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My MIL is 61 years old. She went through hip replacement surgery a couple of years ago and never really recovered 100%. A couple of weeks ago, she fell in her home and had to be taken to the ER. During this time, she called her son to check on her cats. When we entered the home, it became obvious that she had not been cleaning her home or removing garbage for quite a long time. It was shocking to us, as we had just been out to lunch with her in the previous week, and she had mentioned nothing wrong. This lack of housekeeping had to have been going on for months. So now we are trying to get things back on track, but it's slow going since both my husband and I work full time. After her first trip to the ER, she was referred to social services, and the social worker reported her home to the city Dept. of Neighborhood Services. We haven't gotten anything regarding code violations, but I imagine it's just a matter of time. I'm assuming that they will order the inside to be cleaned at a bare minimum.

She actually fell again last week and has since been admitted into the hospital. She's been there about a week, so it's given us some time to work on the housecleaning and organization. We are really worried that she won't be able to return home. Another huge concern is that she has five cats, and they are really important to her. We are not sure what is going to happen. Best case scenario is that the city will make her get rid of (2) of them, as the legal limit is (3). Worst case - they will make her find new homes for all of them (or even seize the cats if she doesn't do that). We both know that will crush her, but we're not sure in all honesty that she can take properly care of the cats herself. A pet sitter might be an option if she's able to go home, but I'm not sure if she'll agree to that. We're also going to be talking to her about a professional cleaning service, as there are things like carpet that are above what we can do as far as cleaning goes.

My husband has POA. It was set up before her surgery a couple of years ago. It was one of those "just in case" things, so he doesn't know a whole lot about it. I'm interested in finding out how others have helped their loved ones. It's hard because she doesn't want any other family involved. I feel bad about this situation with my MIL. Thanks in advance.

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Even the most expected death is a little bit of a shock, but I can tell neither of you thought the time was even near. My mom was IN a residential hospice and I was still in shock the morning she actually passed; we thought she had longer and so did they - we'd just paid a month rent for their longer term program since she seemed to have stabilized in the first week there. Something like this happened to my cousin too; her mom (my aunt) had turned into a hoarder and all, but was still working crosswords and going to church with her, maybe was going to move in with her at her parish in WV...well, she went and died at home unexpectedly before any of those plans could happen. They found her in the bathroom when she did not answer the phone or pick up a paper.

You may look back and realize things were going down hill, but you just can't see it coming for the ones you love.

Here's hoping you and hubby have faith and good memories to bring you comfort, strength to get through the funeral and working with the house, and that the difficult times you've just been through can quickly pale in comparison to the better ones.
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I'm so sorry to hear that. When a loved one passes away unexpectedly, I think back to a friend of my parents who told me stoutly on my father's death: "better for him, worse for you." I found that a bit rough as consolation goes, but perhaps it is true that your MIL was spared an undignified decline. I hope your husband is able to come to terms with it, all in good time.
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oh, my cancan, I'm so sorry - I'm just now seeing this but I'm sure you've been busy these past few days - probably even more so today I'm assuming but I feel you'll need us more after today - so please come check back in with us and let us know you both are doing - and again, I'm so so sorry
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CanCan, I'm so sorry to learn of your mother-in-law's passing.
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I wanted to thank everyone who responded to this thread and helped out. It meant a lot to me.

Unfortunately, my MIL passed away on Sunday. It was completely unexpected and shocking. She seemed to be getting better (breathing need improved, responded well to the dialysis treatment, etc.), but in the end, it was not enough. The pulmonary hypertension ended up making her breathing so difficult, and she would have needed to be an a respirator. The doctor said there was nothing left to do.

My husband is doing pretty good in spite of all this. He and his mom were pretty close, and I expect that the future holds a lot of heartbreak and grieving for him, but we will get through this.
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Thanks, everyone. This has really become a rollercoaster. We went to the hospital on Friday and Saturday. She is just - flat. No personality at all (except for wanting orange sherbert - I know that's her favorite). We find out more tomorrow.

Countrymouse - No need to apologize at all. No one saw this really bad development coming, and the family is completely shocked. I have used humor throughout (perhaps in bad taste at times, but that is my style) in order to cope.
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PS- I always found it scary too, when the things I had "just in case" became real necessities. But, I would bet you and hubby will be up to the challenges of what comes next. It was uncharted ground for all of us who have had to set foot on it.
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Tougher decisions ahead than what to keep and what to toss - hugs and prayers for you all. I hope you get her back from this crisis, and have some chance to enjoy a little of your time with her again, with the perspective this has to bring you and maybe her. Or at least get that chance to say all the stuff you need to say. For better or for worse, the "stuff" will be waiting there to be dealt with whichever way it goes. I hope it goes well!
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Oh yikes! - I'm sorry to hear that she's landed in the ICU (I wish I hadn't been so facetious now). It doesn't sound good at all. Is your husband able to get to the hospital to sit with her?
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Cancan, sorry to learn of this development. I think the issue would be whether the feeding tube (nasal or stomach?) and the ventilator are intended to be temporary to allow recovery from current conditions, or if they're expected to be long term.

