When Jimmy Carter was taken under the care of a hospice program in February 2023, there were multiple news reports practically announcing that he had died.
As of this writing, our nation’s 39th president is still alive. Electing hospice care is not a death sentence.
Hospice takes care of someone who is living. Physical, social, emotional and spiritual support is given to enable the patient to live as fully as possible to the very last minute of life. The focus of hospice care is on living, even as death may be imminent. None of us knows when that moment may come. The hope is that it is far down the road, but it may also occur suddenly and unexpectedly. In the meantime, we all hope to live each moment as fully as possible.
Another aspect of the news reports that concerned me was the statement that Carter had given up all medical care. This same characterization was made when former First Lady Rosalyn Carter entered a hospice program.
Hospice patients are not denied medical care. What is true is that the focus of the medical care is no longer aggressive curative care; instead, the focus is aggressive comfort care. It is directed toward providing maximum pain control and to manage symptoms such as shortness of breath and nausea.
In my more than 40 years of providing hospice care, countless patients have told me how isolated and abandoned they felt when their doctor told them that curative medical interventions would not benefit them. The words used by the doctor — “There is nothing more I can do” — were interpreted by the patient and family that the doctor was finished with them.
Most likely, the physician intends to tell a patient that even the most aggressive curative medical intervention will not benefit them. But it would be better to add, “We will not abandon you. We will now provide you with aggressive medical care that is focused on comfort rather than cure.”
It would also be wise for the physician to mention that hospice programs provide this kind of medical care.
The last part of the life journey is an important and sacred time. It is a time for much unfinished business to be addressed.
This was illustrated by a comment a patient made to me on my first visit to her, which was “thank God for cancer.” She explained that she had a conflicted relationship with several individuals, whose names she gave to the hospice social worker and myself. We contacted them about the patient’s interest in visiting with them. Most responded; reconciliation took place. The patient died shortly after accomplishing this with the last individual she identified.
It was a gift of peace for all involved.
Jimmy Carter has embraced this same care to live his final days as fully and as well as possible. Choosing hospice care has been a “life sentence” for him and his loved ones.
Thomas A. Welk is Director of Professional Education for Harry Hynes Memorial Hospice.
