The Carter family’s experience with hospice care, particularly the contrasting durations of hospice care for Jimmy and Rosalynn Carter, raises important questions about the timing and utilization of hospice services.
Hospice care varies significantly in terms of length of stay. In 2018, the average length of stay (LOS) for Medicare patients in hospice was 89.6 days, with a median length of service (MLOS) of 18 days, a figure that has remained consistent over fifteen years. By 2019, the LLOS slightly increased to 92.6 days, but the median remained at 18 days. This statistic remained relatively stable through 2022, with an average lifetime length of stay in hospice reported to be around 97 days.
These statistics demonstrate that while some individuals, like former President Jimmy Carter, may experience longer stays in hospice, a significant portion of patients have much shorter experiences. This disparity could be attributed to various factors, including the nature and progression of illness, patient and family preferences, and lack of understanding of a prognosis.
In the case of Rosalynn Carter, her relatively short stay in hospice care raises questions about why she was admitted later, especially since hospice care was already in place for her husband. The reasons for late admission to hospice care can be complex and multifaceted. They may include a patient’s or family’s initial reluctance to accept hospice care, the hope for recovery, or the late recognition by healthcare providers of the appropriateness of hospice care for a patient’s condition.
I am unaware of exactly what happened to Mrs. Carter and I am sure there were good reasons that her admission to hospice was so late, but it stills begs the question we so often encounter: Why so late?
This situation within the Carter family illustrates a broader issue in hospice care – the challenge of determining the right time for admission. While hospice care is beneficial for patients and families, providing comfort and support in the final stages of life, the decision to transition to this type of care is often difficult and deeply personal. It involves acknowledging the terminal nature of illness and shifting focus from curative treatments to palliative care, aimed at quality of life.
Understanding the varied experiences of hospice care, as exemplified by the Carters, is crucial in recognizing the need for more individualized approaches in end-of-life care planning. It underscores the importance of timely and informed discussions between patients, families, and healthcare providers about hospice care options and the most appropriate time for admission. These discussions can help ensure that patients receive the full benefits of hospice care, tailored to their unique needs and circumstances.
My thoughts are with the Carter family, just as they are with all the families I encounter in my line of work. While the Carters’ situation is distinct, it echoes the experiences of many families I’ve had the privilege to support. Countless couples have navigated terminal illnesses together, finding solace and support in the exceptional care offered by dedicated hospice programs.
Despite Rosalynn Carter’s brief time in hospice, her prior experiences likely played a significant role in her comfort during her last days. Now President Carter’s finds himself in a unique and heartbreaking situation, as he is both a hospice patient and a recipient of their bereavement services.