I have no experience with transplants, but if she's in a weak condition, I'm sure that would be a factor, as well as how long her kidneys would last without intervention.

I do hope that you receive better news, or if not, that you'll be able to understand what the situation is so you know what to expect.
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We got word yesterday that she was being transferred to the ICU at the hospital. Today, my husband found out she'll likely need a feeding tube and ventilator. Her kidneys are in pretty bad shape now, too. He's going to the hospital tonight, so we'll know more soon, I hope.

I'm just wondering if she's even eligible for a transplant or if hospice isn't far off. The last week has been extremely discouraging to say the least, and although my husband's been on the grumpy/angry side of helpful so far, he is really starting to understand that what is happening is very serious.
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Cancankant, you'll know you've got the hang of this when you're looking at a bag full of elderly undrinkable wine and think "executive decision: garbage." Or recycling centre, if you are civic-minded. The key phrase is "executive decision." On many of the hoarding programmes of which I used to be an avid consumer but now can't stand the sight of them, so many tears over things like mouldy pizza boxes would have been saved by this. If the declutteree later misses said wine or pizza box and kicks up a fuss, you can say, according to how much hypocrisy you are able to enlist:

a. oh my goodness, did that go in the garbage truck? I'm SO sorry, it was a clerical error.
b. Pizza box? Well I'm sure it must be somewhere - let's look for it at the weekend.
c. I'll get you another.
d. Sue me.

I stress that this approach is only ever to be used for things that are definitely, by anyone's standard, garbage; and NEVER for items that you just dislike intensely, however tempting.
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Your MIL may be so overwhelmed between the hip surgery and the condition of the house that she blocks it out and refuses to acknowledge it. Several of the comments in your posts make me think that she's still on the side of denial and it will take a while for her to realize that what you're doing is actually life saving for her possible return home. But until she reaches that side of the river, she'll continue to be defensive and in denial.

I suppose it's easily understandable; no one really wants to admit that their life is out of control physically. It's just too much at one time. And I think it's a coping mechanism when life becomes too much and too complex for someone to handle.

It may be that when she eventually arrives home to find the house cleaned, she'll be grateful and recognize how much the help her family has provided will assist her recovery. Hopefully that will be the situation.

And hopefully one by one the various physical issues can be addressed and resolved.

You and your family are gracious and dedicated supporters; your MIL is lucky to have you.
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I wanted to make a little update. We went on vacation and had a nice time, but now that we're home, things have taken another turn for the worse. My MIL in in the hospital again. She was transferred there from the rehab facility on Wednesday. She has had really bad fluid retention and can't even move on her own. It takes 4 people to get her out of bed. The cats have been well taken care of and the house is fairly decluttered, if not perfectly clean. That's a plus and a bit of weight off of our shoulders. There is supposed to be a plumber coming by to take a look at some things in her bathroom that will need fixing, but right now, it's looking like if she ever does go home, it won't be for quite a while, but either way, this stuff needs to be fixed sooner or later.

On a frustrating note, I boxed up about a dozen bottles of alcohol (mostly wine that's been around her house for YEARS without it being consumed - none of it is a super expensive or collectible vintage). My husband asked her if she just wanted us to get rid of it, and she said she had to ask her doctor if she could still drink. ***Facepalm*** She is in Stage 3 of cirrhosis (not from drinking, but her liver is still not in good shape). Does she honestly think her doctor will green light drinking? I don't think she actually drink much (if any) of it, since it's been in her house so long, but that's why we wanted permission to simply dispose of it somehow. It was taking up a whole counter in her kitchen and there's really no place to put it. Her garage is full after the decluttering and so is the basement!

