Reflections at a Palliative Care Unit

On February 20, 2002,¹ Charles von Gunten, MD, PhD, introduced Reverend J, a 75-year-old former hospital chaplain with widely metastatic adenocarcinoma, who sought respite in the inpatient palliative care unit of a university hospital for the last days of his life. The author described the various models of primary, secondary, and tertiary palliative care services and the overarching goals of all palliative care, which are to provide comfort and quality of life as death approaches. The interdisciplinary model of care used in this tertiary care inpatient unit offers nursing, pharmacy, chaplaincy, and medical services to provide comprehensive medical and spiritual assistance, as required, for the entire family. Each year the unit hosts a "Day of Remembering" at which families and friends of patients and the unit staff join together to mourn and celebrate their loved ones. The following remarks were delivered by a senior physician at the 2002 Day of Remembering, which was attended by Mrs J, for the third year in a row: