Patient Inclusion Criteria:  Adult (≥ 18 years old) with advanced liver disease defined as cirrhosis complicated by one of the following (new or ongoing) clinically-evidence decompensating events  Ascites (requiring diuretics or large volume paracenteses) Hepatic encephalopathy (requiring medical therapy) History of variceal bleed episode within 1 year of enrollment Admitted to the general medicine service Ability fo communicate in English and provide informed consent Have a score ≥ 7 on the Short Portable Mental Status Questionnaire  Patient Exclusion Criteria:  Patients with severe hepatic encephalopathy or any other comorbid condition which the primary medical team believes prohibits compliance with study procedures Patients with advanced malignancies being treated with palliative intent Patients already receiving specialty palliative care and/or hospice care  Caregiver Eligibility Criteria  A relative or friend of eligible patient, who lives with them and has in-person contact with them at least twice per week Verbally fluent in English or able to complete questionnaires with the help of an interpreter Age 18 or older  Clinician Selection: All palliative care clinicians who deliver the LiverPal intervention will participate in qualitative interviews. Hepatology clinicians who provided direct care to enrolled patients in either the inpatient or outpatient setting will also be eligible to participate in the qualitative interviews.