On a positive side note, if she is able to come home, I feel that we'll be able to get her house to a point where it's 100% livable - clear counters, clear dining room table, minimal clutter. The cleaning/decluttering service was a life saver, even though it was pretty costly for my MIL.
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CanCan, you got good advice. Do not disrupt you trip to do soemthing that does not need to be done. Let Sis do what she needs to do. MILs wish nto to have anything moved is not a reasonable requenst under the circusmtances. You can always put stuff back later if she ever does come home, and you can let her be mad about it if she really needs to be that wasy instead of grateful that some one is trying to help by dong things she can't do for herself. Ask SISTER what she "took" from the house, and run interference with the neighbor. Maybe neighbor would take care of cats - but really, you can't just leave them untended, that would be wrong and make someone liable for animal neglect or abuse. Bring the neighbor brownies, thank them effusively for looking after mom's place while she is away, and explain what Sis is doing - what the heck, maybe introduce them.

My mom's nosy neighbor had a key to her place before I did. Just sayin'. If you think you can trust her, go for it, and you might eventually even be abel educate about dementia. I know after all the times my mom's neighbor said how "sharp" my mom was, I was stunned when I borke the news that we were going to sell because Mom could never come home, and she was actually relieved and had come to that conclusion herself already. People focus too much on the physical part that would not have been that big a problem, since I'd cleared a path for wheelchair use...which of course Mom yelled at me for even doing. :-)
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What a lovely attitude you have on you, Cancan. I know it's incredibly difficult, but I repeat that she's lucky to have people like you on her side.
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Thanks, Countrymouse. I am trying to stay objective. I understand she's probably scared and lacks basically any control over her situation right now, so she's using any sort of power she has right now as a means to an end. I also think she might be reacting to medication(s) she's been given. There's a long history of strain in this family, and I'm staying at the fringes of this whole thing. We do care about her and want her to get help. I'm also worried and feel responsible for her animals. When we are out of town, they must be taken care of, even if that goes against her wishes of having her sister not be involved right now. There's no guarantee anyone else will step up and help with this issue or any other pertaining to her care right now, as no one has yet. It's really only my husband, his aunt (the sister she'd feuding with) and me. There is also a caseworker from the county that's been really helpful, as well as the paid cleaning crew who is going through her home as we speak and boxing up things and beginning to make it livable.

The irony of this situation is she is mostly worried her sister will "move" things around in her house. Everything is being removed for cleaning, so there is nothing her sister can "move" to a "wrong" place.

I agree patience is going to be needed. It's not something I'm known for (and neither is my husband), but we're working on it. Hopefully she can see we really want the best for her in this situation.
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Cancan, to understand your MIL you have to look at things strictly from her point of view (you don't have to act on it, please note!). Given that she is someone who has actively avoided facing up to her health issues over many years, and has now had the misfortune to have a bad experience with a hip replacement, she is hurt, she is frightened, and her very natural instinct is to run back to her home and bolt the doors.

Natural, but hopeless - I agree with you. It is totally unrealistic. All I'm suggesting is that it is going to be patient, time-consuming work to win her compliance; so meanwhile your poor husband will have a heck of a job on his hands. Somehow you will need to help him find a way of going round her, so that he can accomplish the changes she needs *now* without forcing her to give explicit, detailed agreement to them.

She is in extraordinarily bad shape, unrelated to her age - her condition is the result of a cavalier approach to managing her health and especially her diabetes over many, many years. Am I blaming the victim? :/ It's hard not to; only I wouldn't put it like that, I'd say I'm holding your MIL responsible for her own health, as a competent adult. So don't feel bad for not having done anything about it before: these things pile up gradually, and it's not until the pile topples over that anyone wakes up. It just happens like that. And anyway there's nothing to be gained from wishing.

I think if you and your husband can stop being surprised by her attitude you will perhaps find it a lot less frustrating and stressful. Don't waste your breath reasoning with her: go in there tight-lipped, do what needs doing, make no judgements but stick like glue to matters strictly practical. Here are your options, this is what we recommend, this is what we will do to get things done. You don't like them? So what's your better idea? Ok, this is what will happen if we act on your better idea… And that's why we're not doing that.

You will need the patience of Job. Frankly your MIL is extremely lucky to have you and your husband taking charge. Watch your backs, both of you, and be ready to hand her over to professionals if you're getting overwhelmed: there is nothing wrong with doing that.

But I don't think MIL's situation is hopeless. The CHF is bad news, but it's not necessarily the beginning of the end. I'm sorry for the hard time she is inevitably going to have adjusting after this crisis, but she's young enough to do it. God willing it could turn out to be a new start for her.
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My husband hasn't been able to get any real updates from the nursing home staff, but she is supposed to meet with her doctor sometime this week. We did find out that she has kidney and congestive heart failure in addition to the other problems. This is extremely discouraging.

