An 80-year-old Spanish-speaking female with a past medical history of COPD and CHF is admitted for pneumonia, multiple falls, and a weight loss of 30lb in the past three months. She is listed as a Full Code. She has increasing oxygen needs and is on a NIPPV mask, struggling to breathe but able to talk briefly. Her primary support is her husband; they are Catholic, although she has not attended church in many years. She is the primary caregiver for her adopted grandchild, who is sobbing at the bedside. The family is at the bedside and states that she has always told them she does not want intubation.