Hi Andrea, I am sorry you have to care for your mother who is very sick. It seems like she needs lots of caregiving and medical attention and 24 hours care. It does not mean it is end stage if she needs 24 hours care and medical attention. However, our home care people explained that in my father-in-law's case (he has severe Alzheimers), he would need to  go to a nursing home for medical attention but if the caregivers are able to care for him at home, then it is best to stay home. My father-in-law does not have sores and he is not that actively sick like your mother although he is quite severe in his Alzheimers (his mind is not rational anymore.) I cannot say it for you because I don't know what is going on and what happened to her sores and diseases... But if you find that it is difficult to attend to her sores and care for her in details for 24 hours, you probably need to hire some caregiver to help you out. If she is really sick and needs hospital's attention or even nurses' attention for the sores and etc, then a proper nursing home is better. The most important thing now is to see if you really can cover all her problems at home. For example, my father-in-law had severe nose bleeding last week twice and it was horrible to see all the blood. Now he is ok. But I can imagine if he bleeds frequently, then the home care would not be able to handle it. He could not breathe last Monday night and they called 911 the 4th time in a row to make sure he is ok again. (He had sort of heart failure due to the stree.) If he continues to be needing medical attention, the home care caregivers are not equipped to do it medically and he would have to go to a nursing home. So you can decide based upon how much you can cover her medical need. I don't know about her sores, but it sounds like she needs more medical attention for her sores. It does not mean it is end stage but it means medical attention 24 hours or overnight. My father-in-law is probably not in the end stage yet for another year. So medical attention is not about end stage, it is about caregiving.   Hope this helps, Nina