What is hospice care? The end-of-life services Jimmy Carter chose

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Former President Jimmy Carter entered into hospice care, his charity announced last week, with the 98-year-old expected to spend his remaining time at home surrounded by his family.

“After a series of short hospital stays, former U.S. President Jimmy Carter today decided to spend his remaining time at home with his family and receive hospice care instead of additional medical intervention,” the charity, created by Carter and his wife Rosalynn in 1982, said in a statement.

Carter, the oldest-living former U.S. president, and a Nobel Peace Prize winner, had dealt with a number of health issues in recent years. Like many Americans, Carter is receiving care that focuses on making life as comfortable as possible as death nears.

Hospice care is a popular option for patients who meet certain criteria. Here’s how the care works.

What is hospice care?

Hospice care is provided to patients who choose to no longer receive treatment for a terminal illness and have a life expectancy of six months or less, according to the National Institutes of Health’s National Institute on Aging.

“Its goal is to help people die pain-free…with dignity and surrounded by family and friends,” said Amy Tucci, president of the Hospice Foundation of America. “So it’s a very special thing.”

The care is designed to maximize comfort and quality of life for the patient as they near their death, according to the National Institutes of Health.

Both patients and loved ones receive support from a hospice team, consisting of a physician, nurses, nurse assistants, social workers, chaplains, and volunteers, Tucci said.

Patients do not receive any medical intervention designed to prolong life. But hospice care is not medically assisted death either, for which it’s often confused, Tucci added.

Where does hospice care happen?

Hospice care is usually provided at home, which can be defined as a private residence a nursing home, or assisted living facility, Tucci said. The care is also sometimes provided at a hospital or a dedicated hospice facility, according to the Mayo Clinic.

In 2018 , more than half of Medicare patients enrolled in hospice care died at home, according to research by National Hospice and Palliative Care Organization.

Typical hospice routine:

When a patient begins hospice, a hospice team assesses their needs and devises a care plan based on the patient’s specific condition. A doctor determines which medications the patient should continue, focusing on pain management.

A primary caregiver, usually a trusted friend or family member, spends the most time administering the patient’s care.

A common hospice routine might include multiple visits by a nurse and assistants throughout the week to check on the patient’s condition and help with bathing and other needs, Tucci said.

A social worker helps the patient and family manage any stresses that arise with hospice.

Volunteers help patients and caregivers with simple tasks, such as mowing the lawn or taking care of other chores.

A chaplain or other faith-based counselor provides spiritual support.

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Who qualifies for hospice care?

Families and patients begin to consider hospice when treatment for a disease is proving unsuccessful and the debilitations associated with treatment become unbearable, according to the Hospice Foundation of America.

The bar for admission is typically a prognosis from a doctor of six months or less to live, Tucci said. Typically, patients get a referral to hospice from their doctor.

In most cases, Medicare and most private insurances cover all costs.

“People tend not to know about hospice care until they have to know about hospice care,” Tucci told USA TODAY. “Because we are a death-denying society. We just don’t talk about it.”

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History of hospice care

The concept of hospice care was put forth in the 1960s by English nurse Dame Cicely Saunders, who was a visiting faculty member at Yale University, according to the NHPCO.

Saunders founded the first modern hospice center, St. Christopher’s Hospice, in the United Kingdom in 1967, according to NHPCO. Hospice care gained traction in the United States in the 1970s, and the first hospice was founded in Connecticut in 1974.

Today, hospice service is available around the country and was made largely accessible by a 1982 federal bill that made it a benefit under Medicare, according to the NHPCO.

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