| Course | NR 579 Palliative Care in Adult-Gerontology Across the Spectrum |
|---|---|
| Week | 1 |
| Paper type | Discussion post with two replies |
| Length | About 520 words |
| Format | Discussion post with APA 7 citations |
| School | Chamberlain University |
| Program | MSN, Adult-Gerontology Primary Care NP (AGPCNP) |
| Updated | October 2026 |
Free sample paper for NR 579 Week 1
Week 1 Discussion: Initial Post
Drooling Through a Disease-Directed Plan: Why Relief for a 66-Year-Old With ALS on Riluzole Belongs Beside the Neurology Visits Rather Than After Them
Initial Post
The patient I have in mind is 66, a retired high school chemistry teacher with amyotrophic lateral sclerosis diagnosed 22 months ago. The disease-directed treatment is running: riluzole twice a day and noninvasive ventilation at night, both managed by the neurology clinic every three months. The symptom neither touches is saliva. The patient now drools enough to soak two towels a day, has stopped eating in front of the grandchildren and typed to me on a tablet last week: "I would rather choke than have them watch me wipe my chin."
My claim is that relief for that symptom belongs beside the neurology visits now, not after them, when riluzole has stopped working or the patient is in the last weeks of life.
Where palliative care begins is contested, and the sources I read disagree in useful ways. The World Health Organization's definition places palliative care early in the course of illness, alongside therapies meant to prolong life (Sepúlveda et al., 2002). A newer consensus definition, developed by an international association, ties it to serious health-related suffering rather than to stage or prognosis (Radbruch et al., 2020). Kelley and Morrison (2015) distinguish palliative care, which can be given at any stage alongside curative or life-prolonging treatment, from hospice, which in the United States is tied to a prognosis of six months or less. On any of the first two definitions, this patient qualifies today. Only the hospice definition would make the patient wait.
The evidence for not waiting comes from another illness. In a randomized trial, patients with metastatic lung cancer who received palliative care from the time of diagnosis, alongside standard oncology care, scored higher on quality of life and lower on depression than patients given oncology care alone, and also survived longer (Temel et al., 2010). That was lung cancer, not ALS, so I am borrowing the principle rather than the result.
What relief would look like for this patient: a medicine to reduce saliva, a suction device at the table and a referral to the palliative care team that sees patients in the ALS clinic, so the neurology plan and the symptom plan are written in the same room. Waiting until riluzole stops working would mean waiting for a point ALS does not clearly mark, while the towels pile up now.
Reply to Nicole
Nicole, your patient with heart failure on full medical therapy and constant breathlessness is a strong example of the same point. You defined palliative care as "comfort when treatment fails," though, which would place your patient outside it. Which of the sources in your post would you defend if a classmate argued your patient is not yet eligible?
Reply to Eric
Eric, you cited three sources that agree with each other. Would one that disagrees help? If your argument is that palliative care starts at diagnosis, the hospice eligibility rule is the strongest objection, and answering it would make the post more convincing.
References
Kelley, A. S., & Morrison, R. S. (2015). Palliative care for the seriously ill. New England Journal of Medicine, 373(8), 747-755. https://doi.org/10.1056/NEJMra1404684
Radbruch, L., De Lima, L., Knaul, F., Wenk, R., Ali, Z., Bhatnaghar, S., Blanchard, C., Bruera, E., Buitrago, R., Burla, C., Callaway, M., Munyoro, E. C., Centeno, C., Cleary, J., Connor, S., Davaasuren, O., Downing, J., Foley, K., Goh, C., . . . Pastrana, T. (2020). Redefining palliative care: A new consensus-based definition. Journal of Pain and Symptom Management, 60(4), 754-764. https://doi.org/10.1016/j.jpainsymman.2020.04.027
Sepúlveda, C., Marlin, A., Yoshida, T., & Ullrich, A. (2002). Palliative care: The World Health Organization's global perspective. Journal of Pain and Symptom Management, 24(2), 91-96. https://doi.org/10.1016/S0885-3924(02)00440-2
Temel, J. S., Greer, J. A., Muzikansky, A., Gallagher, E. R., Admane, S., Jackson, V. A., Dahlin, C. M., Blinderman, C. D., Jacobsen, J., Pirl, W. F., Billings, J. A., & Lynch, T. J. (2010). Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine, 363(8), 733-742. https://doi.org/10.1056/NEJMoa1000678
What the NR 579 Week 1 assignment asks for
The opening post in this course asks you to argue where palliative care begins, through one patient. Somebody should be in it from the first lines: an illness, a treatment still running and a symptom that treatment is not touching. Then make the claim that relief belongs beside the disease work. Two or three sources should do real work, chosen because they disagree about where the field begins rather than because they all say the same thing. Most prompts warn against a definition that quietly turns the course into one about the final weeks of life, since later assignments involve patients still on treatment. Replies should test a classmate's definition against the classmate's own patient.
