My mom is in an independent living apartment, has a companion that comes in from 10-2 M-F 5days/week. She has a guaranteed spot in skilled nursing when time comes. She has declined gradually since moving there 6 mos ago. We started companion after she fell in July and spent a week in the hospital. MRIs showed no damage to brain and no dementia even though she was hallucinating prior to fall. Now she is sometimes incontinent, uses walker, bed rail and today companion said she almost fell asleep on her feet otw to bathroom. I bought electronic pill dispenser to help with meds but she tore it up within a week - pried back off and ripped batteries and wires out. I am afraid for her when she is alone but can't afford 24/7 care and I work. Should I try to see if they would approve her for skilled nursing? Does Doctor make that determination? She always perks up at dr appts and puts on a great show of being perky, then goes back to a flat affect when we get home. She goes in and out of alertness when I'm with her. She spent about 10 days in rehab after hospital stay and now has physical and occupational therapy in her apartment and a nurse comes and checks her every week. Not sure what comes next - it's almost like awaiting for the next disaster to happen.