Hi, Lost. I also wanted to welcome you to the forum. I am sorry your mother is suffering from this disease. I would try to find out if she sees a hepatologist when she is in the hospital. Did she have one who followed her prior to her hospitalizations and NH placement? She undoubtedly doesn't see one at the NH. Other docs, particularly general practice physicians, are not at all equipped to deal with liver disease. You mentioned pain. Is your mom having abdominal pain? I hope they will give her the Lactulose as needed, as that should help with the encephalopathy.
I'm not sure how much help we can be to you, but we certainly can offer information and support, and a place to just "vent."
My prayers are with you, your mom, and your brother.