On another front, she found out from her next door neighbor that her sister has been over at her house and "took things" (most likely garbage or cat litter in bags). My MIL had not wanted this sister to be in her house but never bothered to take her key or change the locks. Well, and all heck broke loose and now she wants the locks changed. My husband and I are supposed to go on a road trip next week, and we had arranged with this sister to take care of the cats when we were gone (pending MIL's approval). MIL had also mentioned that the neighbor might be able to help with the cats, but hasn't "gotten around" to asking her if she's willing to help. My husband is at his wits end with his mother about this. We are tempted to refuse to meet the locksmith and let the sister take care of the cats, since we're worried that otherwise no one will be taking care of them. Our only other option would be to hire a pet sitter, and they are likely going to charge a fortune for (5) cats. We are completely flabbergasted that she is refusing help with this. We understand that they have a weird relationship, but there is not a whole lot of family or friends to help to begin with, and even fewer who can make a commitment of taking care of the animals.
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Cancan, whatever you do with her home, bear in mind that chances are pretty good she will not be going back. She is too young to lose her faculties and her health, you are right - but that's exactly what is happening. Her "filter" is slipping and she can't think in a logical goal-oriented fashion. I would be surprised if you don't notice some degree of "sundowning" soon also. I will be even more surprised - very pleasantly, of course - if she can pull out of this and participate in a realistic plan to go home with adequate help...again, so sorry to see this happening. Ask the people evaluating her to be frank with you about what her abilities will be at maximum recovery as they see it. Sometimes they think it is obvious and don't come out and say it, and everyone acts like things are going fine, so you feel bad for not having more optimism and hope!
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She was admitted into a short term nursing home/rehab center yesterday. She has cirrhosis, water on the lung, still has the UTI and now they have her on oxygen. My husband visited her yesterday, and he said she could hardly move. Two staff are needed to help move her, and she's just laying in bed for now. Not sure if or when any physical therapy will happen, but probably not anytime soon given her condition.

On a positive note, the caseworker for the city was able to get her to agree to have her home cleaned. It will cost almost $2000, but it needs to be done. I'm sure a bunch of her furnishings (such as her bed) will need replacement. The caseworker is also working on arranging some cleaning services for her once she returns home. Hopefully this service will scoop the cat boxes. I'm still unsure how she'll take care of 5 cats, but right now that seems like putting the cart before the horse. For now, we're able to check up on them.
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Insist on a psychiatric evaluation before she's released. Jump up and down, do whatever you have to, but get psych to see her. Their insight can be invaluable.
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We will likely find out today if she's going to be referred to another facility for short term (possibly long term) physical therapy. My husband and I both have experience with mental health treatment, so we've been pushing for a mental evaluation from the start. We had a nice visit yesterday, but both of us had to basically bite our tongues when she complained about the staff at the hospital. While there is likely some truth to her statements, I have the feeling that she is a difficult patient, especially with staff members that she can't manipulate easily. She was bragging about getting certain staff members "banned" from her room. I just have a feeling that the hospital is getting really sick of this. I heard her use some really coarse language that seemed out of character (not sure I've ever heard her use the "F" word before in the 20 years I've known her). I'm sure she's very frustrated, but none of what's she's doing seems to be helping her cause.

We're still trying to wrap our heads around how she thinks she could go home and live by herself when she needs two staff people to get her out of bed and walk her to a chair. She's complained that they aren't giving her physical therapy, but then states that ever time they try to move her, they hurt her.

She is quite overweight (definitely morbidly obese - maybe 100 lbs overweight). She did lose weight when she had her hip surgery (likely because she could not go out and get fast food meals), but I'm pretty sure she has gained all that back and then some. I am hoping that whatever recommendations that the doctors have she will listen and take it to heart. Otherwise, I don't see this ending well. She is way too young to be in this poor of shape, and these are things that my husband and I didn't think we'd have to deal with for many years.
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I know one of my biggest hurdles in dealing with declining function in my MIL and parents was simply that I felt bad about insisting that they do anything they did not want to do even though they obviously needed to, and it took a while to realize their plans and wishes were not realistic at all. I mean if Mom said don't sell this or don't move that, I would genuinely feel bad about "disobeying...." until it was an absolute necessity and I could finally realize that Mom was simply not making sense because she could not make sense any more. I hope you can get enough support and information to help you get to the point you need to be a lot quicker than I did.
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CanCan,

This could be bad. I don't think it's "as if" she's unrealistic, I'd be very concerned that she has early diabetic encephalopathy that is something like vascular dementia. What happens with that is that people seem OK because they recognize everyone and converse witih them, and memory per se is not so bad; but on the other hand, judgement, reasoning, and problem solving skills may be just about gone. By "very overweight" I am guessing you mean "morbidly obese" and I'm also guessing the liver biopsy is for non-alcoholic fatty liver disease, which is a consequence of the obesity and can lead to the hypoglycemia. This will go nowhere but downhill without some weight loss - but the good news is even a 5-10% weight loss could make a substantial difference, and changes to medication management would tend to help as well.

