### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My mother had a massive stroke on 4/6. Our family is devastated. Long story short, she is 66, diabetic. We believe she had the stroke, then went to bed afterwards. We found her unable to wake up the next morning (about 12 hours later). Called an ambulance, she went into cardiac arrest at the hospital, she developed septic shock, which she miraculously recovered from. This all left her with brain damage to the frontal lobes. Doctors completely gave up to her, told us that she will never get better and to put her in hospice. Hospice told us that she was NOT eligible, because she was and is NOT on any type of life support. We bought some baby food and took her home, where she is now receiving in home hospice care. It has been 4 months and she is still alive, her vitals are good. She eats a soft diet everyday and we just started her on cereals and soups. She swallows and drinks perfectly and definitely WANTS the food. She is bed bound, we change her diapers and bathe her. She does not respond to commands, but it seems like she tries to touch her nose when asked, but she is TOO weak to do it. So, we are cautious about giving her the Glasgow scale assessment, because maybe she really is just too weak to lift her arm (we want to be fair to her). She has trouble speaking, but inconsistently will say yes , no and small phrases like Stop it Kim or Oh sure or That s good or Shut up or she will nod her head when asked a question. At times, she will say things that we cannot understand, but we can see that she is trying to communicate something...The problem and reason for for me reaching out to you today is that sometimes she looks spaced out, not fully there, like she s looking off into space. Her eyes will be looking up to the right direction and she is not saying anything. She looks like she is not fully there . We know it is the brain damage she suffered, but we are wondering IF she will pass through this stage or is this the best she will be? And what state of consciousness would you say she is in? Again, it has been 4 months since the initial stroke and she is 66.

### output:

Hello, It would be useful to have the imaging reports understanding the extent of the damage, but however by your account on what the doctors said it is clear it was a case of massive damage. Frontal damage is commonly associated with apathy and depression so those episodes where she doesn't seem to be there may be in that setting.  Epileptic seizures would be another possibility, so you should watch her for abnormal, even subtle, movements in her face and limbs. As for her level of consciousness since it seems she is able to obey some commands, pronounce some phrases and alert I would tell her consciousness is intact, inability to communicate is probably related to damage to the language areas, not due to a diminished level of consciousness. As for expected improvement. Improvement is expected in the first 6 months, afterwards very little can be expected.  However, most improvement takes place during the first 3 months, so while there may be some advanced in the next 2-3 months it should be a minor one, she will probably remain bed bound I am afraid. Hope I have answered your query. Let me know if I can assist you further. Take care Chat Doctor. 