| Course | MED 475 Palliative Care Managing Complex Serious Illness |
|---|---|
| Module | Module 3 |
| Paper type | Communication script with rationale |
| Length | About 534 words, 4 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | BS in Medical Studies |
| Updated | October 2026 |
Free sample paper for MED 475 Module 3
"What Matters Most to You?" A Script for Advance Care Planning With a Patient Who Has Dementia
Student Name
BS in Medical Studies, Arizona State University
MED 475: Palliative Care: Managing Complex Serious Illness
Instructor Name
Month Day, Year
"What Matters Most to You?" A Script for Advance Care Planning With a Patient Who Has Dementia
Why the Conversation Matters
Advance care planning is most useful while a person with dementia can still share their values. In Mitchell and colleagues' prospective study of advanced dementia in nursing homes, when proxies grasped how serious the illness was and what complications lay ahead, residents were much less likely to face burdensome measures, like transfers to the hospital or feeding tubes, near the end of life (Mitchell et al., 2009). Talking early, while the patient can participate, gives the proxy that understanding.
The Setting (Illustrative)
Mrs. Elena Torres, 79, has mild Alzheimer's disease. She lives with her daughter, Ana, who attends the visit. Mrs. Torres can follow a short conversation, repeats some questions and tires after about 15 minutes. The clinician has scheduled a 20-minute visit in a quiet room.
The Script
Clinician: "Mrs. Torres, thank you for coming. Today I'd like to talk about what matters most to you, so that your family and I can follow your wishes in the future. Is that all right?"
Mrs. Torres: "I suppose so."
Clinician: "When you think about a good day, what does it look like?"
Mrs. Torres: "Being home. Cooking with Ana. Going to Mass."
Clinician: "Home, cooking with Ana and going to Mass. Those sound important."
Clinician: "If you became very sick and could not speak for yourself, who should talk to the doctors for you?"
Mrs. Torres: "Ana. She knows me."
Clinician: "Ana, are you willing to do that?" Ana: "Yes."
Clinician: "Mrs. Torres, some people want every treatment possible, even if it means long hospital stays. Others want to focus on comfort and being at home. What feels closer to you?"
Mrs. Torres: "Home. I don't want machines."
Clinician: "I want to make sure I understood. So I'm sure I have it right, what would you want if you got very sick?"
Mrs. Torres: "Stay home, with Ana. No machines."
Clinician: "Thank you. I'll write that down, and we'll look at it together again at your next visit. Ana, I'll give you a copy and some information about what to expect as the illness changes."
Rationale for the Techniques
Communication guidance for serious illness recommends asking before telling, responding to emotion and checking understanding (Back et al., 2005). Patient-facing tools can also help: in a randomized trial among older veterans, pairing an interactive planning website with a simple advance directive form increased documented advance care planning compared with the form alone, 35% versus 25% (Sudore et al., 2017). The script ends with written materials for that reason.
| Technique | Why it fits dementia |
|---|---|
| One idea per question | Reduces load on working memory |
| Values before treatments | Values are more stable than opinions about specific procedures |
| Two clear options instead of long lists | Easier to compare than technical choices |
| Teach-back | Confirms understanding respectfully |
| Involving the proxy early | Prepares the person who will decide later |
| Revisiting at each visit | Preferences and capacity change over time |
Conclusion
A short, values-centered conversation, confirmed with teach-back and repeated over time, lets a person with dementia shape her own care while she still can and prepares her daughter to honor it.
References
Back, A. L., Arnold, R. M., Baile, W. F., Tulsky, J. A., & Fryer-Edwards, K. (2005). Approaching difficult communication tasks in oncology. CA: A Cancer Journal for Clinicians, 55(3), 164-177. https://doi.org/10.3322/canjclin.55.3.164
Mitchell, S. L., Teno, J. M., Kiely, D. K., Shaffer, M. L., Jones, R. N., Prigerson, H. G., Volicer, L., Givens, J. L., & Hamel, M. B. (2009). The clinical course of advanced dementia. New England Journal of Medicine, 361(16), 1529-1538. https://doi.org/10.1056/NEJMoa0902234
Sudore, R. L., Boscardin, J., Feuz, M. A., McMahan, R. D., Katen, M. T., & Barnes, D. E. (2017). Effect of the PREPARE website vs an easy-to-read advance directive on advance care planning documentation and engagement among veterans: A randomized clinical trial. JAMA Internal Medicine, 177(8), 1102-1109. https://doi.org/10.1001/jamainternmed.2017.1607
MED 475 Module 3 instructions, in plain terms
Communicating an Advance Directive is the Module 3 assignment in MED 475, worth 20 points, completed alongside the module's discussion on palliative care and dementia. Create a script that shows how to communicate effectively with a patient who has dementia about advance directives. A strong script models the actual words a clinician would use, adapts to the patient's cognitive abilities and includes the family or proxy where appropriate. Brief annotations or a short rationale explaining why each technique works will help your reader see the reasoning, and citing communication and dementia research strengthens it. Follow the Canvas instructions for format. Write the dialogue as it would actually be spoken, with stage directions only where they help. Keep the patient at the center of the conversation even when family members speak.
How the MED 475 Module 3 example is put together
The sample opens with research showing why early planning matters in dementia, then sets the scene with an illustrative patient, her daughter and her limitations. The script itself uses short turns, reflects the patient's words, offers two clear options and closes with teach-back and a plan to revisit. Margin notes explain three key techniques in place. A table summarizes why each technique suits dementia, and a short rationale cites communication guidance and a randomized trial of a planning tool. The conclusion restates the goal in one sentence. Because the patient is illustrative, every detail serves the teaching purpose rather than identifying anyone. The script length fits a real 20-minute visit.
MED 475 Module 3 rubric: what earns full marks
Graders scoring the script look for realistic, respectful language suited to a person with dementia, techniques that support understanding and autonomy, appropriate involvement of a proxy and a clear rationale. Scripts lose points when they use medical jargon, ask several questions at once, focus on forms rather than values, talk only to the family or skip checking understanding. Unsupported claims about dementia or advance directives also cost points. A script that a clinician could actually use, with reasons drawn from research, usually earns the most credit. Scripts that show the clinician adjusting to the patient's pace, for example by pausing or rephrasing, demonstrate the skill the assignment targets.
MED 475 Module 3 help: mistakes that cost marks
Picture a specific patient and stage of dementia before writing. Keep each clinician line short and focused on one idea. Start with values, then move to choices. Reflect the patient's own words back. Include the proxy without sidelining the patient. Add a teach-back moment. Plan to revisit the conversation. If writing dialogue feels awkward, the desk can review a draft with you. Say the lines out loud; stiff phrasing shows up quickly. Time yourself reading the script aloud; if it runs past fifteen minutes, trim. Ask a classmate to play the patient and note any confusing line. Keep each turn brief.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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MED 475 Module 3 questions, answered
Where can I find a free MED 475 Module 3 sample paper?
The full advance directive conversation script for a patient with dementia is on this page.
What does the MED 475 Module 3 assignment ask?
A script showing how to talk with a patient who has dementia about advance directives.
Why plan early with people who have dementia?
Planning while they can share their values helps proxies avoid burdensome treatments later.
What is teach-back?
Asking a person to explain in their own words what was discussed to confirm understanding.
Do online tools help with advance care planning?
In one trial, an interactive website plus an easy-to-read form raised documentation from 25% to 35%.