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My recently widowed mom, 76, was just informed by a social worker 1. that her brother is terminally ill, and 2. he has directed hospice to my mother's home. She was shocked. Can he do this? He's difficult, stubborn and knows my mom is a soft touch. She cannot manage him, which he knows. I believe he's decided that without her husband around, he can just move in and have her cater to him in his final months. The siblings are not close. Mom only sees him when he needs money. The social worker says he is "self neglecting." He refuses to bathe or eat.

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Your uncle can't just move into your mother's home, with or without hospice care, unless he has her permission and she agrees to the whole arrangement! She can just tell hospice and the social worker that she's unwilling to have her brother move into her home as she's not equipped to care for him, being a recent widow and grieving herself. Not that she has to explain herself, mind you. Even with hospice care, your mother would have A LOT to manage on her own with end of life care for a terminally ill patient who refuses to eat or bathe and it would be very stressful for her, I would imagine.

Good luck and Godspeed with a difficult situation
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ScoutBloom Nov 2021
Thank you. I truly believe he'd put her in an early grave with his manipulations and demands.
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Your mother should tartly inform the social worker that her client has MISdirected hospice to her address. That ought to be the end of the conversation.

No, of course he can't just decide he's moving in with her. Yes, of course it would have been sensible, not to mention courteous, to have asked her before filling in the forms. But she needn't be shocked, just firm. Alternative arrangements will be made for him.
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ScoutBloom Nov 2021
I ended up having that conversation with the social worker who called to check in on my uncle. I got the impression they'd just like him off their books and in my mom's house. But since we were putting up a fight, they'd lay off.
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He's been using your mother over the years, and he's determined to keep doing that to his dying day.

Your mom can tell him that if he moves in, she'll kill him.

Sorry for my bad humor.

To answer your question, yes, hospice MUST have your mom's permission. They can't just drop him off at her place. Tell your mom to keep her doors locked and don't answer if he shows up.
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ScoutBloom Nov 2021
Thank you. I appreciate this.
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Yeah, no -- Bro can't do that. If an ambulance transport shows up at her door, tell her not to answer it.
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ScoutBloom Nov 2021
Thank you.
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I don't believe that anyone -- in hospice care or not -- can simply move into another person's home without that person's permission. He is ill, but it doesn't confer the prenatural ability to override laws. Your mom has to inform the social worker that she is not prepared to take her brother into her home. If she and you wish, you can confer with the social worker about where he will live, but that is entirely optional.
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ScoutBloom Nov 2021
Thank you. I listed the reasons she cannot care for him to the social worker. My mom is worried she'll be accused of neglect. I said that's only a possibility IF she lets him move in.
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ScoutBloom, I want to make a few things clear

Just because your mother and her.brother are blood relation, that does not make her legally responsible for him in anyway. None.

Your mother is no more obliged to care for him than a neighbor is.

Even if your mother is able to provide care, she is not obliged.

She also doesn't owe any reason to anyone as to why she doesn't take her brother in. None.

If her brother has no other place to go, then the social worker will find him a bed in a facility like a nursing home. Hospice will go there and provide care for him. Your mother can cone to visit and check on him to ensure he's getting proper care.
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ScoutBloom Nov 2021
Thank you for this. He has a daughter who won't take him in. He's made a lot of mistakes my mom can't save him from.
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She is 76 and widowed she does not need this burden. The fact that he did not ASK her is pretty telling what her future with him will be. Hospice comes in and leaves. They do not do the “ heavy work”. That will be on her. She needs to say NO . IMMEDIATELY and redirect them to a hospital or nursing home or his OWN home. Also I do not think hospice is free of charge. Good luck
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Lestax Nov 2021
Aseemingly he is on Medicare, the cost to the family is zero.
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Oh , no ,no ,no… he needs to be cared thru the system… just the emotional , stress aspect will take years off your mom…
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Don’t fall for it. The social worker is looking for an easy placement. They’re known for using ploys like this, along with ample amount of guilt to get family members to take on these responsibilities. The financial, physical and emotional cost of using your mom’s home as a hospice will not be cheap. Tell your mom to not feel obligated to do this. She will lose years off of her life from the stress.
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JoAnn29 Nov 2021
Medicare pays for hospice
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No, your mother does not have to take him in. You don’t know what he told the told the social worker. But she is under no obligation to care for your brother. Let them look for a placement for him if needed. She should not be guilted into this. All she needs to say is that he cannot come to her home.
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I guess you got your answer. 😊 No Mom does not have to take her brother in. First, that she is a recent Widow and has enough on her plate. Second, they are estranged and for very good reasons. Third, she may not be capable of the care it will take. Hospice care in the home is primarily left to the family. An aide comes 2 or 3x a week for bathing and a nurse 2 or 3x to check in.

As said all the time on this forum "No is a one word sentence". And, you are not responsible for the reaction you get from the other person when you say no. Mom cannot be made to take brother in. And like said, do not even allow him passed the front door. Once in the house, u will never get him out. She cannot be brought up on charges. The SW is trying to lighten her work load. They will say anything to get family to care for someone. The SW will just need to place him in a NH. SHE will have to do the Medicaid application. She will need to set up Hospice. When he passes, she will have to make the arrangements for his burial and the State will have to pay for it. Oh yes, a State guardian may be set up for him by the court. DO NOT allow them to talk Mom into being his temporary guardian. She then will be responsible to do everything the SW will have to do.

Mom needs to call that SW first thing tomorrow morning and tell her she is not to transport her brother to her home. He may have directed Hospice to her house but he did not have permission to do so. She needs to be firm that she will take on no responsibility for him. The State will need to make provisions for his care. Maybe u can be there for support if the SW tries to argue. Be firm that this will not happen, tell the SW not to call Mom again and then hang up. Any calls after that tell Mom not to answer. Like said if they do transport Uncle to her house. She can refuse to take him saying she gave no permission or don't answer the door.
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rovana Nov 2021
You might also point out to mom that she will be free to visit her brother and comfort him. But he will get better care in a nursing home and the social worker can organize all this much better and faster than you and mom could. No one is saying that she cannot be compassionate, just that in these circumstances, hospice in her home is NOT the best solution.

