77yo M previous smoker w vascular dementia and recurrent pneumonia presents w wife 3w after episode of R middle lobe pneumonia that is improving
wife says that he has slight increase in chronic cough after meals + rhonchi are heard over the R midlung field + diaphragm has poor excursion + speech is mildly dysarthric + MMSE score is 20/30
what is the most appropriate next step in management?
