Thanks, Jimmy.
Again.
President Jimmy Carter entered hospice care on February 18, 2023. Which means, on the day I started writing these thoughts, he had been served by a hospice agency for fifteen days. The former president may die before I post this piece (on Tuesday, March 7) or before some readers read it. Nonetheless, in his own quiet way, the Navy officer, peanut farmer, governor, president, and long-time husband of Rosalyn Carter, has provided another wonderful example of how to live.
And, even more, how to die.
When first learning of Carter’s decision on February 18, I selfishly hoped that he would not breathe his last within hours or a few days of becoming a hospice patient. After all,
Most patients do not enroll in hospice until their time of death draws near. According to a study that was published in the Journal of Palliative Medicine, roughly half of patients who enrolled in hospice died within three weeks, while 35.7 percent died within one week.
35.7%. Within one week. And in my experience, there are dying patients who enter and “leave” hospice care in less than twenty-fours.
Would the former president be among the hospice patients that spend their final days dealing with chaos, pain, and hurried (or nonexistent) goodbyes to their loved ones? Based on statistics that have been fairly constant over the decades, that’s what happens to many—those 35.7%—who enter hospice on the verge of death. People wait too long. Families resist hospice’s care because they desperately search for another, and another, cure. Some physicians remain hesitant to discuss any form of palliative care with patients facing end-of-life decisions. A grim mix of procrastination and magical thinking and ignorance about hospice care leads to that startling 35.7% statistic.
More than two weeks after entering hospice, the former president lives on. By all accounts, whatever pain he has in under control. By all accounts, his family has been able to spend time with him. By all accounts, his choice of staying home for comfort care has been a simple and successful decision.
President Jimmy Carter (in office, 1977-1981) will never be considered among the greatest or the worst of our country’s Commander-in-Chiefs. In recent history, only Carter and former President Trump lost in their bid for a second term. Though the passage of time has given more positive marks to Carter’s accomplishments while in the Oval Office, I doubt that he will be viewed as anything more than an “average” president. Never in the top ten; never in the bottom ten.
But I could easily argue that his post-presidency has been the most successful ever! Habitat for Humanity. Advocating for fair elections across the globe. Teaching Sunday school. Writing books. The Nobel Peace Prize. And on and on and on . . .
And now, hospice.
Jimmy Carter has given us one more gentle, powerful example about making the best choice for himself and for his family.
Thousands of people enter hospice care every week. Unless they are part of “my” family, I don’t know about them. When someone like the thirty-ninth President of the United States chooses to be served by a hospice, all of us know. I truly give thanks that Jimmy Carter did not join the 35.7% of those dying within a week or less. I wonder how many people volunteered time or money or both with Habitat for Humanity because of a former president’s work? I wonder how many people, who voted a president out of office back in 1980, came to admire the man from Plains, Georgia? I wonder how many people read one of Carter’s books and sat in one of his Sunday school classes and learned something new?
And I wonder how many, as they grapple with the tough decisions around a dying loved one, will remember Jimmy Carter’s decision to focus on living?
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Photo Credit: The Carter Center. Place/Date: Monrovia, Liberia. October 11, 2005.
My book, A Companion for the Hospice Journey, is available at Amazon.