LiverPAL: A Trial of Inpatient Palliative Care for Patients With Advanced Liver Disease

Patient Inclusion Criteria: 1. Hospitalized patient with a diagnosis of advanced liver disease, defined as cirrhosis with one of the following (new or ongoing) within the prior six months from date of consent: * Ascites (requiring diuretics or serial large volume paracenteses) * Spontaneous bacterial peritonitis * Hepatic hydrothorax (requiring diuretics) * Variceal bleed (with one or more occurrences) * Overt hepatic encephalopathy (requiring medications) 2. Ability to comprehend English Patient Exclusion Criteria: 1. Prior history of liver transplantation 2. Have uncontrolled hepatic encephalopathy, cognitive impairment, psychiatric disorder or other comorbid condition which the primary medical, hepatology, and/or transplant surgery teams believes prohibits the ability to provide informed consent 3. Current or recent (within 5 years of receiving curative cancer treatment) history of extrahepatic malignancy (excluding non-melanoma skin cancer) 4. Presence of hepatocellular carcinoma beyond Milan criteria 5. Are already receiving hospice care 6. Receive a score of \<10 on the Simplified Animal Naming Test Caregiver Inclusion Criteria 1. Adult caregiver (≥ 18 years of age) 2. A relative or friend identified by the patient upon whom the patient relies for help and who likely is to be present in-person during hospitalizations or clinic appointments, or willing to participate by phone 3. Ability to comprehend English and can complete questionnaires Caregiver Exclusion Criteria 1\. Inability to comprehend English