| Course | NURS 6914 Advanced Palliative Concepts and Interdisciplinary Perspectives |
|---|---|
| Week | Week 10 |
| Paper type | Interdisciplinary case report |
| Length | About 1,030 words, 6 pages |
| Format | APA 7 student paper |
| School | Walden University |
| Program | Master of Science in Nursing (MSN) |
| Updated | September 2026 |
Free sample paper for NURS 6914 Week 10
Where Can He Die? An Interdisciplinary Case Report for a 55-Year-Old Man With Advanced Liver Cancer, an Alcohol Use Disorder and a Shelter Bed He Is About to Lose
Student Name
College of Nursing, Walden University
NURS 6914: Advanced Palliative Concepts and Interdisciplinary Perspectives
Instructor Name
Month Day, Year
Where Can He Die? An Interdisciplinary Case Report for a 55-Year-Old Man With Advanced Liver Cancer, an Alcohol Use Disorder and a Shelter Bed He Is About to Lose
Case Summary
Diagnosed three months ago at a county hospital emergency department, a 55-year-old former roofer has advanced hepatocellular carcinoma on a background of alcohol-related cirrhosis. He is not a candidate for cancer treatment. He has lived without housing for six years and for the past year has had a bed at a downtown shelter, which requires residents to climb two flights of stairs and leave during the day. He is now growing weaker, and staff expect that within weeks he will not manage the stairs. He drinks most days, less than he used to. He calls the people he spends days with in the park his "street family" and wants to stay near them. He distrusts hospitals after, as he puts it, being "treated like a drunk" in emergency departments. He has capacity. A shelter-based clinic referred him to the county's palliative care team, which held a case conference.
Structural vulnerability describes how a person's position in social hierarchies, including housing, income, race and stigma, shapes the risks they face and the care they can reach (Bourgois et al., 2017). His options at the end of life are constrained less by his illness than by where he sleeps.
Discipline Reports
Each discipline reported in the same format: what it found, what it recommends and where it disagrees.
Table 1
Discipline Reports
| Discipline | Findings | Recommendation | Disagreement |
|---|---|---|---|
| Palliative APRN | Prognosis likely weeks to a few months; abdominal pain, fatigue, rising fluid in the abdomen | Symptom plan; goals conversation; hospice eligibility likely soon | Doubts the shelter can manage pain safely |
| Nurse | Shelter cannot provide daytime rest, personal care or overnight nursing | A setting with daytime beds and nursing | Agrees with APRN |
| Social worker | No identification card; eligible for Medicaid and disability benefits; medical respite program has a bed in two weeks | Apply for benefits now; plan move to medical respite | Worries respite's no-alcohol rule will push him out |
| Pharmacist | Shared sleeping space; risk of opioid theft; liver failure changes drug handling | Lockbox or daily dispensing; drug choices adjusted for liver function | Prefers supervised dispensing to home supply |
| Chaplain | Speaks of a mother he wants to see again; no religious community | Visits at the shelter or park | None |
| Peer support worker | Knows him from the park; says he will leave any place that bans his friends or treats him as a drunk | Choose a setting he will stay in, even if imperfect | Disagrees with plans that ignore his street family |
Why a Peer Support Worker Is on the Team
The peer support worker has lived without housing himself and knows the patient from outreach work. A systematic review of qualitative research on palliative care for people who are homeless found that distrust of services, unstable settings and the importance of social networks were among the main barriers, and that trusted relationships helped people engage (Hudson et al., 2016). The peer worker holds that trust. His report changed the discussion: the question became not where the best care is, but where this man will stay long enough to receive care.
How the Report Handles His Drinking
The team agreed that his drinking is part of his illness and his life, not a reason to withhold care. Professionals caring for people who are homeless at the end of life describe substance use policies in health and social services as a major barrier, with some services excluding people who use substances (McNeil & Guirguis-Younger, 2012). The team took a harm reduction approach: it will not require abstinence, will talk with him about how alcohol interacts with his medicines and his liver and will plan for alcohol withdrawal if he becomes unable to drink. The social worker will ask the medical respite program whether it can make an exception to its no-alcohol rule for patients in hospice care, which some programs do.
The Decision
After discussion, the team and the patient reached a decision in two stages. First, he will stay at the shelter for the next two weeks with daily visits from the palliative nurse, supervised dispensing of pain medicine through the shelter clinic, and the chaplain and peer worker visiting him in the park. The social worker will obtain identification and apply for benefits. Second, when the stairs become impossible or the respite bed opens, he will move to the medical respite program, with hospice enrolled there, if the program agrees to allow alcohol. If it does not, the team will seek a hospice inpatient bed near the park and ask whether his street family can visit. He agreed to both stages, saying, "As long as my people can find me."
The team also agreed on what would change the plan. A fall on the shelter stairs, confusion from liver failure that makes him unsafe in the shelter, or a crisis of pain that daily dispensing cannot meet would each bring forward the move, even before the respite bed opens. The team discussed, and he accepted, that such a crisis might mean a short hospital stay; the palliative APRN will write to the emergency department in advance, describing his goals and his wish to be treated with respect, so that he does not meet the reception he fears. He named the peer support worker as the person he would like called if he is admitted.
