Since 1978, every November is recognized as National Hospice and Palliative Care Month, thanks to former President Jimmy Carter who established this to raise awareness about hospice care. Carter continues to demonstrate his advocacy for hospice care, now as the recipient of the benefit. He enrolled into hospice care earlier this year, after enduring a series of health crises that included a bout with melanoma that spread to his liver and his brain, leading to frequent, short hospital stays. His wife, former First Lady Rosalynn Carter, also began to receive hospice services soon after him. They celebrated their 77th wedding anniversary in July, which made them the longest-married couple in presidential history. She died at their home in Plains, Georgia on Nov. 19, 2023 at the age of 96.
Former President Jimmy Carter and First Lady Rosalynn Carter
Photo Credit: Universal History Archive & Scott Cunningham/ Getty Images
“Once again leading by example, [the Carter family] is showing us how to embrace a stage of life that people don’t want to think about — that people don’t want to talk about,” National Hospice and Palliative Care Organization (NHPCO) COO and interim CEO Ben Marcantonio said. “They’re showing us how hospice helps patients
live life to the fullest to the end of life.” Hospice is indelible to Carter’s legacy as president. He founded the federal payment model demonstration, which has now evolved into the current Medicare Hospice Benefit. During his presidency, the Health Care Financing Administration (HCFA) was established which was later reorganized as the U.S. Centers of Medicare & Medicaid Services (CMS).
Hospice care — regardless of length of stay — saves Medicare approximately $3.5 billion for patients in their last year of life, a 3.1% reduction. Recent data show that longer stays reduce health care costs in the last year of life by as much as 11%, according to a joint report, from NHPCO, the National Association for Home Care & Hospice (NAHC) and NORC at the University of Chicago.
There are few common misconceptions about hospice:
In the U.S, hospice care is delivered to personal homes. It is not only designated for those in end-of-life care facilities. Majority of hospice patients receive hospice care at home, like the Carters.
Hospice is not just for the rich. It is part of the Medicare benefit that a person can choose to enter if they have a terminal illness and a prognosis that they have six months or less to live. A person entering hospice care agrees to forgo medical treatment, in favor of therapy aimed at easing their pain and preparing them and their families for the end, experts said.
You can always dis-enroll from hospice. You are not signing up for something you cannot change. In fact, about 15% of people wind up “graduating” from hospice, going back to their regular Medicare benefits after their disease stabilizes and their prognosis improves, according to the 2022 Medicare Payment Advisory Commission report.
Unfortunately, many people wind up choosing hospice care too late to receive its full benefits. “Too often, people don't get to access the support that hospice provides that would allow them to do the things that [former] President Carter is doing, just because it happens too late in the course of illness,” said Dr. Sean Morrison, chair of geriatrics and palliative medicine at Mount Sinai in New York City.
Sources:
•“Jimmy Carter 'Happy' in At-Home Hospice Care as 99th Birthday Nears” by HealthDay published Sep. 29, 2023
•“How Former President Carter Helped Shape Hospice Care” by Hospice News, Jim Parker, published Aug. 17, 2023