Problem: The patient's workup showed worsening heart failure, right greater than left. This suggests worsening pulmonary hypertension, however cardiac ischemia both right and left remain a concern. Cardiac cath showed multi-vessel disease, however, stent placement for the worst lesion failed. In addition, it appeared that some of his sudden symptoms were due to GERD with mild bronchospasm. His medications were changed to address his worsening heart failure and prevention of GERD. He was also given an inhaled bronchodilator to use should symptoms get worse. You were also part of his palliative care team meeting to discuss the poor prognosis for his heart failure due to both ischemia and pulmonary hypertension. At the time of his diagnosis 16 months ago he was given an estimated survival of 3 years on optimal therapy. His latest test results suggest his time is more limited. As part of his palliative care team, you job is to develop an approach to assess his level of dyspnea that is both accurate and reproducible over his EOL (end of life). In the free text box below, describe your approach.