Jimmy Carter Celebrates 100th Birthday: Former President Addresses Misconceptions About End-of-Life Care After Over a Year in Hospice.

On the momentous occasion of October 1, the venerable former President Jimmy Carter reaches the illustrious milestone of turning 100 years old, an accomplishment that renders him the first U.S. president to mark a centennial birthday in the annals of history.

In a poignant twist of fate back in February 2023, when he was still in his 98th year, Carter made the profound choice to eschew further medical interventions in favor of cherishing his remaining days in hospice care, nestled within the familiar comforts of his home in Plains, Georgia. His health had been precarious, marked by a series of hospitalizations due to a multitude of ailments, including serious liver surgery and a battle with cancer.

As whispers of his possible final days echoed around him, tributes poured in, capturing the hearts of many. Yet, nearly 20 months beyond that fateful decision, Carter has astonishingly defied expectations. He now harbors aspirations of casting a vote for Kamala Harris in the upcoming elections this fall, as shared by his family, with early voting in Georgia set to commence on October 15.

“It is a common expectancy among hospice patients to strive for pivotal landmarks—like monumental birthdays or family gatherings,” states Angela Novas, the esteemed chief medical officer at the Hospice Foundation of America, who is not directly involved in Carter’s care. “Hospice care diligently endeavors to ensure that patients are present for such significant milestones.”

Carter’s indomitable spirit has cast a radiant, perhaps even transformative perspective on hospice care—a phase of life often shrouded in misunderstanding. So, what, exactly, does one need to know about hospice care?

What is hospice care?

When Carter first transitioned into hospice care, Yahoo Life had a illuminating conversation with Dr. Sunita Puri, who helms the Hospice and Palliative Medicine Fellowship at the University of Massachusetts Chan Medical School, and is also the author of That Good Night: Life and Medicine in the Eleventh Hour. She eloquently described hospice as “intensive comfort-focused care,” intended to alleviate the physical, emotional, and spiritual anguish experienced by patients and their families when confronted with a prognosis of six months or less to live.

While most hospice care unfolds within the walls of one’s own home, it can also manifest in nursing facilities or standalone hospices.

How long does hospice usually last?

According to Dr. Phillip Rodgers, a palliative care specialist guiding the University of Michigan’s Department of Family Medicine, hospice care is typically available in the crucial final six months of life; however, many individuals engage in hospice for far shorter spans. As revealed by the National Hospice and Palliative Care Organization, the median duration for hospice care hovers around 18 days, with a staggering 75% of patients receiving care for under 90 days—this period even shorter within Black, Latinx, and Indigenous communities.

“Certainly, there are exceptional cases—like President Carter, who has been embraced by hospice for an extended time—but they are indeed rare,” remarks Rodgers.

The late former first lady Rosalynn Carter herself spent merely days in hospice care before her passing in November 2023.

Nevertheless, Dr. Kathleen Unroe, a distinguished research scientist at the Indiana University Center for Aging Research, notes that around 10% of hospice patients continue to receive care beyond a staggering 264 days.

Novas notes the noteworthy aspect of Carter’s extended stay, clarifying that while it may surpass the norm, it is not entirely without precedent. “Hospice eligibility entwines itself with prognosis, typically anticipating a six-month countdown to inevitable death—but absolute certainty eludes even the best of medical predictions,” she explains. “Should hospice patients transcend their primary prognosis, they can still receive care as long as the medical team deems it appropriate.”

Dr. R. Sean Morrison, head of the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai, highlights the difficulty many face in accepting the need to transition into hospice care. “The reality that entering hospice signifies an acknowledgment of dying can be a harrowing truth for both patients and their caregivers,” he states.

What people get wrong about hospice care

Beyond questions of duration, misconceptions about hospice care abound.

• Myth 1: Hospice is for those who have “given up.” Contrary to popular belief, hospice often represents an elevation of care, augmenting support for patients and families, particularly those at home or in supportive living arrangements, quips Rodgers.

• Myth 2: Hospice care is solely for those with mere days to live. Carter’s journey exemplifies that hospice may extend weeks or even months of life to patients.

• Myth 3: Hospice care equates to staff residing at the bedside around the clock. “The vast majority of caregiving lies with families or designated caregivers,” explains Novas, while Morrison underscores that hospice is not a destination, but a holistic form of care provided predominantly at home.

• Myth 4: Hospice expedites the dying process. While not administering life-prolonging measures, hospice centers around delivering compassionate comfort to individuals with terminal illnesses, says Novas.

• Myth 5: Hospice is exclusive to cancer patients. Novas clarifies that hospice serves individuals with a wide variety of diagnoses.

Novas further states that Carter’s candid disclosure about entering hospice has sparked vital discussions surrounding end-of-life care, helping to dismantle these persistent myths. “We have all observed him partake in significant events, including his beloved wife Rosalynn’s funeral, all while receiving hospice services,” she points out. “Mr. Carter has significantly contributed to demystifying the notion that hospice is solely for those facing imminent death. His legacy includes this essential awareness he has fostered surrounding hospice care.”

This article was originally published on August 9, 2024, and has been meticulously updated.