An eleven-year-old living will, read clause by clause after a stroke it never anticipated, anchors this NU435 Unit 6 analysis of what the document authorizes and what his agent decides. Searches like "nu 435 unit 6 assignment example", "nu435 unit 6 sample" and "nu435 unit 6 example" land here.
A Living Will That Does Not Yet Apply: An Advance Directive Analysis Ten Days After a Large Stroke
[Student Name]
Purdue University Global
NU435: Hospice and Palliative Nursing Care
Unit 6 Assignment
[Instructor Name]
[Date]
Composite patient and documents written as a model document. This is coursework, not legal advice; state law governs.
Case
Aphasia; a failed swallow study; a nasogastric tube declined by his wife pending a family meeting; and the question of a feeding tube placed through the abdominal wall. His neurologists expect partial recovery of uncertain degree.
Question 1: What Does the Document Say?
The living will's operative clauses, paraphrased: it applies once two physicians certify that he has a terminal condition or is permanently unconscious; in either state, he declines artificial nutrition and hydration. A second document names his wife as his health care agent under a durable power of attorney for health care.
Question 2: Does It Apply Today?
Terminal condition: no physician has certified one; his stroke is not expected to cause death in a defined short period. Permanent unconsciousness: he is awake and responds to his wife. Neither trigger is met, so the living will is not yet in force, the finding most often missed.
Question 3: Who Decides When It Does Not Apply?
His wife, as health care agent. She is to decide as he would have wanted, using what she knows of his values. The living will still matters here as evidence: a man who refused tube feeding if terminal has told his family something about his values, even if that clause is not triggered.
The law supports that approach. In Cruzan v. Director, Missouri Department of Health, the Supreme Court recognized that a competent person has a constitutionally protected interest in refusing unwanted medical treatment, including artificial nutrition, and allowed states to require clear evidence of an incompetent person's wishes (Cruzan v. Director, Missouri Department of Health, 1990). The Patient Self-Determination Act of 1990 requires hospitals to ask patients about advance directives and inform them of their rights. Advance directives are associated with surrogate decisions that match patients' preferences (Silveira et al., 2010).
One Option the Agent Could Choose
A time-limited trial of tube feeding, with review points at [two] and [four] weeks, judged by named measures: swallowing progress, alertness and his own responses. If he does not improve, feeding can be stopped, consistent with his stated values.
Nursing Responsibilities
Confirm both documents are in the chart and noted in the record's advance directive section. Arrange the family meeting with neurology, speech-language pathology and the palliative team. Make sure his wife understands the difference between the living will's conditions and his current state, and that she is not being asked to apply a document that does not fit.
References
Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990).
Silveira, M. J., Kim, S. Y. H., & Langa, K. M. (2010). Advance directives and outcomes of surrogate decision making before death. New England Journal of Medicine, 362(13), 1211-1218. https://doi.org/10.1056/NEJMsa0907901
How this NU435 Unit 6 example is structured
Three questions order the paper: what does the document say, does it apply today, and who decides when it does not. The first is answered from the text alone, before any opinion about what he would want. The second applies each defined condition to the neurology notes and concludes that the living will is not yet in force, the finding students most often miss. The third moves to the durable power of attorney, where the analysis argues that the living will still matters as evidence: a man who refused tube feeding if terminal has told his family something about his values, even if the clause is not triggered. A time-limited trial of feeding with named review points appears as one option the agent could choose. Nursing responsibilities close the paper: confirming both documents are in the chart, and arranging the meeting.
Get an NU435 Unit 6 example written to your instructions
Directives in case prompts come in many forms, from state statutory documents to Five Wishes, and the analysis depends on their exact clauses. Paste the directive text your case provides beside the prompt and grading rubric. The resulting analysis of those clauses, free as a first request, is typically ready in 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU435 Unit 6 questions, answered
Should the analysis reproduce the whole directive?
No. Quote or paraphrase only the operative clauses, the conditions that trigger it and the treatments it addresses, and cite the form they come from. Reproducing the whole document pads the paper without adding analysis. The sample paraphrases three clauses and spends its length applying them, which is where markers look for the reasoning.
Is a POLST form the same thing as an advance directive?
No. A POLST is a medical order, signed by a clinician for a seriously ill patient and meant to travel with that patient across settings, whereas a living will or an agent appointment is the person's own document. Many states use other names for it. If your case includes one, the analysis should treat it separately and explain how the two documents relate.
What if my state's form defines the triggers differently?
Use the definitions in the form your case provides, and say which state's statute they come from if the prompt names one. Trigger language varies considerably, with some forms adding end-stage conditions or advanced dementia, and the whole analysis depends on it. The sample's reasoning transfers; its conclusion may not, which is exactly why the text comes first.