Hello, My mother who is 89 with non-specific dementia is at the point of confusion off and on, hallucinations, getting much weaker, hands shaking to where it is difficult for her to feed herself, and increasingly more incontinent. Yesterday, she would repeatedly be laying in bed with her eyes closed and take a shuddering, moaning breath. How do I know if she is in pain? She says she is not. And at what point is it time to call hospice?