Opinion: President Carter’s many months on hospice highlight a surprising truth

October 30, 2023 5:28 am

Former President Jimmy Carter and wife Rosalyn are shown before the start of Game Three of the NLDS of the 2010 MLB Playoffs between the Atlanta Braves and the San Francisco Giants on Oct. 10, 2010, at Turner Field in Atlanta. (Photo by Jamie Squire/Getty Images) (This image cannot be republished unless you have a Getty subscription.)

I saw a clip last month of President Jimmy Carter, now 99 years old, taking a ride with his wife through a peanut festival in their hometown. That’s a happy story for many reasons. As the former president approaches his eighth month on hospice care, it’s also a chance to clear up a common myth.

Back in February, when the president’s family announced he was ending curative treatments and beginning hospice, it was perhaps natural to assume he wouldn’t live much longer. Instead, President Carter has spent the better part of a year not just holding on, but truly living — in the ways that matter most to him, like with a celebratory drive beside his sweetheart.

Like many others, I was grateful to President Carter for publicly sharing his decision to begin hospice those many months ago, because it helped us raise awareness about this crucial type of care. Now, his long run on hospice gives us a chance to spotlight a truth that many find surprising: Some patients actually live longer on hospice.

We sense this regularly in our work at HopeHealth, as the region’s largest and oldest non-profit hospice and palliative care organization. We have the privilege of supporting patients and families through their final time together, and we care for patients who get an extra summer with their loved ones, who are able to attend that big family reunion, who defy all expectations and live long enough to meet their grandchild.

Several landmark studies back up these personal observations with research, including a 2007 report in the Journal of Pain and Symptom Management and a 2018 report in the Journal of the American College of Cardiology: Heart Failure. These studies offer several theories for why patients may live longer on hospice than if they had remained on curative-focused care. In general, they come down to this: Hospice offers extra support at a time when it often matters most.

For example, as part of his hospice care, President Carter has had access to experts who can help with difficult medical decisions, and coordinate between all his doctors. He has a doctor who specializes in making sure he is on the right medications to feel his best, and a medical team that comes out regularly for home visits, noticing and managing any problems early. If he experiences a difficult symptom at any time of day or night, his family can call a 24/7 nurse to come to his side, instead of rushing to the hospital. They have the extra support of a hospice aide for activities of daily living, so they can focus on quality time together. They have access to chaplains and social workers, for spiritual and emotional support.

Above all, President Carter and his family have a team who helps them identify and honor the ways they want to spend their precious time together — like, for example, a pleasant drive through a local peanut festival.

All of these services are available to every patient and family on hospice, not just former presidents. Whether it lasts months, weeks or days, that’s the value of this type of care: It helps us fill our final chapter with comfort, hope and meaning.

I know that President Carter’s final chapter will be every bit as full and meaningful as the life he lived. As in every other chapter, he is leading from the heart.

This commentary first appeared in the Rhode Island Current.

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Diana Franchitto
Diana Franchitto

HopeHealth President & CEO Diana Franchitto has been a strong, leading voice in hospice and palliative care for more than a decade. She has facilitated many partnerships with hospitals, physician organizations, nursing homes, home health agencies, and more to improve the quality of care to seriously ill patients. Franchitto also established HopeHealth’s academic affiliation with the Alpert Medical School of Brown University. As a fellow of the American College of Healthcare Executives, she actively serves on the boards of several health care organizations nationally and in Massachusetts and Rhode Island.