Hope never ends: Jimmy Carter’s death at 100, his choice of hospice care, and what Canada’s health care system can learn from it.

Jimmy Carter, the longest-serving former president of the United States, has died at the age of 100 at his home in Georgia, after nearly two years of hospice care.

When we look back at the contributions of his life, we can see how the values ​​he had in his international work are reflected in his final life decisions. These decisions offer lessons for Americans and all Canadians.

Carter and his wife Rosalynn, who died in November 2023, each chose hospice care at the end of their lives.

Both hospice and palliative care focus on patient well-being and quality of life for people who are seriously ill, but who receive hospice care no longer seeking treatment to treat the condition. see. Patients with disabilities may or may not be seeking treatment for their illness.

Living our values

Canada faces a huge gap in palliative care. Eighty-five percent of Canadians support the government’s standards for palliative care and up to 89 percent of Canadians who are dying could benefit from it.

However, only 15 per cent of Canadians receive publicly funded home care in their last year of life. Only 15 percent have primary access to palliative care in the community.

Looking at what the Carters experienced in the last months of the former president can help Canadians better understand the importance of closing this gap.

It’s a moment to think about how the values ​​we embody throughout our lives are just as important when it comes to how we choose to define our end-of-life decisions.

Carter in Canada

Carter has been hailed as a hero in Canada for his role in helping to prevent the world’s first nuclear accident: the 1952 meltdown in Chalk River, Ont. As a junior naval officer, Carter was part of a group of Americans who were asked to help manage the response. He and others used a virtual machine to practice disassembling parts of a real machine for 90 seconds to try to reduce radiation exposure.

Carter and his wife Rosalynn are also celebrated by Canadians as important partners of Habitat for Humanity. Habitat has built more than 3,800 homes for hard-working, low-income Canadians in every province and nearly 40 territories.

Try for peace, fight disease, and build hope

After leaving the White House in 1979, Carter dedicated his life to building a peaceful and healthy planet. The Carter Center’s mission is to “Provide Peace. Fight Disease. Build Hope.”

As these three goals have changed the lives of millions of people around the world, they are equally important when applied to the ultimate personal choice.

The Carters are widely praised for their bravery, from dealing with deadly and neglected tropical diseases to oppressors.

The conversations that are part of hospice care also show courage and can ultimately bring peace of mind.

These include options such as the choice of medical interventions, cultural or religious attitudes towards death, family involvement in caregiving, financial considerations, and discussions with children or grandchildren. This is often a time when unresolved issues in relationships can be resolved.

Healing family relationships is often a great source of satisfaction for the dying. Seeking help to have these courageous conversations can bring peace. It can also be a time to deepen and enjoy existing relationships, and as the Carter family did, leave behind a legacy of memories of the time you spent together.

Final decisions

Palliative care focuses on reducing the burden of life-threatening illnesses on patients and their families, especially when seeking a cure or treatment. The focus is on addressing the overall well-being of the individual and their family, which includes physical, emotional, social and spiritual support.

These are particularly important issues in Canada, where Canadians are living longer but less healthy lives as rates of chronic conditions, chronic diseases and cancer continue to rise.

The fight for quality of life is not a single battle. Choosing palliative care includes the family as part of the care system and encourages courageous conversations about what is most important to the patient and family.

Deciding on the chosen place to receive care is of particular importance. It stands out as one of the most important discussions that families must engage in, often revealing unexpected differences in preferences between family members.

Patients who fear being a burden on their families are often surprised by the eagerness of their loved ones to provide this type of support during their final days.

In some cases, this discussion reveals the need to seek alternative care. Speeding this up means that patients and families can make plans that work for everyone involved.

Care and hope

Hope never ends when you enter hospice care. Indeed, hope has an important place in the ultimate purpose of life. Respite care can be a time of hope for the patient and family as they focus on their goals and wishes.

As the Carters weaved these threads together in their global efforts to promote a better, more peaceful life, spirituality and religion also play an important role in hope and finding meaning in death. Patients and families can redefine hope in the end-of-life process.

At different stages, people may find that the concept of hope has different meanings. It can appear as a persistent desire to get treatment or to survive until a certain important event, such as marriage or birth. Instead, hope may be based on a disease that fits the patient’s needs and preferences.

Canada’s approach to palliative care

Carter was a supporter of the Canadian health care system and actively promoted the idea of ​​using a similar system in the United States throughout his life.

In Canada, funding and policies related to palliative care services vary by province and include home care programs, inpatient facilities, drug/benefit programs and other services. Some programs, such as the Compassionate Care Benefit, are nationwide.

As Carter did, learning about available options and finding the courage to face terminal feelings can guide us to find hope and dignified end-of-life care.

Rachelle Rebman RN, BSN, MPH, CHPCN(C) wrote this article. Rebman has provided health care and oncology for nearly two decades, including providing community health care on Nova Scotia’s South Shore for eight years, and now in Victoria, B.C.