September 18, 2024
Jimmy Carter Nears 100 Years of Age — What Does This Say About Hospice Care?
In February 2023, former President Jimmy Carter announced he was receiving hospice care at his home in Plains, Georgia. At the time, Carter was 98 and had been treated for metastatic melanoma that had spread to his liver and brain. Now, more than 18 months after his announcement, Carter is nearing his 100th birthday.
What does this say about hospice care?
A widespread misconception about hospice care is that it’s only used during the last few days of a person’s life. While that can be true, hospice experts like EveryStep’s chief medical officer, Dr. Tom Mouser, say most people with a terminal illness expected to be in their last 6 months of life could benefit from longer hospice care. Former President Carter is one example of that.
“I think that’s probably the biggest myth — that you really need to wait until you're close to the end of life, so you don't miss out on time to live. That is not only incorrect, but it been shown over and over that a side effect of hospice care is often longer time to live.”
“I think that’s probably the biggest myth — that you really need to wait until you're close to the end of life, so you don't miss out on time to live. That is not only incorrect, but it been shown over and over that a side effect of hospice care is often longer time to live. When we focus on disease and symptom management for better quality of life, rather than curative treatment that’s not working, we see people living better and longer. It is not uncommon to see somebody stabilized to the point that after six months or more, we begin to think maybe they are not as close to end of life as we thought,” says Mouser.
One study of patients 65 years and older with metastatic cancer found patients receiving four or more days of hospice care lived a median of more than 3 months longer than those receiving three days or fewer of hospice care.
The hospice benefit of Medicare provides coverage for hospice care in specific benefit periods. Initially, a patient can receive hospice care for two 90-day benefit periods. After that, they can continue to receive hospice care for an unlimited number of 60-day benefit periods. If a patient improves to the point they are expected to live longer than 6 months, the individual can be discharged from hospice care; however, they may re-enter care if their condition later declines.
“In essence, someone has nothing to lose and everything to gain if they choose to end aggressive life-sustaining treatments and if their goal is to just live to the best and highest quality for whatever amount of time they have to live,” says Mouser. “Ultimately, the regrets we see are nearly always about wishing they would have elected hospice sooner because they didn't understand how much it would benefit them.”
Dr. Mouser says selecting hospice care changes the focus from curing a patient’s terminal illness to comfort care for pain relief and symptom management. This does not mean the patient is taken off all medications. “Hospice is replacement of curative care with aggressive evidence-based management of the disease in a way that makes sense for quality of life and comfort. So, we still use the medications that you've been on. For instance, if you have heart failure and lung cancer, you're going to live better if we keep your heart failure managed while we treat the symptoms from the lung cancer. If you're a diabetic, we certainly want to continue to manage your blood sugars, considering that your blood sugars are going to behave differently because of your illness. We continue to aggressively manage your health conditions to best provide for a better quality of life.”
EveryStep Hospice is Iowa's oldest and largest nonprofit, community-based hospice provider. Since launching our hospice program in 1978, thousands of Iowans have turned to us to find comfort and care when they needed it most. You can find EveryStep Hospice programs based in Centerville, Des Moines, Mount Ayr, Mount Pleasant, Osceola and Winterset. When a patient needs around-the-clock hospice care, EveryStep Hospice’s Kavanagh House in Des Moines is available. Kavanagh House provides a home-like atmosphere with private bedrooms, living rooms, a family kitchen, spa room, children's play areas and other family amenities. To learn more about EveryStep Hospice, click here.
If you or someone you know is struggling to find the support they need, please contact EveryStep at 515-558-9946 or complete the commitment-free, confidential “Find Care” form on EveryStep’s website. EveryStep staff will follow up with a phone call to answer your questions and provide assistance.