Former President Jimmy Carter’s Long Hospice Stay Honors the Model

Pick hospice, such as Hospice of Health First, 'to feel the best you possibly can at the end of life.'

FORMER PRESIDENT JIMMY CARTER entered hospice care more than a year ago. For Medicare-certified hospice, the Centers for Medicare & Medicaid Services requires a patient to be terminally ill with a prognosis of six months or less to live.

BREVARD COUNTY, FLORIDA – In February, 2023, a few months after his 98th birthday, news broke that former President Jimmy Carter, whose cancer had spread to his brain years earlier, was ending treatment for it and entering home hospice care. Nine months later, in November, his wife Rosalynn also entered hospice.

Hospice and palliative care is skilled medical treatment for the symptoms and side effects of serious illness, not the illness itself. It typically follows a lengthy period of traditional therapies intended to fight disease.

For Medicare-certified hospice, the Centers for Medicare & Medicaid Services requires a hospice candidate be terminally ill with a prognosis of six months or less to live.

Former President Jimmy Carter met those requirements more than a year ago and has been in hospice ever since. Rosalynn Carter’s hospice lasted two days.

“We have plenty of folks who are with us for over a year,” says Hospice of Health First Associate Medical Director Gary Dana, MD, “and we have plenty of folks who are well under the six-month guideline – because often you can’t predict.”

Most patients enroll in hospice just before dying. About half will die within 3 weeks. About 1 in 3 patients die within just the first week, and a substantial number of these are in hospice for three days or less.

HOSPICE OF HEALTH FIRST Associate Medical Director Gary Dana, MD, says many of his patients exceed one year in hospice care – “and we have plenty of folks who are well under the six-month guideline – because often you can’t predict.” He also says, “By far the majority of our hospice patients get care from the comfort of their home.” (Health First image)

Dr. Dana has been a hospice and palliative care physician for more than 30 years. Hospice, he says, is the right choice “if you want to feel the best you possibly can at the end of life.”

Studies show that people in hospice have a longer lifespan than they would without it. President Carter’s case exemplifies the finding.

Hospice of Health First carries a census that typically falls between 250 and 300 patients. There are inpatient facilities at Cape Canaveral Hospital and William Childs Hospice House in Palm Bay, but the majority of Health First’s hospice patients stay in their homes.

“By far the majority of our hospice patients get care from the comfort of their homes,” Dr. Dana says. “I’ll come by the hospital in the morning, and then I’ll spend the rest of the day going out to homes, and nurses do as well.”

Hospice, he points out, “is a nursing model” of medical care designed by nurses. Many, like Health First’s, offer and coordinate support services for patients’ families, such as bereavement counselling and support groups. Health First’s Bright Star Center for Grieving Children and Families is dedicated to supporting children and adolescents who have suffered the loss of someone close, such as a parent.

Dr. Dana says it would be a mistake to think people don’t leave hospice once in it.

“A new medication came out, or they get a call from the Moffitt Center that they qualify for a new treatment – we have folks who drop out of hospice to pursue treatment, and we’re supportive.

“No one’s forced into hospice. You can change your mind at any time.”

To learn more about Hospice of Health First, visit HF.org/hospice, or call (321) 434-1744, 24 hours a day, seven days a week.

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