What President Carter’s Hospice Decision Teaches Us About Comfort and Quality at the End of Life

Apr 04, 2023 at 11:41 am by Staff


By Laura Templeton, RN, BSN, MBA

Executive Vice President, Chief Operating Officer, Compassus

Since announcing his decision to enter hospice, people across the country have shared an outpouring of support and affection for President Jimmy Carter and his family. The heartfelt messages pay tribute to the 98-year-old former president’s extraordinary life – a life that he is continuing to share with loved ones during his time in hospice care.

There is still a fundamental misunderstanding of hospice and its benefits among most Americans, and President Carter’s choice to utilize this type of care stands to educate more people about what hospice truly means. It is fitting that the former political leader who enjoyed a long career in public service continues to serve as a role model and teacher to the end.

Hospice is a benefit that offers comprehensive team-based care that prioritizes patient and family well-being. An interdisciplinary team of health care professionals and trained volunteers address symptom control, pain management and emotional and spiritual support tailored to each patient’s needs and wishes. Hospice care is provided where the patient lives with regular visits from hospice team members and on-call 24-hour access to support. It also encompasses bereavement support to the family.

Patient preference is at the center of every hospice patient’s care plan. For people with a terminal prognosis of six months or less to live, electing hospice turns the focus on caring, not curing. Unfortunately, the myth persists that opting for hospice means giving up. To the contrary, it’s an opportunity to spend one’s remaining days as comfortably and meaningfully as possible.

Hospice nurses often hear patients and families say they wish they had accessed hospice sooner. I personally know how hard it is to talk about the need for hospice care. Failing to have those difficult conversations, however, often leads patients and families to initiate hospice so late in the health care journey they don’t have the opportunity to experience its greatest benefits.

In 2020, 25% of patients were enrolled in hospice for five days or less; 10% for two days or less. Yet under the Medicare hospice benefit, patients can receive hospice for two 90-day benefit periods, followed by additional 60-day benefit periods if criteria are met.

People surveyed by the Kaiser Family Foundation provided insights into how many Americans may feel about what is most important at the end of life. Seventy-one percent of those surveyed prioritized “helping people die without pain, discomfort and stress” over 19% who said, “preventing death and extending life as long as possible.”

As a nurse, it is helping people find peace and comfort at the end of life that has led me to dedicate my career to hospice. My hope for every patient and family that chooses hospice is that they find themselves relieved of some of the stresses borne through a difficult journey, and surrounded by support that allows them to experience comfort and focus the time that is left – however long that may be – in meaningful ways.

Patients in hospice care are patients who continue to receive high-quality care where they live, surrounded by their loved ones. I join the millions of Americans keeping the Carters in their thoughts and wishing them well.

Laura Templeton is executive vice president and chief operating officer at Compassus, a national leader in post-acute care, providing a full suite of home-based care services including home health, infusion therapy, palliative care and hospice.