By Toni L. Eaton, RN, BSN, MS
President & CEO of Old Colony Hospice & Palliative Care

As Valentine’s Day approaches, an unexpected, modern-day love story comes to mind – one involving a president, first lady, and hospice.
Hometown sweethearts, former President Jimmy Carter and his first lady, Rosalynn Carter, shared a decades-long relationship, making them the longest-married presidential couple in American history. In July of last year, the first couple celebrated their 77-year wedding anniversary.
From birth to death, the Carters’ story is a love story of togetherness. It begins in their tiny hometown of Plains, Georgia, follows them through parenthood, politics, the presidency, and gently ends in hospice care surrounded by loved ones. Rosalynn died on November 19, at 96. Her husband continues to be cared for by hospice and family.
Their two experiences with hospice show the expansiveness and flexibility of hospice’s end-of-life care. Jimmy Carter entered hospice care a year ago, in February 2023, while Rosalynn joined him in hospice care only a short time before her death. Once considered only a service to be called upon in the last days of life, hospice has grown into healthcare that can now offer long- and short-term care, depending on the circumstances.
Jimmy Carter experienced a lot of health and healthcare firsts. Born in 1924, he was the first president to be born in a hospital. At 99, he is now the longest-living president and the first president to receive hospice care.
In 1978, he became the first president to sign a presidential proclamation honoring November as hospice month. At the time, U.S. hospices served several thousand patients and their families each year. That number has grown remarkably to more than 1.7 million annually.
While Rosalynn’s hospice care was what you might consider more traditional, as she entered hospice only several weeks before she died, Jimmy’s experience is a newer approach to hospice care. This longer-term care has many benefits for patients.
As anyone working at Old Colony Hospice and Palliative Care or in the hospice field can tell you, both types of hospice care are critical in taking care of our loved ones and helping them live their best life in their last days.
What makes President Carter’s hospice situation a little different from most is that he has been in hospice for a year after being diagnosed with the reoccurrence of a life-limiting cancer. What this means is you can enter hospice when you have a life-limiting diagnosis, generally meaning life expectancy is in six months. However, if at the end of six months, you continue to have that life-limiting diagnosis, as Jimmy Carter does, you may continue with hospice.
While many think of hospice services as a “last resort,” the Carters embraced it for what it is meant to be: a way to help people live as fully as they can as long as they are able.
If I could change one thing about the way most people view hospice services, it would be to change the perception that accepting hospice services means that the person has given up or that hospice is a death sentence. It is, in reality, a “life” sentence, maximizing quality of life according to an individual’s choices and lifting some of the healthcare burden on caregivers, allowing family more time to spend as simply spouse, son, daughter or friend.
The comment we hear most is, “We should have called sooner.”
For those new to the idea of hospice, this care is defined as medical care for patients with an anticipated life expectancy of six months or less, and the focus of hospice shifts to symptom management and quality of life.
Contrary to commonly held myths, hospice is not care that hastens death. Studies have actually found the opposite. Research published in American Family Physician revealed that just one day of hospice care can enhance life expectancy by up to three months. This may sound like a lot, but often, when people are relieved of pain, they can focus more on living – on spending time with loved ones, reflecting on their lives, doing some of the things they’ve been wanting to do before they die.
The Carter family understood this. When President Carter decided to seek hospice services after several hospital stays, the family released this statement: “He wishes to spend his remaining time at home with his family and receive hospice care instead of medical intervention.”
The former first couple did just that, enjoying such activities as celebrating their anniversary with friends and riding in the parade of the peanut festival in their hometown. Instead of focusing on dying, they were intent on living in ways that mattered most to them.
The fact that Rosalynn Carter chose hospice and that Jimmy Carter has spent so much time with hospice is not a surprise to those of us involved in hospice. The American Family Physician also found that people who received hospice care for at least several days lived an average of four months longer than those who did not.
Without a doubt, hospice services turn the focus back to relationships – so patients can revisit, restore, and enhance those connections that make life truly worth living. The hospice experience is about lives well lived. No matter how close to the end stages of life a person happens to be, hospice services can make things better.
Neighbors in their hometown, Jimmy Carter was three years old and Rosalynn was only a few days old when they first met. Their romance started when they were young adults, blossomed into a family and a lifetime of public service, and closes with them being an example of how end-of-life care can be compassionate and meaningful.
In keeping with their story of loving togetherness, the couple decided that they both will be buried under a willow tree on the land of their house in Plains.

Toni L. Eaton, RN, BSN, MS, is the President & CEO of Old Colony Hospice & Palliative Care of West Bridgewater, a dynamic non-profit hospice serving more than 55 communities south of Boston. OCH also runs the Dr. Ruth McLain Hospice Home in Braintree. A native and resident of the South Shore, Toni brings her compassion and experience as a nurse, veteran, and community leader to her insightful columns for South Shore Senior News. She is also the founder of Sunny Paws Dog Rescue. Several groups have honored her leadership, including the South Shore Women’s Business Network. She currently sits on the board of the Hospice & Palliative Care Federation of Massachusetts. For more information, call (781) 341-4145 or visit Old Colony Hospice & Palliative Care at