A 78-year-old patient with end-stage heart failure is frequently hospitalized for decompensation. The patient expresses fatigue with treatments and desires to spend more time at home. The family is divided on whether to pursue aggressive interventions. What is the most appropriate initial step for the healthcare team?

✓ Correct Answer: Option B

In patients with advanced illness, especially with patient fatigue and family disagreement, the most appropriate initial step is to conduct a comprehensive goals-of-care discussion. This helps to understand the patient's values and preferences, guiding future treatment decisions and facilitating family alignment.