Acute palliative and supportive care units provide unique and tailored care: A case report

OBJECTIVE: Acute Palliative and Supportive Care Units (APSCUs) provide unique and tailored care to patients with advanced chronic illness. In an APSCU, patients receive intensive palliative care while remaining in an acute care hospital setting. This allows for physical and psychological suffering to be aggressively treated by a dedicated interdisciplinary team. In the case of our patient, the APSCU changed the trajectory of his expected outcome of in-hospital death to a successful discharge home. METHODS: We report the case of a patient with advanced colon cancer who suffered cardiac arrest in the emergency department and was expected to die soon after transition to comfort-oriented care. RESULTS: After terminal extubation, our patient continued to have agitated delirium and was transferred to our APSCU for aggressive symptom control. He stabilized and progressively became more responsive, prompting a change in his plan of care with a goal of discharge home with hospice. The APSCU's interdisciplinary team was able to adapt to the patient's unexpected clinical improvement and provide him and his family with the medical, psychosocial, and spiritual expertise to prepare him for a successful discharge home, where he ultimately died 6 weeks later. SIGNIFICANCE OF RESULTS: The case report demonstrates that an APSCU, with its skilled interdisciplinary team in the acute care hospital, is an ideal setting to provide patient-centered care for seriously ill patients and their families.