Former US President Jimmy Carter celebrates 99th birthday after entering end-of-life care

Former US President Jimmy Carter. [VOA]

Seven months after the Carter Center announced he was entering end-of-life hospice care, former President Jimmy Carter and his wife Rosalynn made a rare, surprise appearance during a peanut festival in their hometown of Plains, Georgia.

Carter was the 39^th President of the United States and served between 1977 and 1981.

As they waved to bystanders while riding in an SUV that proceeded down the main street of Plains, it marked the beginning of a week celebrating Jimmy Carter's 99th birthday on Sunday - a milestone few thought the longest-living U.S. President might reach.

"I think there is a misunderstanding about hospice that it's only for people who are days away from death," explains author Jonathan Alter. "That's not what the hospice movements say."

Alter, who wrote a biography about Jimmy Carter titled His Very Best, says the Carters are choosing to spend the end of their lives in much the same way as the rest of it. "Do as much as you can for as many as you can for as long as you can," he says.

While retired from public life, Alter says announcing Carter's transition to hospice, and revealing that Rosalynn Carter has dementia, provides the former president and first lady the opportunity to use their journey as another teachable moment for others.

"It was very intentional on their part to do some good for the world by sending a message that you don't have to shrink from these end-of-life decisions, and there are other options for letting go," he says.

While they have let go of the day-to-day operations of the global non-profit they founded in 1982, Carter Center CEO Paige Alexander says thousands of employees and volunteers around the world continue their work without interruption promoting peace and combating neglected tropical diseases.

"The last time we talked, he didn't ask me about politics, he didn't ask me about anything except guinea worm numbers," Alexander told VOA during a recent Skype interview.

In a 2015 press conference announcing he was battling life-threatening cancer, which he recovered from, Carter expressed his greatest wish: "I want the last guinea worm to die before I do," he told the assembled crowd.

When the Carter Center took on guinea worm in the 1980s, there were 3.5 million cases in 21 countries. Alexander says the complete eradication of the neglected tropical disease is now closer than ever. "We're down to six human cases in two countries," she says.

Alexander told VOA she continues to have occasional phone conversations with President Carter.

"When I spoke to him last to wish him a happy birthday early, he said 'I'm not quite sure how happy it is to be turning 99.' His body is failing him. He doesn't have the same physical abilities he used to have, but mentally, he remains pretty sharp, and I think that keeps him going," Alexander said.

She notes that Carter is aware, and appreciative of the continued outpouring of support and admiration, most recently the stream of happy birthday wishes by video and photos the Carter Center is collecting for an interactive online mosaic.

"I think it might be the special sauce of what keeps him going right now. That and peanut butter ice cream," she said.

It is a special dessert Alexander says the Carters enjoy together, sometimes surrounded by family, in the small community they have called home since the 1920s.

"They are exactly where they want to be - together ... in their hometown of Plains, Georgia," says Alexander.