Jimmy Carter has opted for home hospice care. This is what that means. End-shutdown


Former President Jimmy Carter has decided to “spend whatever time he has left at home” and receive hospice care. the Carter Center announced on Saturday.

Carter, 98, has passed a countless health obstacles over the past decade, including brain cancer, liver surgery, and hip replacement surgery. Now the longest-serving president is choosing to spend his final days at his home in Plains, Georgia.

“After a series of brief hospital stays, former US President Jimmy Carter decided today to spend his remaining time at home with his family and receive palliative care rather than further medical intervention,” a statement read. “He has the full support of his family and his medical team. The Carter family asks for privacy during this time and appreciates the concern shown by their many fans.”

Although hospice care is not uncommon in the US, with 1.6 million patients receiving it in 2018according to the Centers for Disease Control and Prevention, Dr. Sunita Puri, director of the Hospice and Palliative Medicine Fellowship Program at the University of Massachusetts Chan School of Medicine and author of “That Good Night: Life and Medicine at the Eleventh Hour”, Yahoo News said hospice care is often misunderstood.

“I think this dichotomy between medical intervention and hospice care is a false dichotomy, and it’s really continuing care,” Puri explained.

Puri spoke to Yahoo News to help demystify end-of-life and hospice care. Some answers have been edited for length and clarity.

Yahoo News: What is hospice care?

dr. Sunita Puri: I like to think of it as intensive care focused on comfort. It is provided with the goal of minimizing the physical, emotional, and spiritual suffering experienced by patients and their families when someone has six months or less to live. Hospice can be provided in the home, which is where most hospice care takes place, but it can also be provided in a facility such as a nursing facility, and sometimes in a freestanding hospice facility.

One thing that is very important for people to know is that hospice care is medical care. It is a medical intervention, and it is one that takes into consideration the totality of one’s experience with serious illness and the suffering associated with it.

How do a patient (or their family) and doctors decide to start hospice care?

That’s usually a conversation between doctors and their patients and family based on a couple of things. One, when we get close to the point where the options to treat the primary disease don’t work or there are no options left to treat the primary disease, that’s when people start having discussions instead of focusing on the disease, focusing on the treatment of the symptoms. And it’s also quite possible that at any point in their illness, a patient could say, “I understand there may be more treatment options, but my goal is to focus on living well and managing my symptoms for as long as I have to live.” So there’s kind of a discussion about prognosis or life expectancy, which is part of this, but the other intertwined elements are about suffering, quality of life, and how someone wants to spend their time.

Who provides hospice care?

Hospice care is usually provided by agencies. For example, I work in a system where we don’t have our own hospice agency, so it’s very common for whoever your primary medical team is to refer you to another organization that provides hospice. There are doctors, nurses, spiritual care providers, and social workers involved, and sometimes there may be music therapists or physical therapists or occupational therapists, depending on the agency and the needs of the patient.

Jimmy Carter's childhood home in Archery, Ga.

Jimmy Carter’s childhood home in Archery, Ga. (Elijah Nouvelage/Reuters)

What happens during hospice care?

When you start receiving hospice services, there is a team that will visit your home, and usually the nurse is the face of the hospice team. So the nurse will visit, assess how someone is feeling in terms of pain or nausea, shortness of breath, or other sources of suffering. The nurse will talk to the patient and family about the other dimensions of what they are going through emotionally and spiritually.

One doctor oversees the entire plan of care, making sure the correct medications are prescribed and dosage changes are made when someone needs more than what we are currently giving. The entire team talks about ways they can meet the individual needs and goals of patients and families as they go through this process. Hospice is very much an iterative process and a team effort, so when we start out in terms of pain management or patient support, that evolves a lot as someone gets sick.

How long does hospice care last?

Hospice is technically if you have a life expectancy of six months or less, but in the US, hospice stays average about three weeks. And I think that’s unfortunate, because it speaks to the fact that we have a really hard time talking about these issues, like suffering, quality of life, whether certain treatments really add to or take away from someone’s life experience. And because those conversations can be delayed, we have a situation where people are referred to hospice very late. That statistic has always fascinated me and not surprised me.

What is important for people to know about hospice care?

Hospice is not about giving up, or throwing in the towel, or losing the fight, or anything like that. Hospice is about recognizing where your body is, at a certain stage of the disease, and honoring that and honoring the person that you are, which is different from the disease that you are suffering from.

I think it’s very important that people know that hospice is a very comprehensive and humanistic plan of care and service that really tries to maximize dignity and minimize suffering when living with an illness that we cannot cure. And most diseases cannot be cured, so thinking about when you would like to transition from treatments intended to prolong life to treatments intended to improve the quality of your life is a conversation in which I always encourage people start thinking the moment they are given a serious diagnosis.

I think it’s very important for people to know that hospice care is very much focused on the needs of the patient and their family, and supporting what is most important to them and what they value and what their goals are for their time. on earth.

Jimmy Carter addressing a community meeting in Elk City, Oklahoma, in March 1979

Carter addressing a town meeting in Elk City, Oklahoma, in 1979. (Getty Images)


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