Jimmy Carter ‘Isn’t Awake Every Day’ Says Grandson– Prayers For 99-Year-Old Former President, Who Recently Lost His Wife Rosalynn, In Hospice Care

Update On President Jimmy Carter

• It’s been 16 months since former President Jimmy Carter, 99, entered hospice care, and his 48-year-old grandson Jason Carter has shared an update on his grandfather’s health, revealing he’s “isn’t awake every day.”
• The main difference between palliative care and hospice care is that during hospice care, no efforts are made to cure the illness, while palliative care may also provide treatment “intended to cure” the illness.
• The former president is also a cancer survivor whose metastatic melanoma was previously treated with Keytruda, a type of immunotherapy drug called a checkpoint inhibitor.
• Immunotherapy drugs have made a significant impact on advancements in cancer treatment. They work by activating immune cells against cancerous cells, using the body’s own ability to fight off the cells. Immunotherapy drugs are used for many different types of cancer, including melanoma, bladder cancer, colorectal cancer, lung cancer, blood cancer, pancreatic cancer, and breast cancer.

Sixteen months have passed since metastatic melanoma survivor and former President Jimmy Carter, 99, entered hospice in his Plains, Georgia, home—and the 39th president's grandson, politician Jason James Carter, 48, has shared a heath update on his grandfather. Speaking exclusively to Southern Living , Jason said there's "really been no change" in Jimmy condition since he went into hospice care in February 2023. Jason, who is the oldest of Jimmy and his late wife Rosalynn's 22 grandchildren, revealed to the news outlet, that his grandfather "isn't awake every day," but his family, including himself, as well as his aunts and uncles often visit without knowing his condition. Jimmy is still "experiencing the world as best he can as he continues through this process," Jason explained, noting that his grandfather has been coping with the loss of his wife, who passed away peacefully in November. "After 77 years of marriage… I just think none of us really understand what it’s like for him right now. We have to embrace that fact, that there’s things about the spirit that you just can’t understand," Jason added.

The Southern Living article, published on June 7, also offered some insight into Jason's' most recent visit with Jimmy, when the two of them talked about family, The Carter Center , and enjoyed watching an Atlanta Braves home baseball game. Jason, who drove nearly four hours from his home in Atlanta to see his grandfather in hospice, explained, "I told him, I said, 'Pawpaw, you know, when people ask me how you’re doing I say, 'honestly I don’t know.' And he kind of smiled and he said, 'I don’t know, myself.'" That was a moment Jason remembers as "pretty sweet."

Jason also described his grandfather's connection with his hometown of Plains as "remarkable." He continued, "[Plains] is the place that has given him the greatest support and it is the only place where he would go through this part of his life. That’s his home in every way, and he really cherished that time and that support. “I think the fact that he and my grandmother both came from that small town, it's a 600 person village, really, and it’s not near any interstate and it is truly out in the country and it is a fundamental part of who he is and who he has been for his whole life. There is no other place in the world that he would be at peace other than Plains.” Last month, according to U.S. Weekly, Jason admitted at the annual Rosalynn Carter Georgia Mental Health Forum, that he believes Jimmy is "coming to the end" and maintaining faith through this time. "There’s a part of this faith journey that is so important to him, and there’s a part of that faith journey that you only can live at the very end and I think he has been there in that space," Jason explained.

Carter's Remarkable Legacy of Service

Jimmy Carter served as President of the United States from 1977 to 1981. The former peanut farmer, Georgia Governor, and Navy service member was confronted with several challenges domestically and abroad throughout his career, including an energy crisis and mounting issues in the Middle East. The Iranian hostage crisis influenced his defeat of President Ronald Reagan. During the crisis, Carter tried to secure the safe return of hostages. Carter is the longest-lived American president, and his legacy has become more adored in the five decades since he left the White House. He has long advocated for democracy, public health, and human rights and was awarded a Nobel Peace Prize. However, amid those accolades, Carter also successfully overcame health challenges that helped grant him the blessing of celebrating 77 years of marriage to the former first lady, Rosalynn Carter, who passed away last November at age 96.

While the scope of President Carter's health when he began hospice care is unclear, it's known that he's had several health scares over the years. Carter underwent elective surgery at Emory University Hospital in Atlanta, Georgia, “to remove a small mass in his liver” in August 2015. The operation was successful, but it also revealed he had cancer that had spread or metastasized to other parts of his body. He received care for his metastatic melanoma at Emory’s Winship Cancer Institute.

