Palliative care

Consider referral to palliative care if not already involved. Ensure that an advance care directive is in place. An important part of care at this stage is good symptomatic management of the liver disease such as ascites, infection, encephalopathy and variceal bleeding.

Communication

The lead clinician’s responsibilities include:

• being open about the prognosis and discussing palliative care options with the patient
• establishing transition plans to ensure the patient’s needs and goals are considered in the appropriate environment.

Checklist