Some time ago, a friend requested my advice. Her mother was in hospital for the seventh time in one year. The tests just kept coming but the patient was no better. Her body was failing and her cognition faltering. The doctors were openly pessimistic on their daily rounds. And yet, after three weeks, there didn’t seem to be a clear plan, or at least one the family understood.

“Why can’t someone tell us the big picture?” my friend said. Her mother’s downward trajectory was evident, but she felt guilty thinking “bad” thoughts. However, if her mother was dying, she wanted to take her home.

“What you need is palliative care,” I said.

I explained that, judging by her account, her mother was nearing the end of life. Doctors commonly struggled to identify this, and specialist palliative care was best equipped to pull things together. A doctor or nurse would facilitate conversations about the goals of care, manage troublesome symptoms and help figure out the venue of care. If going home mattered, palliative care would help, but if things didn’t work out, they could initiate admission to hospice.

I rattled off this advice as routine for an oncologist, but to my friend it felt like an epiphany. She had heard of palliative care but had little idea of what they did – and no idea she could request it.

Sadly, my friend’s mother died three days after our conversation. Months later, my friend........

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