How this NR 579 Week 1 example is built
The sample opens with a retired chemistry teacher, 22 months into ALS, on riluzole and night ventilation, whose drooling now soaks two towels a day and keeps the patient from eating in front of the grandchildren. The claim follows in one sentence. Three sources are set against each other: an early-palliative global definition, a consensus tied to serious suffering and a review separating palliative care from hospice. A randomized trial of early palliative care in lung cancer is cited for its principle, with the limit of borrowing it stated. The post closes with what relief would look like. The replies point out a self-defeating definition and ask for a dissenting source.
Reading the NR 579 Week 1 grading rubric
The post that loses most describes a field instead of arguing about a patient, since the application row has nothing to attach to; this one is built on a single person. Running close is a definition that makes palliative care a matter of final weeks, which breaks later assignments; the post explicitly rejects that reading. Sources used as decoration, cited once at the end of a paragraph, cost the evidence row, while here three sources disagree and each changes the argument. Being honest about borrowing evidence from another disease earns credit. Replies that catch a contradiction in a classmate's own post score well. A claim stated in one sentence near the top makes the argument easy to find.
Common NR 579 Week 1 mistakes, and how to avoid them
Many NR 579 Week 1 posts define palliative care at length and never mention a patient. Others assume it means hospice and so exclude anyone still on treatment. Sources are often cited together because they agree, which makes the definition look settled when it is not. Some posts claim evidence from one disease proves a point about another without saying so. Replies that only agree add little. Choose a patient whose treatment is still running and whose symptom it cannot reach, then let the sources argue. If your patient has a different illness, send the illness, the running treatment and the untouched symptom, and a sample post can follow from those three facts.
Get a NR 579 Week 1 example written to your instructions
Give us the prompt your classroom published, whatever rubric sits beside it, and the length it allows, and a Week 1 post built to that specification lands with you inside 24-48h and the first costs nothing. Where the discussion runs off a supplied case, pass that along and the example argues from it.
More NR 579 papers and AGPCNP samples
- NR 579 Week 2: Symptom Management Plan
- NR 579 Week 3: Goals of Care Write-up
- NR 579 Week 4: Advance Care Planning Note
- NR 579 Week 5: Family Meeting Summary
- NR 579 Week 6: Pain Management Case Analysis
- NR 579 Week 7: Ethical Dilemma Write-up
- NR 579 Week 8: Narrative Reflection
- NR 578 Week 1: Older Adult Preference Discussion Post
- NR 568 Week 1: Citalopram Dose Discussion Post
- NR 577 Week 1: Diabetes Screening Discussion Post
- NR 576 Week 1: Old Label Versus New Complaint Post
NR 579 Week 1 questions, answered
Should the Week 1 post be built on a real patient?
No, and it should not use one. A composite built from a classroom vignette or from a case in the assigned reading does the job, with the illness and stage specified and nothing that could identify anybody. What a grader wants is a person concrete enough to argue about, not a person who exists.
How much of the post should be definition?
Less than most drafts give it. A paragraph is usually enough to state what palliative practice adds and where writers disagree about its starting point. The rest of the space goes to the patient and to the claim, since a post that defines carefully and applies nothing reads as a textbook summary with a citation attached.
Can I mention hospice at all?
Yes, and naming it deliberately is stronger than stepping around it. The example distinguishes the two by eligibility and by what carries on alongside, then moves back to its patient. Trouble starts when the words are used interchangeably, because every later assignment about somebody still receiving treatment stops making sense.
Where can I find a free NR 579 Week 1 sample paper?
The full post arguing for palliative care beside ALS treatment, with replies to Nicole and Eric, appears here, annotated part by part in the margins.
Which sources does the NR 579 Week 1 post set against each other?
A global definition placing palliative care early in illness, a consensus definition based on serious suffering and a review distinguishing palliative care from hospice, which is tied to a six-month prognosis.