@gently , my impression would be taking someone with her condition on a trip 2 hours away would have a substantial impact. Transition out of their normal environment can be disorienting. My dad and cousin didn’t do well after returning from even short trips. You might check for UTI as well. My dad had a recurring illusion that he was urinating when he wasn’t. You couldn’t convince him otherwise. The problem was that he would sit on the toilet so long his legs would go numb and he’d collapse to the floor. Then we needed to call 911 to get him off the floor.

It sounds like you might be fatigued. Have you considered hospice care? The decline in mental status and substantial weight loss might qualify her. They can offer some additional services and also free respite care so caregivers can get time off to rest and recharge.

I would encourage you to get extra help lined up and ready to step in because once my dad began to struggle with incontinence we needed help fast. They got us a hospital bed and incontinence supplies.