Expert Resources On Melanoma

• A Melanoma Vaccine for Metastatic Patients
• A Biopsy of Your Mole Doesn’t Mean You Have Melanoma
• Am I at High Risk for Melanoma?
• An Immunotherapy Success Story: Mary Elizabeth Williams Lived Through Metastatic Melanoma
• Be Aware of the Side Effects of Targeted Therapy for Melanoma

WATCH: Understanding Your Melanoma Diagnosis. Melanoma starts in the same cells that give your skin, hair, and eyes their color. Only in melanoma do the cells change in a way that allows them to spread to other organs. While it’s mostly found on areas of your skin exposed to the sun, it can also develop in areas that rarely receive sun rays. These areas may include the palms of your hands, soles of your feet, your eyes, inside your mouth, and under your nails. “At the time, Carter thought he might have only weeks to live, but Winship doctors quickly developed a treatment plan for him, beginning with stereotactic radiation to control metastatic tumors in his brain and a new immunotherapy drug that worked systemically,” a statement from the Cancer Institute reads. During a press conference before his first radiation treatment , the former president clarified that his melanoma had spread to his liver and brain and would have four rounds of the immunotherapy drug pembrolizumab(brand name Keytruda) at three-week intervals. Immunotherapy drugs work by activating immune cells against cancerous cells using the body’s ability to fight off the cells. The drug Keytruda, which Carter took, is a type of immunotherapy called a checkpoint inhibitor, which works by interfering with signaling pathways between T cells and cancer cells and prevents cancer cells from hiding from the body’s T cells. WATCH: Should you worry about melanoma? Learn about its risk factors. “I’ve had melanoma patients early on who, many years ago, wouldn’t have had a chance,” Dr. Scott Strome explains to SurvivorNet. The former president reportedly announced to his church in March 2016 that doctors stopped his treatment after seeing no more signs of tumors. Then, in 2019, Carter had surgery to relieve pressure on his brain caused by bleeding from his multiple falls at home. In recent months, Carter has made rare public appearances but was present at his beloved Rosalyn's funeral service. He was also spotted riding in an SUV at a parade in his hometown of Plains, Georgia. When spotted, the resilient former president still has a smile on his face.

Hospice and Palliative Care

According to the National Institute of Health (NIH) , "Hospice care focuses on the care, comfort, and quality of life of a person with a serious illness who is approaching the end of life." Hospice care provides comfort care, but it does not attempt to cure the illness. It's recommended families faced with potential hospice care talk to their care team early enough before pursuing hospice care to take advantage of all the comforts it provides. "Starting hospice early may be able to provide months of meaningful care and quality time with loved ones," the NIH says. During palliative care , the patient is provided specialized medical care as they manage symptoms associated with their medical condition. This form of care may also provide treatment "intended to cure" the illness as opposed to hospice care which does not. WATCH: Palliative care improves your overall treatment by focusing on comfort. "It's not the same thing as hospice. It's really important to recognize that palliative care, whether provided by your oncologist or by a specialty palliative care team, is an important adjunct to your oncologic care," Dr. Lisa Diver, a gynecologic oncologist and Medical Director at ImmunoGen tells SurvivorNet. "It doesn't mean that your doctor is going to stop treatment or even wants to talk about that, but simply that he or she thinks it's important to support all aspects of your health. That could be pain control, [relief for] nausea or constipation, or mental health care. All of these other symptoms that commonly arise and are intertwined inextricably with your cancer care," Dr. Diver added. Dr. Scott Rushing , a gynecologic oncologist and surgeon with Compass Oncology, expands on this by saying that palliative care is meant "to try and optimize a patient's quality of life." "Quality of life is something that we've always got to keep at front stage and center," he previously told SurvivorNet. "Palliative care is a very important player in helping our patients have many good days." Dr. Rushing continues by saying that palliative care can transition to hospice care "when we have reached a point where we don't have any therapy that we feel like is going to be effective." Research has been published showing the benefits of beginning palliative care early on in the course of treatment sometimes as soon as the initial diagnosis. In 2016, based on results from a total of nine randomized clinical trials, one quasi-experimental trial, and five secondary analyses, the American Society of Clinical Oncology (ASCO) issued a set of guidelines stating that "inpatients and outpatients with advanced cancer should receive dedicated palliative care services early in the disease course, concurrent with active treatment." Some oncologists have adjusted how they talk about palliative care because of the common misconception about it compared to end-of-life hospice care. Dr. Ishwaria Subbiah , a medical oncologist and palliative care physician at the MD Anderson Cancer Center, shared a fascinating experiment from 2009 (published in 2011): rather than trying to eliminate the deeply ingrained end-of-life connotations of the term "palliative care," Dr. Subbiah's colleagues at MD Anderson decided to change the name altogether, rebranding their palliative care center as the "Supportive Care Clinic." "We found out that the name was a big barrier to referrals," Dr. Subbiah said. "The name itself was a barrier to accessing our services." Within a year of changing the name, MD Anderson's Supportive Care Clinic saw their referrals (that is, patients coming from their medical oncologists and tumor-directed cancer treatment to access their symptom management services) rise 41 percent. "And it has been consistently increasing in the double digits ever since," Dr. Subbiah said. Contributing: SurvivorNet Staff