Palliative care on the acute medical unit: an update

The acute medical unit is a busy environment, and nowhere else in the acute hospital can the contrast between providing life-saving treatment and care for a dying patient be so candidly seen. As Professor David Clark says, ‘A key part of the business of hospitals is death.’ It is vital that all healthcare professionals are competent and confident in recognizing patients who may be dying or have an uncertain recovery. Healthcare professionals must be able to assess the palliative care needs of these patients and their families, and communicate effectively and empathically. Care must be personalized, compassionate and well coordinated with the involvement of the multidisciplinary team and community team when needed. Tools such as the SPICT (Supportive and Palliative Care Indicators Tool) might also help identify patients with palliative care needs on an acute medical unit. Clinicians must be proactive in seeking opportunities to discuss the disease trajectory and explore patient and family wishes around future care.