It is quite possible that brother has not been truthful with the social worker. So you will have to stand by to make mom's refusal very clear.
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Wait a minute.
I thought Hospice is free. It was provided to my parents at the end of their life in NYC, first at home, and then at a facility/hospital in their last 24-48 hours of life. They had Medicare and AARP insurance.
It was the same thing in Virginia for my in-laws (retired with BC/BS and medicare), as with a friend, (also in VA), who was 49 yrs old and on disability.
I believe it's part of Medicare.
Anyway, 10 yrs ago, while my father-in-law was at a hospice facility his last 24 hours in Arlington VA, there was an ambulatory man, there in PJ's and a rope, playing cards with an attendant in the lounge. I don't know his home story but he was definitely dying, as he couldn't have stayed there otherwise. If I remember correctly he was able to stay for months if that's what it took.
I don't know the rules but if a person takes too long administrators don't like the paperwork involved with first taking you off of your regular health care, which I believe is dropped, and then onto hospice's ledgers just to be taken off again if you've out lived the allowed window, which you can still get back on when it really becomes a dire situation. I know it sounds crazy.
I know, ordinarily we think of hospice care being given only days before the end. I think the response from Contented One is most accurate.
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rovana Nov 2021
I would double check of course, but my understanding that hospice services are covered by Medicare BUT if hospice is taking place in an institution then the room and board in the institution must be paid for by patient or family.
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My brother moved into my home just over 2.5 years ago. We were told that he was dying and everyone at the hospital and hospice wanted him to be a hospice patient.
i took him in to prevent my sister taking him as she could barely care for herself and her husband.
hospice promised an bath twice a week and a nurse once a week.
Everything else was my job.
He came home with me on my 75th birthday.
Please call adult protective services for this poor lady. And tell the hospital and social worker that you did so. Tell everyone.
i do not know if they really did anything when I called them for the same sister when her legally blind husband broke his hip in Dec 2019, but the hospital dis not try the sqme tactics that time.
i wish I had known sooner.
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My brother moved into my home just over 2.5 years ago. We were told that he was dying and everyone at the hospital and hospice wanted him to be a hospice patient.
i took him in to prevent my sister taking him as she could barely care for herself and her husband.
hospice promised an bath twice a week and a nurse once a week.
Everything else was my job.
He came home with me on my 75th birthday.
Please call adult protective services for this poor lady. And tell the hospital and social worker that you did so. Tell everyone.
i do not know if they really did anything when I called them for the same sister when her legally blind husband broke his hip in Dec 2019, but the hospital dis not try the sqme tactics that time.
i wish I had known sooner.
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Maryjann Nov 2021
When he next goes into the hospital, do not take him back. That's a tough birthday "present."
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Your uncle can not just move into your mom's home and demand that she care for him. She needs to tell social worker that she is not able to do this. Then, social work will place your uncle into a long term care facility for hospice.
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Hospice is supposed to support both the family and the patient. Not all hospices are created equal. I found an amazing one on the Medicare website that was very highly rated. Since your mom’s a soft touch you may need to advocate for her with hospice and let them know what a poor idea this is. Does anyone have Power of Attorney? That person would probably be the best person to intervene. Having your mom’s brother be in the best placement possible will make hospice’s job easier. Push back on the social worker. Sounds like he’d get better care in a nursing facility and your mom would live longer.
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rovana Nov 2021
I think it would be wiser and quicker for mom to tell the social worker that she cannot agree to this. It is simply not safe and beyond mom's capabilities. That she has not and will not agree to this placement. That another plan will have to be made. I should think that legally her refusal would be sufficient.
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ScoutBloom: Imho, this social worker needs to be informed that your mother will not be housing, nor caring for her brother.
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ScoutBloom Nov 2021
She was informed in no uncertain terms. She confirmed he'd lied to her to get out of the hospital faster.
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The social worker or some other local social worker might be able to connect your mother with an attorney (pro bono), if needed, who can advise her on this. It seems illogical to expect a 76 year old to care for a terminally ill person who needs a lot of care without her express agreement. Is your mother his POA for medical decisions? If so, she may have authority to place him in a hospice facility.
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ScoutBloom Nov 2021
She is not his anything, honestly. He communicates NOTHING to her. She knew he had cancer but not that he'd been terminal for a year. She's already relenting after the initial shock. My siblings and I are leaning on her HARD to NOT let him live there. Even holiday visits worry me.
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ScoutBloom, where is your uncle's actual home? What are his circumstances?

I only ask because I'm trying to "picture the scene" during which your uncle announced he would be moving in with your mother.

The Social Worker would have interviewed him prior to discharge. He wants to get out of hospital, okay, so what next? If he returns to his home, how will his social care needs be met? If they can't be met at his home, where else might he go?

"Do you have any family?" would be the natural first question. Yes, he has a sister. Would she be willing to help? If his answer was yes, maybe, could be - anything except an emphatic No Chance! - that's the option they would naturally explore. There isn't necessarily any expectation that she will agree, let alone any obligation for her to do so; but of course family is often involved and there is nothing wrong with their asking.

At all costs steer your mother away from all thoughts akin to "he has no one else to look after him" and "he has nowhere else to go." YES HE DOES. She may be his only living relative, but there are plenty of terminal cancer patients who have no living relatives at all and they are taken care of. So will he be.

Once people start feeling responsible for their loved ones' wellbeing (he does qualify as that even if she has been thoroughly fed up with him for years) they begin to form romantic or heroic ideas about the project of caring for them through to the end of life. Nip any such ideas in the bud.