What the Case Shows
No single discipline could have produced this plan. The APRN and nurse saw that the shelter could not provide end-of-life care; the social worker found a path to a better setting; the pharmacist made medication safe in a shared space; the chaplain heard what he hoped for; and the peer worker made sure the plan was one he would accept. The case also shows the limits of the system around him. A plan built on a bed that may not open, a policy that may not bend and benefits that may take weeks is fragile. The team's report names that fragility so that anyone who picks up his care knows which parts of the plan are secure and which are hoped for.
References
Bourgois, P., Holmes, S. M., Sue, K., & Quesada, J. (2017). Structural vulnerability: Operationalizing the concept to address health disparities in clinical care. Academic Medicine, 92(3), 299-307. https://doi.org/10.1097/ACM.0000000000001294
Hudson, B. F., Flemming, K., Shulman, C., & Candy, B. (2016). Challenges to access and provision of palliative care for people who are homeless: A systematic review of qualitative research. BMC Palliative Care, 15, Article 96. https://doi.org/10.1186/s12904-016-0168-6
McNeil, R., & Guirguis-Younger, M. (2012). Illicit drug use as a challenge to the delivery of end-of-life care services to homeless persons: Perceptions of health and social services professionals. Palliative Medicine, 26(4), 350-359. https://doi.org/10.1177/0269216311402713
What the NURS 6914 Week 10 instructions ask for
Interdisciplinary case reports in Week 10 usually ask you to present a complex palliative case from the perspective of several disciplines and show how the team reaches a plan. Reports of five to six pages are typical. Summarize the case with the social facts that constrain care, not only the diagnosis. Present each discipline's findings, recommendation and disagreement in a shared format. Include roles that bring trust, such as a peer worker, when the patient distrusts services. Address substance use without making abstinence a condition of care. Reach a decision with the patient, stage it if options are uncertain, and state what would change it. Close with what the case shows about the system as well as the patient.
Inside the NURS 6914 Week 10 example
The case summary introduces his illness, housing, drinking, street family and distrust of hospitals, and cites Bourgois and colleagues on structural vulnerability. Table 1 records six discipline reports with findings, recommendations and disagreements. A section explains the peer worker's role, citing Hudson and colleagues' review on palliative care for people who are homeless. A section on drinking cites McNeil and Guirguis-Younger on substance use policies as a barrier and sets out a harm reduction approach. The decision section describes two stages and the events that would bring the move forward. A closing section names what each discipline contributed and which parts of the plan remain uncertain.
Reading the NURS 6914 Week 10 rubric
Interdisciplinary case reports are commonly scored on the completeness of each discipline's contribution, the handling of disagreement, the patient's voice in the decision and attention to social determinants. Completeness requires that every role reports specific findings. Disagreement handled openly, in the report itself, earns credit. The patient's voice is scored by whether the decision reflects what he said he wants. Social determinants, such as housing and stigma, should shape the plan rather than appear as background. Harm reduction approaches to substance use are valued. A staged plan with named contingencies shows realism. Scholarly sources and APA formatting complete the rubric. A report that names which parts of the plan are secure and which are hoped for tends to score well on realism.
NURS 6914 Week 10 help from the desk
Case reports lose marks when disciplines report in separate paragraphs that never meet. Another common loss is making housing or sobriety a condition for palliative care. Some reports reach a decision the patient would never accept, such as a facility that bans his friends. Others present the plan as secure when it depends on a bed that may not open. Use a shared format, surface disagreements, include the people he trusts, take a harm reduction stance, stage the decision with contingencies and say which parts are fragile. The desk can draft a report for the case in your prompt. Describe him with respect and in terms he would recognize.
Get a NURS 6914 Week 10 example written to your instructions
Give the desk the composite patient in your Week 10 prompt, the disciplines your course expects on the team, and the rubric. The report returns organized by discipline, with named disagreements, a reasoned decision and a review point, within 24-48 hours, with nothing owed on the first.
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- NURS 6914 Week 7: Case analysis
- NURS 6914 Week 8: Discussion post
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- NURS 6914 Week 11: Reflection
- DNRS 6501 Week 10: Case presentation
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- NURS 6910 Week 10: Palliative Case Analysis
NURS 6914 Week 10 questions, answered
What is structural vulnerability?
A concept from medical anthropology, associated with Quesada, Hart and Bourgois, describing how a person's position in social, economic and political hierarchies shapes their health and their options. Applied here, it shows that housing, poverty and past treatment by institutions shape every choice in his care, rather than serving as background details your report can mention and move past.
Why include a peer support worker?
Because someone with lived experience of homelessness can explain what the patient will actually accept, which the licensed disciplines may misjudge. Here, the peer worker's report changes two proposals, including where he stays. Including this role shows your team analysis reaches beyond the usual hospice disciplines, and it models the humility the case requires.
How does the report handle his drinking?
Through harm reduction, argued rather than assumed. The team disagrees: one member wants abstinence as a condition of placement, others argue that requiring it would push him back to the street. The report records the disagreement, the reasoning for a harm reduction approach in his final weeks, and the safety measures attached, without presenting any of it as clinical instruction.
Where can I find a free NURS 6914 Week 10 sample paper?
The complete case report, discipline table, peer worker and drinking sections and the staged decision, is on this page to read without charge. A report for your own scenario can be requested.
How does the NURS 6914 Week 10 report handle his drinking?
With harm reduction: no abstinence requirement, a talk about how alcohol affects his liver and medicines, a plan for withdrawal if he stops drinking and a request that medical respite relax its alcohol rule.