A 79-Year-Old Man Is Undergoing Evaluation for Hospital Admission Due

A 79-year-old man is undergoing evaluation for hospital admission due to an exacerbation of chronic obstructive pulmonary disease.  His wife expresses concern about his health due to multiple hospitalizations over the last year for various complications related to his comorbidities.  The patient has smoked cigarettes daily for more than 50 years.  Medical history includes coronary artery disease, type 2 diabetes mellitus, and obesity.  After performing a thorough history and physical examination, the physician prepares to admit the patient and decides to continue his existing medications for diabetes and heart disease.  Admission orders also include supplemental oxygen, bronchodilators, antibiotics, and systemic corticosteroids.  Which of the following additional components is most critical to include during the admission process?

A) Discussion about diet and exercise to improve glycemic control and heart health
B) Discussion of whether the patient has advance directives or a health care proxy
C) Discussion regarding smoking cessation to reduce the patient's risk of dying from heart or lung disease
D) Facilitation of a social work assessment to arrange for home health care and expedite discharge
E) Verification of insurance coverage to determine eligibility for supplemental oxygen at home

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