There is no requirement for her to explain why she can't be his primary caregiver (and landlady, and breadwinner). In the immortal words: "a simple no will suffice."
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ScoutBloom Nov 2021
He lives quite a distance from his three siblings. They've tried to get him to move closer, but he's refused. He had a falling out with his brother after things weren't to his liking following a radiation treatment. He's pulled a similar stunt on his other sister. Years ago he'd told his daughter she could live with his other sister, again without clearing it with her first. She told him flat-out that wasn't legal OR a possibility. He seems to think his siblings exist to make his life easier.
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Scoutbloom,

Has anyone told your mom what his prognosis is? He has been terminal for a year. This means that he will eventually die from this cancer but, it could be many months or even years before that happens.

If he won't allow anyone to share the facts, I would bet that death isn't looming but, could be within 6 months or less. That doesn't mean it will happen though. It is what a doctor "believes" to bring hospice on board. Right now it sounds like self neglect is the driving factor for the SW.

Your mom should be encouraged to NOT make any life changing decisions for at least the 1st year after becoming a widow. Her head isn't screwed on properly because she is in mourning. Letting her brother push his way into her home falls heavily into this category.

Point out to her the total lack of regard, respect and care he has already shown for her by not asking if she would help. He will use her up, even unto death and NOT CARE, as long as he gets what he wants.

Tell her for me: laying down so your brother can use you as a doormat doesn't show you love him. Everything you have done throughout his life shows that you do but, you matter and he doesn't even consider that you do. In his world the only thing you are is a source to get something for himself.

You have children and grandchildren that want and need you in their future's. If you lay down for your brother, you may very well die before him.

People that do what your brother has done and is trying to do, devour others to prop themselves up and don't care what it does to others.

Living his last days in a care facility is not a bad thing. He will be taken care of and his needs will be met. What he wants doesn't matter if he can't provide it for himself. He needs a village and you, precious lady are not a village.

My sister came home with terminal cancer and we had 2 caregivers all day, everyday, that wasn't including her mom and other family and it was still so very hard. Imagine having 2 extra sets of hands and yourself and it still being too much to deal with. That's how it was, she demanded so much that we scheduled caregivers for 4 hour shifts and they left exhausted. Dying people can suck your life force and it sounds like your brother is one of them that would.

If you can't say no for yourself, please say no for your family. They can't lose you too. They need you now and in the future!
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ScoutBloom Nov 2021
Thank you for this. My siblings and I have all told her this. I tried to phrase it as I wouldn't try to tell her whom she can invite into her own home. But if he moves in, I will NOT visit, at least as often. I even told her if he stays over for Christmas, I will not stay over, as is our custom. I warned her it would be a bad idea to let him in the house. She insists she won't refuse to host him for what may be "his last Christmas." I assured her I wouldn't interfere in her decision. But I'd make my own decision to make myself scarce. I refuse to watch him order her around, soil himself and stain all her furniture. If he couldn't help that, it would be one thing. But he won't wear protective underwear and won't even tell her he's made a mess. And his refusal to bathe means the house stinks while he's there and after he leaves. I know she has every right to do what she thinks she must for her brother. But I refuse to spend my first Christmas without my dad watching (and smelling) their dysfunction.
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Scout, do your parents have a family lawyer they trusted? Or a minister? This "plan" of your mom's sounds like suicide.

Has mom had a good physical recently? Could you email or call her doctor about this?
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ScoutBloom Nov 2021
Our priest told her flatly she is under NO obligation to take in her brother.
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Well, it sounds like it is time to start making your own family traditions that don't include your mom.

I absolutely agree with you. I wouldn't be around someone that thinks wearing incontinence products has less dignity then sitting in your own crap, ruining other people's furniture.

I would be concerned about your mom's mental capacity to allow this. Hopefully she can afford new furniture when he is gone.

