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Hi my mother in law has advanced Alzheimer's. We think stage 6. She was recently diagnosed with stage 4 kidney failure. She's been sleeping a lot lately, not eating much, not much urine, breathless. All the signs of kidney disease but also of possibly dying. She slept again all day yesterday and normally she sleeps through the night from 6pm until as late as 11am. Sometimes she went to bed at 4pm only to wake up at 10:30am! She only went to the toilet twice yesterday. However last night she woke up 6 times. She either went to the toilet or stood in her bedroom door or kept shouting. Each time she was fully dressed and ready for breakfast. This didn't stop until an hour ago. She kept coming out of her room and going into all other bedrooms. She said she was lost. At one point she tried to wash her lunch tray including the plate, cutlery and a cup in the bathroom. Afterwards she went round all bedrooms and cupboards again trying to work out where to put her spare tights. We are very confused as to why she acted like this in the last 24h. She has never done anything like it before and she's lived with us for a year. For some reason she thinks she lives in a residential care home as she also said that the cook told her to go in the lounge. And the other day she told me to take her lunch tray out of the bedroom so that those who take the trays away don't need to come in the her bedroom. My question is: would this be down to her Alzheimer's getting worse or are these the symptoms of her kidneys deteriorating? I research a lot about kidney failure and the mental confusion could be down to this condition. However if I didn't know that she has a stage 4 kidney failure I would have put it all down to Alzheimer's. It's hard for us to establish whether it is down to Alzheimer's as it is happening so quick and I thought Alzheimer's was a very slow progressing disease. Any advice by those with experience of looking after someone with both Alzheimer's and/or kidney failure would be greatly appreciated.

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Blossom, hospice evaluators are used to folks masking their symptoms. They can make a recommendation to your doctor or for the one that's consults for them to get her admitted. If hospice does not think it's time, they will tell you, because they don't get paid for those whose charts don't back up their hospice rec. Many doctors don't realize how close people are to death or how helpful hospice is.
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She's been asleep all night. She never went to the bathroom. When we checked on her in the morning she was fine which was great but we are now even more confused.
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I would call hospice but the doctor had been a few weeks ago to asses her to see if she needed hospice care and my mother in law was as good a ever during the visit! It was as if there was nothing wrong with her. The doctor left and she was ill again and she forgot the doctor had been. One day she was sweating for no reason there sweat was literally dripping off her, her pyjamas were soaked, we called for ambulance only to be told there was nothing wrong with her. We don't want to sound like we are overreacting. No one wants to listen to us because when they egzamin her she's fine and she suddenly even remembers her own address! Even though she has stage 4 kidney failure the doctor doesn't seem to be worried or advising a different diet etc as if he gave up on her. I don't know what to think anymore. Was her recent confusion due to failing kidney or Alzheimer's? 
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I agree. I'd contact Hospice immediately. Sometimes people with advanced dementia are not able to verbally tell you that they are in pain, but they act out instead. I'd try to ensure that she is not in pain.
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She says she doesn't want to eat but when we bring it to her she eats it all. I thought if someone was close to passing away they refuse to eat even if it's in front of them. Or am I wrong? She always says she's not in pain. She has some water around the heart but not enough to cause concern. Her feet only ever swell 2-3 times when she drunk more water. Sometimes she's too breathless to get up after a meal. That's why getting dressed 6 times in one night was very strange as if she wasn't short of breath anymore.
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Call hospice. This sounds like the rally before the end. Kidney failure is very painful and Hospice has the meds to make the pain better while she's at home and more comfortable than at the hospital.
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