What Happens After President Jimmy Carter is on Hospice for Six Months?

Former President, Jimmy Carter has now been on hospice five months, which begs the question, “How long can someone be receiving hospice services for?”

For an individual to begin to receive hospice services, they must have a terminal diagnosis and a prognosis of six months or less. These qualifying factors need to be verified by two separate physicians. This means that at the time of admission, two physicians estimate that this person will die within six months.

How does a physician know when someone will die? There are many things that impact the prognostication. The underlying severity of the disease of course. In addition, there are other factors such as recent falls, hospitalizations, weight loss, cognitive changes, other presenting symptoms, as well as overall health.

As you might expect, individuals don’t always die exactly when we think they will. Some die much sooner than we expect. Others live much longer. Some fall within the initial estimation.

After 90 days of a person being on hospice, they are evaluated again by the hospice physician to determine if they are still eligible for hospice. After another 90 days, they are evaluated again. This brings us to the original six month prognosis.

So what happens after six months? What will happen to President Carter if he survives until six months? He is then evaluated every 60 days by a physician to make sure he still qualifies for hospice. This process continues every 60 days. There is no cap on the amount of 60 days a person can be re-certified for hospice. However, they have to continue to meet the criteria to qualify.

Occasionally, people start doing a little better on hospice and no longer qualify. When this happens, the individual is discharged from hospice. The hospice interdisciplinary team, including physicians, social workers, chaplains, home health aids, nurses (and volunteers if one is assigned to the patient) provides their input to the physician during every re-certification. The physician relies on the hospice team to share their observations on what decline or improvements the individual has made. The decision to re-certify or discharge is based on the interdisciplinary team.

The good news is, a person can be re-admitted to hospice if they begin to decline. They will be evaluated to determine if they qualify at that point in time. There is no limit to how many times a person can be re-admitted to hospice.

I continue to be so grateful for President Carter for being public with his decision to enter hospice as it provides such a needed opportunity to spread information about hospice services.

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