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I am glad that your mother is able to make the decision. Hospice or palliative care will handle any pain that she has which may be none, She will be able to ask or her visiting nurse may train you to look for the signs. Her palliative care place should be able to answer your questions on how many visits she will receive, but it may only be 3 days a week for a couple of hours to assist in custodial care. She may not need much care right now but eventually you will have to make the decision on where she lives. It will be either at home with you hiring caregivers or family help, or she may have to go to a facility for which she ultimatly have to pay her way.
I recommend that you look at her AL contract now to see how much of a notification is needed that she will be moving. My mom was 60 days. However, if she needed more time than 60 days, she could continue to stay. You might want to put in that notice soon. She will have to pay depending on the contract just like she had an apartment.
Here is the site to determine how to pay for 24/7 care vs an SNF
http://em.agingcare.com/dc/Fx-jTanHtEUnDVLn1xruyTFjA9EpM3io6XPKgHHTdihpX7IAQu_i67QhPdRmW2LX0PrXkGyDCxDL91H9HvTGSA6LpAHUuFI4_f2iqn6nuPOvBVt5_7PwD-fSfDGp7eznewYw3SjBw-nYF6DjWozUYSYQUz4QBneuHgRiqN5r52J7-LuurTdUDmyD7Za1ZHyz4gRDIaNJt98-4vssSkoBIOM15RsRZ8GD86h-qwABEl7EXgvdLSvUVfc3UrRRVnUG/MzA1LVpYWi00NjYAAAGIQ-Lyab8a1DNj6oG1sl1j_1HlvsdO_vMPp9Ntp3KbOsvCzRn7RDuJRnCFulYBJKtUTSJCexA=
You should ask now if her doctor feels she will be able to stay in AL or need more care before she is discharged.
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lealonnie1 Dec 2022
My parents' ALF allowed dad to stay until death as long as hospice was on board, no matter HOW much care he required. Same went for mom who was in Memory Care AL; she stayed until death with hospice on board. Asking a resident to relocate during their end of life experience is a terrible thing to do, and places a huge burden on the resident and her family! The 'care' that's required is administered by hospice, considering no hospital stays or diagnoses are going to go on anymore, once hospice is on board.
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Hospice staff will not and can not stay 24/7 when someone is dying. But most Hospice do have Vigil Volunteers that are specially trained to sit/stay with a patient that is Actively Dying.
There are indications, changes that the body goes through at End of Life and when they are actively dying. Breathing changes, skin color changes are two that are watched for. The Nurse or CNA can describe these changes so it is not frightening for you.
Hospice will make sure that mom is comfortable.
When the body begins to shut down there is no feeling of hunger like we get. The body stops processing food and in many cases to give food at that point can be harmful.
((hugs))

*side note*
This past week someone on this forum mentioned a YouTube video "Hospice Nurse Julie" I have since watched a few of the videos and she is to the point, informative and well worth watching some of the videos.
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I'm sorry that you're having to go through this with your mom. It will be up to you how often you want to be with her in her final days. Hospice should be better to give you some sort of a timeline, though only God knows the day and time that He will take her Home.
My husband was under hospice care in our home for the last 22 months of his life, and when he started his dying process, hospice told me he would be dead in 3 days. Long story short, it took 6 weeks for my husband to die with not eating for 41 days and not drinking for over 25 days.
So just enjoy whatever time you have left with your mom and make sure that you leave nothing left unsaid.
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I'm glad you're honoring her wishes to not be kept alive by machines. It must be very hard for both of you to go through. Is her hospice going to be done in the actual AL, or another facility?
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razzmatrazz Dec 2022
They are transferring her from the hospital to her ALF this morning, and hospice will evaluate the end of life strategy; family members and friends will comfort her on the last leg of her journey. I suppose everyone has their own reasons for extending a loved ones life and I respect that, but she is steadfast in letting nature run its course the stroke really did a number on her and the bleeding in her brain continues. The only input I was adamant about was her not passing in a hospital if it could be avoided. Her neurology team members all agree the likelihood of recovery is very very slim so I wont force the issue of a feeding tube. She made her choice a long time ago and as difficult as this is on our family we have to honor her wishes.
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