| Course | NR 579 Palliative Care in Adult-Gerontology Across the Spectrum |
|---|---|
| Week | 5 |
| Paper type | Family meeting summary |
| Length | About 960 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN, Adult-Gerontology Primary Care NP (AGPCNP) |
| Updated | October 2026 |
Free sample paper for NR 579 Week 5
Family Meeting Summary: A Feeding Tube Decision for a 66-Year-Old With ALS, With Each Person's Position Attributed and the Son's Disagreement Left Standing
Student Name
College of Nursing, Chamberlain University
NR 579: Palliative Care in Adult-Gerontology Across the Spectrum
Instructor Name
Month Day, Year
Family Meeting Summary: A Feeding Tube Decision for a 66-Year-Old With ALS, With Each Person's Position Attributed and the Son's Disagreement Left Standing
Attendance
The patient, 66, with amyotrophic lateral sclerosis, participating by tablet. Linda, spouse and named health care agent. Michael, son, who lives 20 minutes away and visits most weekends. Sarah, daughter, joining by speakerphone from another state; last visited in the spring. The ALS clinic nurse practitioner, who led. The clinic social worker. The palliative care nurse practitioner. Me, as student, taking these notes.
The Update Given
The clinic nurse practitioner explained that the patient's breathing strength had fallen to 38% of the expected value, that swallowing had become slower with two choking episodes in the past month, and that weight had dropped by 4 kg in three months. A gastrostomy for feeding can be placed more safely while breathing strength is above about 50%, and the risk rises as it falls; the neurology practice parameter recommends offering it early (Miller et al., 2009a). The window for a safe placement is narrowing.
The conversation followed the serious illness approach of checking understanding before giving information (Bernacki & Block, 2014). New to the family: Sarah had not known about the choking episodes. Michael had not known the breathing strength had fallen below 50%. Linda knew both.
Positions, Attributed
The patient typed: "I want the tube in my stomach, not in my throat." Asked to explain, the patient added: "The stomach tube keeps me at dinner. The throat tube puts me in a home."
Linda said the choice belonged to the patient and would be supported, and was worried mainly about the procedure itself, given the breathing.
Michael supported the feeding tube but wanted the family to "keep all the options open," including a tracheostomy later, adding: "I'm not giving up on my dad."
Sarah agreed with the patient and asked that the family stop discussing the tracheostomy "because Dad has already said no."
The palliative care nurse practitioner explained that the feeding tube and the tracheostomy are separate decisions, and that choosing one does not commit anyone to the other.
What Was Decided
The feeding tube: the patient decided yes. The placement will be arranged with gastroenterology within two weeks, with the anesthesia team aware of the breathing strength and the patient's wish not to be intubated during the procedure.
What Was Not Decided
The tracheostomy: the patient's decision stands, recorded in the advance care planning note, and was restated by the patient in the meeting. Michael did not agree and said so. The meeting ended without agreement on this point, and the summary records that rather than reporting consensus.
Questions Asked and Answered
Michael asked how long the patient might live with the feeding tube. The clinic nurse practitioner said that nobody could give a precise answer, that the tube would help with nutrition and choking but would not stop the breathing muscles from weakening. Sarah asked whether the patient would be in pain after the procedure; the answer was that the plan would include pain relief and the patient's limit on evening sleepiness would be kept.
Time and Tone
The meeting lasted 55 minutes. The first 15 went to the update and questions, and the rest to positions and the decision. Michael spoke most in the second half and left the room once for a few minutes. Sarah asked twice for things to be repeated because of the speakerphone. Nobody raised their voice, and the patient's tablet was given the time it needed after every question.
The Patient's Closing Statement
At the end of the meeting, the clinic nurse practitioner asked the patient if there was anything to add. The patient typed for nearly two minutes, and the tablet read aloud: "I know you are all scared. I am too. The stomach tube I'll take because I want to keep eating with you. The other one I won't. That's not giving up. That's me deciding." Michael did not reply. Sarah, on the phone, said, "Okay, Dad."
Where the Family Stands After the Meeting
The patient, the spouse and the daughter agree on both decisions. The son agrees on the feeding tube and disagrees on the tracheostomy. The agent knows the patient's wish and has said the agent's role is to state it. These positions are recorded so that, if breathing fails suddenly, the clinician on duty knows where each person stands before walking into the room.
Practical Arrangements
Gastroenterology will call the spouse within two days with a date. The patient will continue to eat by mouth for pleasure after the tube is placed. The home health nurse will teach the spouse to use and clean the tube. A dietitian will see the patient in clinic the week after placement, and the feeding plan will be built around Sunday dinner, which the patient will still eat by mouth in small amounts. The social worker will also help the family apply for a home health aide for the weekday mornings, when the spouse needs to run errands.
Follow-Up
The social worker will meet Michael separately this week. The palliative care nurse practitioner will call Sarah after the procedure. The next family meeting is set for one month, or sooner if breathing changes. A strategy of proactive family conferences and written information reduced symptoms of stress and anxiety among relatives of dying patients in intensive care (Lautrette et al., 2007); this family will receive a written summary of the decisions.
