President Carter's Legacy on End of Life Care

When President Carter’s spokesperson announced that the former president had entered hospice to receive comfort care, the decision prompted a new wave of reflection on his legacy, including where he wanted to spend his final days.

“When you take stock of his life, he won at life. Ninety-eight years, longest-lived president, married for close to 77 years, happily.”

“I think that it is fitting that Jimmy Carter is ending his journey on his own terms. He was the first American president ever born in the hospital, but he doesn’t want to die in the hospital.” — Journalist and biographer Jonathan Alter, speaking to Voice of America

Why Carter’s Decision Matters

Carter’s decision to enter hospice was understandable given his age and medical history. In recent years, he had faced several serious health challenges, including melanoma that spread to his brain in 2015.

His decision may also become a defining part of his legacy.

Carter’s experience began a national conversation about hospice and palliative care. It also highlighted the importance of referring people with life-limiting illnesses to hospice early enough for them and their families to benefit fully.

Hospice is designed to provide comfort and support to people approaching the end of life. Its central goal is to improve quality of life for patients and their families during a person’s final months.

Care can be provided in hospitals, nursing homes, hospice facilities, or private homes.

Hospice focuses on the person’s overall well-being. Care teams work closely with patients and families to develop an individualized plan based on their needs, preferences, and goals.

That plan may include medical care, pain and symptom management, emotional support, spiritual care, and practical assistance.

Hospice is one form of palliative care. Under current eligibility requirements, it is generally available to patients expected to live six months or less if their illness follows its usual course.

People often enter hospice after curative treatment is no longer effective or no longer reflects what they want.

How Hospice and Palliative Care Improve Quality of Life

Palliative care focuses on relieving the pain, symptoms, and stress associated with serious illnesses such as cancer, heart failure, and dementia.

Unlike hospice, palliative care can begin at any stage of an illness and is appropriate for people of any age. It can also be provided alongside treatment intended to cure or control disease.

Research has shown that early palliative care can help patients live longer, experience a better quality of life, and face less depression and anxiety. Earlier referrals have also been associated with improved symptom management, fewer hospitalizations, and lower healthcare costs.

Early hospice care can offer similar benefits.

Patients who receive hospice earlier in the course of an illness may experience fewer unwanted hospitalizations, more appropriate treatment, fewer symptoms, and greater comfort.

Hospice also helps families manage the emotional and practical demands of end-of-life care, offering support throughout the caregiving process.

Support for Patients and Families

By choosing hospice, Carter and his family gained access to the care and resources needed to manage his symptoms and protect his quality of life.

That support may include medical care, pain management, emotional and spiritual support, and assistance with everyday activities.

Hospice teams also work with families to develop care plans that reflect their circumstances and preferences.

For patients, hospice can provide the support needed to remain comfortable, preserve dignity, and spend meaningful time with loved ones.

For families, it can offer guidance through the emotional and practical challenges of caregiving, along with respite care, grief support, and bereavement services.

A Lasting Part of His Legacy

The decisions President Carter and his family made near the end of his life may become an enduring part of how he is remembered.

By allowing the public to witness his experience, Carter helped normalize hospice and raise awareness of the value of beginning hospice and palliative care earlier.

His final chapter offered one more lesson in public service: living well also means making thoughtful choices about how we hope to end well.