One mealtime decision, four abilities, quoted answers: NU585's Unit 6 summary finds a composite resident able to choose eating with acknowledged risk and records how that choice is supported. Searches like "nu 585 unit 6 assignment example", "nu585 unit 6 sample" and "nu585 unit 6 example" land here.
Regular Toast and Coffee With Milk: A Capacity Assessment Summary for One Decision to Refuse a Modified Diet
[Student Name]
Purdue University Global
NU585: AGNP II Clinical - Frail Elderly Focus
Unit 6 Capacity Assessment Summary
[Instructor Name]
[Date]
The resident is a composite; scores and dates are bracketed, and the summary is a clinical opinion, not a legal ruling.
The Decision and the Limits of This Summary
Decision: whether to accept a pureed diet with mildly thick liquids, as recommended after his swallow study, or continue regular food and thin liquids. This summary is a clinical opinion about this decision at this time. It is not a judgment of his capacity for other decisions and not a legal ruling.
Preparation
Hearing aids in; dentures in place; quiet room; his preferred time of day, mid-morning. Delirium screened with the 4AT, a brief tool validated in older adults (Bellelli et al., 2014): score [0], no delirium. The swallow study results were explained with the speech-language pathologist present: on the study, thin liquids passed into his airway without a cough, and puree and mildly thick liquids did not.
The Four Abilities
Following Appelbaum's account of decision-making capacity (Appelbaum, 2007), each ability is assessed separately.
1. Communicating a choice. His words: "I want my toast and my coffee the way I've always had it." Consistent across two conversations a day apart. Present.
2. Understanding. Asked to explain what the study showed: "The coffee goes down the wrong pipe and I don't cough, so it can get into my lungs and give me pneumonia." Present.
3. Appreciation. Asked whether that applies to him: "It's my lungs, so yes, I could get pneumonia, and at my age that could be what gets me." He accepts that the risk is his and could shorten his life. Appreciation is where many assessments turn, and his answer applies the risk to himself rather than to people in general. Present.
4. Reasoning. Asked to compare the options: "The puree might keep me safer, but I wouldn't want to come to meals. Breakfast is the best part of my day. I'd rather have a good year than a careful two." He weighs a benefit against a cost, in terms of his own values. Present.
A Higher Bar for a Serious Risk
Because the decision carries serious risk, stronger evidence of each ability is expected than for a low-risk decision. His answers were consistent across two days, specific to his situation and reasoned from his own values, which meets that higher bar.
Conclusion
In this assessor's opinion, Mr. [B.] has the capacity to decide to continue regular food and thin liquids, accepting the risk of aspiration pneumonia.
Supports That Make His Choice Safer
Upright for meals and 30 minutes after; small sips, one at a time; supervision at meals by staff who know the plan; oral care twice daily; a chin-tuck posture he is willing to try; foods he chooses, prepared as he likes them. A trial comparing a chin-down posture with thickened liquids found no clear difference in pneumonia rates among people with dementia or Parkinson disease, which supports offering posture as an option rather than insisting on thickened liquids (Robbins et al., 2008).
Health Care Agent and Reassessment
His health care agent is his niece, [name], who would decide only if he loses capacity for this decision. Reassess if he develops delirium, pneumonia or a change in cognition, or if he changes his mind.
References
Appelbaum, P. S. (2007). Assessment of patients' competence to consent to treatment. New England Journal of Medicine, 357(18), 1834-1840. https://doi.org/10.1056/NEJMcp074045
Bellelli, G., Morandi, A., Davis, D. H. J., Mazzola, P., Turco, R., Gentile, S., Ryan, T., Cash, H., Guerini, F., Torpilliesi, T., Del Santo, F., Trabucchi, M., Annoni, G., & MacLullich, A. M. J. (2014). Validation of the 4AT, a new instrument for rapid delirium screening: A study in 234 hospitalised older people. Age and Ageing, 43(4), 496-502. https://doi.org/10.1093/ageing/afu021
Robbins, J., Gensler, G., Hind, J., Logemann, J. A., Lindblad, A. S., Brandt, D., Baum, H., Lilienfeld, D., Kosek, S., Lundy, D., Dikeman, K., Kazandjian, M., Gramigna, G. D., McGarvey-Toler, S., & Miller Gardner, P. J. (2008). Comparison of 2 interventions for liquid aspiration on pneumonia incidence: A randomized trial. Annals of Internal Medicine, 148(7), 509-518. https://doi.org/10.7326/0003-4819-148-7-200804010-00007
How this NU585 Unit 6 example is structured
The summary follows Appelbaum's 2007 account of the four abilities: communicating a clear choice, understanding the relevant information, appreciating how it applies to oneself, and reasoning about the options. Each is assessed separately, with his words quoted, because a strong answer in one ability does not stand in for another. Understanding is tested by asking him to explain in his own terms what the swallow study found, and he describes food going the wrong way and the chance of pneumonia. Appreciation, where many assessments turn, is shown when he applies that risk to himself and accepts that it could shorten his life. Reasoning is shown by comparison: he trades the safety of puree against the pleasure that makes meals worth attending. Because the decision carries serious risk, the summary notes that stronger evidence of each ability is expected, and shows that bar met.
Get an NU585 Unit 6 example written to your instructions
Name the single decision your Unit 6 case puts in question, then send the scenario, any screening results and the rubric. Our summary removes barriers first, works through the four abilities with quoted answers and states what it leaves to the clinician of record. Delivered in 24-48h; the first costs nothing. 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.
NU585 Unit 6 questions, answered
Is a cognitive screening score enough to judge capacity?
No. A score on the MoCA or a similar tool describes cognition in general, while capacity concerns the abilities needed for one decision. A low score may prompt a closer assessment, and a normal one does not settle the question either. The summary can report a screen as background, then assess the four abilities directly with the person's own answers quoted.
Does a riskier decision need more evidence of capacity?
Many clinicians and ethicists think so. The sliding-scale approach James Drane described in the mid-1980s holds that the standard rises as the consequences of a decision grow more serious. A summary can apply that idea openly, noting that a choice carrying a risk of pneumonia calls for clear evidence in each ability. Present it as one approach, since not every source adopts it.
Who makes the final capacity determination?
Clinically, the attending clinician responsible for the decision, often with input from the team, and some facilities route difficult cases to psychiatry or an ethics committee. A legal finding of incompetence comes only from a court. A student summary contributes observations and a reasoned opinion, and the sample frames its conclusion that way, leaving the signature line for the clinician of record.