Jimmy Carter's Hospice Care Is Not Unusually Long, Expert Says: 'Average Is 60-70 Days'

Spending months at a time in hospice is not at all uncommon, an expert tells PEOPLE, two months after President Carter's family confirmed that he had stopped receiving medical intervention

Jimmy Carter. Photo: Dave Kotinsky/Getty Images

News that former President Jimmy Carter would begin receiving hospice care came in late February, with The Carter Center announcing in a statement that Carter had "decided to spend his remaining time at home with his family and receive hospice care instead of additional medical intervention."

Now more than two months later, experts clarify that spending months at a time in hospice — while not always the case — is not at all uncommon.

"A misconception is that the average length of stay in hospice is for the last several days of someone's life," explains Jonathan Fleece, president and CEO of Empath Health, one of the largest not-for-profit hospice organizations in the country. "The average length of stay nationally is in the 60- to 70-day range."

Fleece adds that while many think of hospice as 24/7 care, it all depends on a patient's own situation.

"A lot of hospice care is not 24/7. It's in and out of the home and working with the family and caregiver to be able to support their loved one," he says. "So we teach them a lot of different ways to help, whether it's helping with bathing or administering medication or keeping them comfortable."

Former President Jimmy Carter smiles as his wife former first lady Rosalynn Carter speaks during a reception to celebrate their 75th wedding anniversary Saturday, July 10, 2021, in Plains, Ga.. (AP Photo/John Bazemore, Pool)
Former President Jimmy Carter. John Bazemore, Pool/AP

Fleece, who co-authored the book, The New Health Age: The Future of Health Care in America, notes that hospice was made eligible for Medicare reimbursement under the Tax Equity and Fiscal Responsibility Act of 1982 — which was passed into law under Carter himself.

"I truly believe that the former president wanted to make this part of the American conversation," Fleece said.

As Fleece explains, hospice care isn't only meant for those at their end of life, but for their family members, as well.

"Hospice also provides caregivers and families the resources they need," he says.

That includes guiding family members through the grief and bereavement process, including the period of "anticipatory grief," in which the family and patient know that death is coming.

Hospice care can also include things like veterans programs (Carter, being a veteran, would likely be provided with a pinning ceremony, in which a decorated soldier administers a flag with military honors).

Hospice also, of course, provides full medical care, as well as spirituality support. Some programs even cover things like Reiki and music therapy.

"We hear all the time from families and patients, 'I wish someone had explained the scale and depth and breadth of what hospice can bring sooner.'"

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Fleece points to research that substantiates the idea that most people, when asked, say they don't want to die in a nursing home or a hospital bed. Instead, they want to be at home, surrounded by family, loved ones and, if spiritual, their spiritual advisers and leaders.

"One component to hospice is that the aggressive phase of treating a serious, advanced, terminal illness subsides and it transitions into supportive care," he says.

"Nobody truly knows the timetable of [death] and while we can still treat symptoms, we specialize in taking away the suffering — the physical toll of suffering and the anxiety and sleeplessness and the emotional and spiritual side, too."

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