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She is epileptic and now she is more confused, trembles and has less appetite.

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I just want to offer a different perspective. Every time anyone posts about the one they care for sleeping excessively people conclude that means they have begun the end of life transition, and while excess sleep and decreased appetite truly is a sign that the end of life may be approaching it is not always the reason, which is why I encouraged a medical evaluation. My mother started sleeping that much and more several years before her death. She mostly lost her appetite and the desire to eat as well, but when food was given she did willingly eat it (although she eventually lost the ability to feed herself I didn't ever "force" food on her).
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Your profile says your mom is 77, which is not that elderly by today's standards. You also say she has ALZ/dementia... is this from a medical test/diagnosis or your own personal assessment?

Sometime changes in personality, behavior (like confusion) and habits can be a sign of a UTI or other medical problem (dehydration, vitamin deficiency, thyroid malfunction, prescription medication dosage problem, diabetes, stroke, etc.) Best to have her checked by her doctor right away if at all possible. Many of these issues are treatable. After a check-up, the hospice discussion can be had.
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Sounds like it may be time to bring hospice on board. They will be better able to let you know what exactly is going on. Sleeping a lot during the day can be a sign that her life is coming close to the end. My husband who was under hospice care in our home for the last 22 months of his life, slept anywhere from 16-20 hours a day the last 6 months or more of his life.
And he too had seizures for many years after he had a massive stroke, which always took a lot out of him and made him more confused.
I'm glad that at least your mother is pain free for now. Please give hospice a call today, or her doctor to at least order a hospice evaluation.
Best wishes.
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If she hasn't been to the doctor recently the first step would be to take her in for a physical and blood work to rule out anything fixable.
Any other advice is just going to be us making guesses because we don't know how advanced her dementia is or what other health issues she has beyond epilepsy (Is that new or long standing and has been under control?)
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From Samaritan Hospice Blog:

End-of-Life Signs: What to Expect as a Loved One Nears Death

As end of life approaches for your family member, it is understandable that you may feel apprehensive and have many questions. Facing a loved one’s final moments is scary. But if you know what end-of-life changes to expect, you’ll feel less anxious, and be better prepared.


End-of-Life Signs
First, it’s important to note that each person’s end-of-life experience is unique. It is influenced by such factors as the specific illness, medications being taken, and the person’s overall health. In some cases, these changes may occur over a period of weeks; for others, the process lasts just a few days or hours.

However, a number of end-of-life signs are fairly common, as a person’s bodily functions naturally slow and stop. Common changes include:

Less interest in eating and drinking.
Not passing fluids regularly.
Speaking and moving less, difficulty communicating.
Sleeping more than usual.

Here is a link: https://samaritannj.org/hospice-blog-and-events/hospice-palliative-care-blog/end-life-signs-changes-expect-end-life/

It's very difficult to speculate about a loved one's end of life signs, so you'd be best off getting her PCP to weigh in on what s/he thinks is happening with your mom. S/he can then write an order for a hospice evaluation if it's thought your mom is approaching the end of her life within the next 6 months. Oftentimes, hospice is on board for longer than 6 months; an evaluation is performed every 6 months on the patient to reinstate services if it's determined to be needed.

Wishing you the best of luck with a difficult situation. I know how hard it is to witness such a distressing time; I went through it with both of my parents, so I feel your pain. Sending you a hug and a prayer for peace.
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Make sure she's taking her epilepsy meds correctly. That can really mess up a person, and seizures -- even small ones -- really take it out of you.
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