 Credit: The Carter Center

President Carter’s legacy on end of life care

February 28, 2023


When President Carter’s spokesperson announced that the former president had entered hospice care to receive “comfort care,” it prompted a new wave of reflections on the president’s legacy. Including where he wants to spend his final days. 

“When you take stock of his life, he won at life. Ninety-eight years — longest-lived president — married for close to 77 years — happily,” journalist and biographer Jonathan Alter told Voice of America. “I think that it is fitting that Jimmy Carter is ending his journey on his own terms. He was the first American president ever born in the hospital, but he doesn’t want to die in the hospital.”

Why this matters

Carter’s decision to enter hospice care was not unexpected, given his age and health history. (Carter has faced a number of health issues in recent years, including melanoma, which spread to his brain in 2015.) But this decision may yet become one of the defining aspects of the former President’s legacy, as his journey started a national conversation about the role of palliative care. It also highlights the importance of early referral to hospice care for people with life-limiting illnesses.

Hospice care is a type of medical care that is designed to provide comfort and support to individuals who are nearing the end of their lives. The main goal of hospice care is to improve the quality of life for patients and their families during the final stages of life. Hospice care can be provided in a variety of settings, including hospitals, nursing homes, and private homes.

Unlike traditional medical care, hospice care focuses on the overall well-being of the patient, rather than just treating their symptoms. Hospice care providers work closely with patients and their families to develop a customized care plan that addresses the individual’s unique needs, preferences, and goals. This plan may include a combination of medical, emotional, spiritual, and social support services.

Hospice care is a type of palliative care and differs from other forms of healthcare in part because it is reserved for patients who have a life expectancy of six months or less. This means that hospice care is typically not recommended until curative treatments are no longer effective or desirable. 

Hospice and palliative care can improve quality of life

Similarly, palliative care is a form of healthcare that is focused on relieving pain and symptoms associated with serious illnesses, such as cancer, heart failure, and dementia. What many people don’t know is that unlike hospice care, palliative care can be provided at any stage of an illness, and is appropriate for people of any age. In fact, studies have shown that when patients are referred to palliative care early on — even alongside curative treatment — patients live longer, have better quality of life, and suffer less depression and anxiety. Earlier referral to palliative care has been associated with better symptom management, reduced hospitalizations, and lower healthcare costs. 

Early referral to hospice care can also improve the quality of life for patients and their families. Studies have shown that patients who receive hospice care earlier in the course of their illness are less likely to experience unwanted hospitalizations, receive more appropriate and effective treatment, and have fewer symptoms and greater comfort. Hospice care has also been shown to help families navigate the emotional and practical challenges associated with end-of-life care, providing them with support and resources throughout the caregiving process.

Help for patients and their families

By entering hospice care, Carter and his family are able to receive the support and resources they need to manage his symptoms and improve his quality of life — including access to medical care, pain management, emotional and spiritual support, and assistance with daily activities. Hospice care providers can work closely with Carter’s family to develop a customized care plan that addresses their unique needs and preferences.

Hospice care provides patients with the support and resources they need to manage their symptoms, maintain their dignity, and spend time with their loved ones. Additionally, hospice care can help families navigate the emotional and practical challenges of caregiving, providing them with support and resources throughout the end-of-life process including grief and bereavement support, as well as caregiver respite.

The decisions that President Carter and his family made near the end of his life may become one of the defining moments of his legacy. By sharing his experience with the world, Carter has helped normalize hospice care and raise awareness about the importance of starting hospice and palliative care early on — teaching us all how to win at life by ending well.

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