The Carter Center announced Nov. 17 that former First Lady Rosalynn Carter, 96, has entered home hospice care six months after her dementia diagnosis. She joins husband Jimmy Carter, 99, the oldest living president, who has been on hospice care since Feb. 18, following multiple occurrences of cancer, including melanoma, liver and brain cancer.
“Former First Lady Rosalynn Carter has entered hospice care at home. She and President Carter are spending time with each other and their family,” according to the statement.
So, what exactly is hospice care?
Think of hospice as a philosophy of compassionate care for a loved one at the end of life. Hospice also offers a needed break and counseling for the family, in particular for a family caregiver. It differs from palliative care, which provides medical care for people with serious illnesses and focuses on symptom and stress.
Though the word “hospice” might trigger the notion of giving up on life, the goal is to give a person the best possible quality of life — emotional, physical and spiritual comfort. And studies have shown that patients who chose hospice care lived almost a month longer than similar patients who did not choose hospice.
“Hospice is an interdisciplinary model of care. It’s holistic, person-centered and aligned with individual needs,” says Edo Banach, president and chief executive of the National Hospice and Palliative Care Organization in Alexandria, Virginia.
Medicare and Medicaid typically cover the full cost of hospice services, and private insurance policies generally follow the Medicare model, says Theresa Forster, vice president for hospice policy for the National Association for Home Care & Hospice in Washington, D.C. Medicare pays for about 85 percent of U.S. hospice care.
“Regarding Medicare or Medicaid, virtually anything that the patient needs for terminal illness which is determined to be appropriate is going to be free of charge,” Forster says. “Once you go into hospice under your plan of care, you will receive it.”
Hospice on rise for
More than 1.5 million Medicare beneficiaries used hospice care in 2018, the most recent data available, a 4 percent increase from the previous year. Fifty-five percent were women, and more than 3 in 5 were 75 or older.
• Younger than 65: 16.3%
• 65 to 74: 22.3%
• 75 to 84. 28%
• 85 or older: 33.4%
Who is a hospice candidate?
A doctor must certify that a patient meets both of these requirements:
1. A fatal medical condition for which the patient is not seeking curative treatment
2. An expected prognosis of six months or less
That may change soon.
“You shouldn’t give up curative treatment in order to get hospice care, and that’s being tested right now through a demonstration from Centers for Medicare & Medicaid Services,” Banach says. “In the future we will be in a better place with fewer limitations on hospice.”
The number of racial and ethnic minorities who receive hospice care has been increasing, especially Hispanics and Asian American/Pacific Islanders. But in 2018, the most recent year for which data is available, more than 4 in 5 hospice patients were white.