Super fast decline to stage 7, what next?

If things were already declining, I wouldn't blame the progression on her being placed. She is safe and cared for, and she is blessed to have both of you watching out for her.

Unfortunately, it is true that further progression is an unknown. I'm sure you've let your other sister know of the decline. If finances allow for your other sis, she could come now to visit a bit, and then again at a later date? Sis may appreciate just having that little window of time once more.

My grandmother did a 'hard slide' into stage 7 and was with us for a few more months. A friend's mom was a moderate slide and was with us over a year and a half. And yes, there are 'signs', and although even that can vary, you can check with the hospice nurse, other posts on here, and I'm sure others would weigh in…

On the one hand if she is still eating, even if not a lot, she could go many weeks or months that way. Some people spend a year in the Broda chair being hand fed purees. It doesn't take many calories to sustain a bed bound person who is hardly moving. But also things can change quickly. Sometimes they just suddenly decline into the dying phase without an obvious reason. Sometimes a common cold, flu, Covid, UTI or similar can be the catalyst. Once she tapers eating to nearly nothing or stops all together you can probably assume her time will be measured in hours, days, maybe a week or two. After that there are obvious signs to look for that hospice can talk about (skin changes, movements, etc.) Towards the end my mother ate just a few sips of ensure a couple times a day for 1 week and a bite of oatmeal here and there, followed by nothing by mouth for another 5 days before she passed. If the sibling who lives abroad wants to see mom while she may be awake and may have a smile for her, now is the time. If she wants to be there at the end probably wait. It's so hard to say, everyone is different in how they progress. But it's likely you will have some warning. Hospice will give you an estimate, though in my experience they over estimate. I think they know people have a hard time with the shorter end of those guesses, like freaking out if they hear they only have a couple weeks. I wanted the end to come, the last weeks were excruciating and I wanted her to be released. When my mom first went on hospice they said it could be a couple months. I could tell by looking at her that was not happening. After a few days they scaled that back to a month, and she was gone 2 weeks later. But it's all estimations. Blessings to you and your family. Mom is lucky to have caring children giving her a loving send off.

Frankly, I would stop cajoling her to eat. I would offer food, but not encourage her, if you know what I mean. My own mother had indicated to me that if she did not feed herself, she did not want to be hand fed. We stopped waking her for mealtimes, where she did not eat anyway + we did not hand feed her, per her wishes.

Perhaps tell your sister who has to travel what the situation is—that you don't know. You can only convey what the situation is at bedside, and let her determine what she wants to do. She might decide it's better to come now if your mom's still a little interactive.

@Middling Child It might help your family to watch this Hospice Nurse Julie video about feeding near the end of life.

Thank you so much for sharing that video. I've been concerned about the hand feeding with my husband and this video was a wakeup call.