How can you tell when someone on a feeding tube is near the end of life in their final stage of MSA- P?

My mom has several close calls of death when came to choking. Her second time she never really bounced back. She wants to open her eyes,but it is like she is too sleepy. The hospice people told us about two months ago they thought her body was transitioning? Her kidneys are good, her heart is good, BUT it is the way her fluctuation of her heart beats and oxygen on the BP monitor that keeps us checking. She has been definitely relying on oxygen more the past two going on three months now. Her urine and BM's are good as well. She uses feeding formula and Nutri Bullet for better nutrition since the formula is empty calories. My dad sits her up on the couch to prevent more bed sores. We use a suction device to clear her air way, and this is part of the disease, so she has been using this at least 8 months now. First dx was I believe 2015?

Yes. She does sleep most of the day. She communicates with me while in bed or the couch ONLY if I ask her to. EX: She can move open and close her mouth twice for -YES. if asked. She can even look at me with one eye since she cannot seem to keep her eyes open.