Psychiatric Indications for Admission to an Inpatient Palliative Care Unit

As inpatient palliative care units (IPCUs) have become more widespread, experience grows regarding the patients for whom they are best suited. We report here on the use of an IPCU in the treatment of several individuals with comorbid psychiatric and advanced life-threatening illness during a 1-year period. At least four categories of such patients—those with suicide risk, dangerous noncompliance, anxiety with substance dependence and diagnostic dilemmas—may benefit uniquely from the individualized, whole person, interdisciplinary approach of an IPCU. Effective referral and comanagement of these patients requires both close collaboration between psychiatric and palliative care clinicians, and awareness of the advantages and limitations of alternatives such as inpatient medical and psychiatric units.