References
Bernacki, R. E., & Block, S. D. (2014). Communication about serious illness care goals: A review and synthesis of best practices. JAMA Internal Medicine, 174(12), 1994-2003. https://doi.org/10.1001/jamainternmed.2014.5271
Lautrette, A., Darmon, M., Megarbane, B., Joly, L. M., Chevret, S., Adrie, C., Barnoud, D., Bleichner, G., Bruel, C., Choukroun, G., Curtis, J. R., Fieux, F., Galliot, R., Garrouste-Orgeas, M., Georges, H., Goldgran-Toledano, D., Jourdain, M., Loubert, G., Reignier, J., . . . Azoulay, E. (2007). A communication strategy and brochure for relatives of patients dying in the ICU. New England Journal of Medicine, 356(5), 469-478. https://doi.org/10.1056/NEJMoa063446
Miller, R. G., Jackson, C. E., Kasarskis, E. J., England, J. D., Forshew, D., Johnston, W., Kalra, S., Katz, J. S., Mitsumoto, H., Rosenfeld, J., Shoesmith, C., Strong, M. J., & Woolley, S. C. (2009a). Practice parameter update: The care of the patient with amyotrophic lateral sclerosis: Drug, nutritional, and respiratory therapies (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 73(15), 1218-1226. https://doi.org/10.1212/WNL.0b013e3181bc0141
What the NR 579 Week 5 assignment asks for
The Week 5 summary reads closer to minutes than to a clinical note. Begin with an attendance list carrying roles, so a later reader knows who is the appointed proxy and who joined by phone. Summarize the update given in a few lines, including how much of it was new to the family. Then record each position with a name beside it. Most rubrics mark down passive phrasing such as concerns were expressed, and reward a summary that records disagreement where it existed. If the patient attended, the patient's own words should be in the record. Decisions and non-decisions both belong, with follow-up named. A written copy for the family is often expected too.
Inside the NR 579 Week 5 example
The summary lists eight attendees with roles, including the daughter on speakerphone and the student taking notes. The update covers breathing strength, choking episodes and weight loss, with the guidance on placing a feeding tube while breathing allows, and records which facts were new to whom. Positions follow, each attributed: the patient's typed choice, the spouse's support and worry, the son's wish to keep options open and the daughter's request to stop discussing the tracheostomy. The feeding tube is decided; the tracheostomy is recorded as not agreed. Sections cover time and tone, the patient's closing statement, where each person stands, practical arrangements and follow-up.
Where the points sit in the NR 579 Week 5 rubric
The summary written in the passive gives up the most, since no person can be located in it; every position here has a name. Manufactured consensus comes next, a meeting that ended in disagreement written up as aligned, which fails the first time someone relies on it; this summary leaves the son's disagreement on record. Where the patient attended and their sentence is missing, a row is lost, so the patient's typed words are quoted. Recording how much of the update was new to each person explains the positions. Named follow-up and practical arrangements complete the criteria. Including how long the meeting lasted and how it felt gives a later reader the context for each position.
NR 579 Week 5 help from the desk
Weak NR 579 Week 5 summaries say the family was updated and questions were answered, with no names. Others report agreement when one person disagreed. Many leave out the patient's own words even when the patient was in the room. Some do not record who already knew what. Follow-up is often left as continue to support. If your meeting ended differently, send the attendance, the update and each person's position; a summary can be written in minutes form with every view attributed. Name every speaker, record what was new to whom, quote the patient if present and leave disagreement on the page. End with who follows up with whom, and by when.
Get a NR 579 Week 5 example written to your instructions
Send the vignette your classroom supplied, the rubric and any meeting template, and a custom family meeting summary written around those particular people returns inside 24-48h, first one free. If the section wants a reflection attached to the record, say so and the example will carry both parts.
More NR 579 papers and AGPCNP samples
- NR 579 Week 1: Palliative Timing Discussion Post
- 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 6: Pain Management Case Analysis
- NR 579 Week 7: Ethical Dilemma Write-up
- NR 579 Week 8: Narrative Reflection
- NR 578 Week 5: Caregiver Education Plan
- NR 568 Week 5: Deprescribing Plan
- NR 577 Week 5: Motivational Counseling Write-Up
- NR 576 Week 5: Diagnostic Work-Up Plan
NR 579 Week 5 questions, answered
How much of the meeting goes in?
Enough for a colleague to act without telephoning you, which is less than a transcript and rather more than most drafts contain. Positions, attributions, agreements, open items and next steps are the parts that carry weight. Small talk, the seating and the emotional weather can go, except where a reaction changed the direction of the discussion, in which case it is data.
What if the patient and the family want opposite things?
Then the summary records both positions with names attached and does not resolve them by writing. Say what was agreed anyway, what remains open, what might move it, and when the group reconvenes. A record ending in genuine disagreement, documented clearly, scores better than one inventing an agreement nobody in the room reached.
Does the summary go in the chart or is it an academic paper?
Usually it is written as though it were going in the chart, then submitted as coursework with citations wherever the rubric asks for them. Check the assignment for whether a reflective section is wanted alongside. Keeping the meeting record itself free of academic commentary is what lets it read as the clinical document it imitates.
Where can I find a free NR 579 Week 5 sample paper?
The full family meeting summary on the feeding tube decision, with attributed positions and the disagreement recorded, is on this page.
Why does the NR 579 Week 5 summary not report consensus?
The son disagreed with the tracheostomy decision and said so, so the summary records that the meeting ended without agreement on that point.