I would see if a really comprehensive geropsych evaluation can be done to objectively see where she is cognitively and help you feel you are doing the right thing if you need to say NO, you cannot go home until _____ . I am so sorry to see you facing this sort of thing. It can be hard to know how hard a person can fight and how much they can change, and how much you have to accept. Diabetes and obesity are much underestimated enemies of health and well-being; there may be few or no major problems for some years, but the microvascular disease and the wear and tear on the joints catch up with you.
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We will find out information about the liver biopsy tomorrow, and the hospital is going to evaluate MIL to see if she can have rehab at the hospital. Otherwise, they are looking at sending her to a rehab facility. We visited today, and she is still insisting on going home. All she did was complain about pretty much everything, so I'm not sure she will cooperate. The home is still overwhelmingly cluttered and dirty. A few other family members have been helping with cleanup and pet care and have visited her in the hospital as well.

We are trying to be loving and supportive, but it's almost as if she's being completely unrealistic. I understand how badly she must want to go home, but she still has an infection and cannot even swing her hips to the side of the bed in order to have the nurses help her get up and walk. There is absolutely no way she can go home unless she is going to have full time nursing there, and there's no way that a nursing agency will allow their staff to be employed there given the condition of the home.

Has anyone dealt with something like this?
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Thanks all for the helpful advice. We have some time, as she is still in the hospital and because she is likely to be transferred to a rehab facility sometime next week, as she can't complete the physical therapy sessions in the hospital.

My MIL is 61, not 81. She is very overweight so it does contribute to a lot of problems and does not help her mobility. The first time she went to the ER, they couldn't find anything wrong with her, but the doctor told her losing weight would help (Thank you, Cpt. Obvious). We knew something HAD to be wrong, though, and tried to get her to go back to the hospital. Then she fell again and had to be hauled out by the paramedics.

She is diabetic, but she is being treated. They do believe that her medication stopped working for her, though. When she was admitted to the ER, her blood sugar was extremely low. We are probably lucky that she didn't go into a coma from low blood sugar. She also has some problem with her liver (they did a biopsy today), and she has a UTI. She had a terrible infection that lasted months after her hip replacement surgery. She technically needs revision surgery for her hip, but she's afraid to have it done. I'm not sure I blame her, since the original surgery went so poorly. I think her mobility is worse than it was before the surgery.

We are focusing on trying to get her house clean while she's away. I do think there is at least some depression issues. I don't think it's anything like Alzheimer's or dementia. I think she just got to a point where she gave up on life. I really wish she'd said something to us sooner. She didn't want any other family involved, but her sister is willing to help, so we will be enlisting her services. Hopefully some of her other siblings will help, too. My parents have offered help as well, so we should be able to get through this.

It's all very overwhelming. I agree about the cats, too. It's not fair to them to live in squalid conditions. I have been involved in animal rescue over the years, and it breaks my heart to see them in a cluttered, filthy environment. We definitely will be talking to her about getting help with cleaning (including cat boxes). She does have many boxes (at least 5 or 6), so that was not the problem. She just was not cleaning them at all. They were literally overflowing when we went to "scoop" them after she had to go into the hospital. We were so blindsided by all of this. The house had gotten bad when she was in complete pain before her hip replacement, but she been able to keep it up pretty well until recently it seems.
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1. Does MIL possibly have untreated diabetes, as well as early cognitive decline from as yet unknown cause?

2. You are ahead of the game from where my husband and I were with my MIL many many years ago...she is letting you help, and you know there could be a name for what is wrong besides stubborn and lazy. Take the next steps; go to the house and find the important papers and make copies of them, and talk with whoever did the POA documents for her and find out more about estate planning issues and untangling any problems with finances that have probably cropped up along with the housekeeping issues. You may be able to help as simply as getting online banking going that she has no problem with you accessing and doing for her, but be aware that putting your name on any account as well as hers can make you liable for debts or overdrafts.

3. This can be time-consuming as well as heart-wrenching. You may both want to do FMLA papers for your work, or you may find it is all doable though probably not easy...

Welcome to the steep learning curve...welcome to the club. We can be kind of a sad bunch on here sometimes, but we do try to help, and at least sometimes succeed!
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Your mom is 61? Not 81? In either eveny, please make sure she's checked out by both neurology and psychiatry while she's in the hospital; make sure that whatever meds she's taking she taking them properly.
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