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?

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I'm so glad she's feeling better! Thanks so much for letting us know.
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Much better today. Talking, washed her own face and combed her hair.
I had a long visit with the doctor and asked her if this is from the dementia or an infection in her body causing the lack of response for the past two days. She said in dementia patients they cannot express well when they are sick or hurting, so they will quite often sleep to avoid the pain, and don't respond well until they are feeling better.
Moms blood work that was taken yesterday shows the infection from the cellulitis is almost all cleared up. So, as she is feeling better she is responding better.
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Just checked your profile. She's in a nursing home? So, what is the medical staff telling you about her sudden change in status? Has she been checked for a uti? What are her oxygen sat numbers? How do her lungs sound?

The question is, is this simply part of her chronic and inevitable decline, or is this an acute episode of something treatable. Get that answered.

You can ask for a hospice eval any time. I'd err on the side of asking too early rather than too late.
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It sounds like she may have a uti. Have you called her doctor to report her symptoms? In your shoes, i would call 911 and let the EMTs evaluate.
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