In Australia, the majority of deaths occur in general hospital wards. Most of these deaths are neither sudden nor unexpected. The Australian Institute of Health and Welfare (2006) reported
that over... 50% of deaths occurred in a hospital, with only 11% of these occurring in a designated palliative care bed. Elderly people and
those with multi-system disease form
the majority of in-hospital deaths. People who die without palliative care support may be in rural or regional centers, where access to a designated palliative care bed is difficult. It is only relatively recently that the need for palliative care services in acute hospitals has been acknowledged, and this chapter looks at how acute hospitals are focusing on the care of people with acute needs and those with reversible exacerbations of chronic illness. It discusses palliative care consult services and integrated care pathways. This chapter also offers case studies and a comprehensive reference list.