Remember, this is her choice and you don't have to be on call to help. Let her deal with it, maybe, just maybe doing alone will cause her to see that he needs a village and that she is not one.

I am sorry for your family. This is a terrible situation to be in.
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ScoutBloom Nov 2021
As was mentioned above, she's deeply grieving. She's also very religious. So to her, this is her paving her way to Heaven. I *think* my reticence and my siblings' anger is weighing on her.
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She can tell the Hospice that her home is not to be used by him for his care. Tell the Hospice that she can not :
1. Manage his care
2. Be there all the time to care for him.
3. He has made the assumption that he can use her home and that he did so without her permission.

Hospice Social Worker can find another location for him. Either in a facility or other location. Most Hospice have facilities that they can get someone into and the Social Worker might be able to "fast track" any aid that he might be eligible for.
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Scout, my mom was once going to make a really dumb choice about a medical treatment. Various family members had tried to steer her in the right direction, but her "Catholic Martyr/offer it up/don't cause a fuss or inconvenience others" way of thinking kicked in. And yes, I'm sure she thought it would get her Heaven-brownie points.

At my wits' end, I called her up and said "mom, you're too smart to do something this stupid". She was stunned. And angry. But she didn't do the stupid thing, which would probably have cost her her life.
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ScoutBloom Nov 2021
THANK YOU for this. Truly.
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Your Mom needs to realize that if she lets him in to her home and it doesn't work, she is going to have trouble getting him out. I understand where she is coming from but I don't think God would want her risking her health and life to care for her brother.

I know u have said No and SW has backed off, but if she were to take him in, I would tell the SW that she had to set up round the clock aides to care for him. That would cost the state more than placing him in a SNF with Medicaid paying.

I may compromise on at least having him for dinner. But then by Christmas he could be really bad and not be able to leave his bed. Mom can always visit but I would not allow her to go alone. He seems to be very manipulative.

If a priest says not to do it, there is her confirmation right there.
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ScoutBloom Nov 2021
That's an excellent suggestion. I'll keep that in my back pocket. Thank you.
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Could you remind your mom that her priest's telling her that there was no moral obligation is a big deal! The facts of moral theology here, not emotion, sentiment, feelings. And she should consider that her priest has more experience of these issues than she does?. Not how things might turn out rosy, but the hard realities here. Her brother would get better care in a facility that was able to provide for his needs than he could get from a 76 year old widow who is trying to mourn and to adjust to her new circumstances. Finally, and I believe this is a moral consideration, this would in fact impact more people than your mother, right? You and your kids would get roped in to help her cope. So, resentment, anger, etc. Not good. Mom has many other ways to be compassionate, wiser ones.
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ScoutBloom Nov 2021
I will do that, thank you. She's not willing to take him in long-term, at least voluntarily. She's just thinking she'll host him for holidays. I DO worry he'll plant himself the day after. But to be honest, after talking to my brother today, even if my uncle pulls a stunt, my brother will TOSS him out.
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Sad for this man (your Uncle) that he is facing this end stage of his life.

But it seems he is under some delusion of entitlement that his (also elderly) sister provide his care.

Probably stems from a survival instinct / self-preservation.

Regardless. It is selfish & a firm NO should be forthcoming.

(Haven't read the replies yet - my guess is a firm NO from 100%)

IF your Mother wishes to help him - visiting him & assisting what tasks she feels comfortable with *in his hospice accommodation* would be more appropriate.

PS read replies now.. I see : the problem is your Mother is in the F.O.G right? Especially Guilt. Can't/won't say no. Many (esp females) have been taught this.

If this is the situation, using the Priest to say no for her is an excellent plan.

Using your Brother to drive him & leave him in ER is another.

Cruel but sometimes necessary: explain to Mom that if she takes on all his care it will probably DELAY him getting other care he needs from other services/people.
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ScoutBloom Nov 2021
THAT'S a really good suggestion. Thank you.
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Scout, buy mom package of chux to place on her furniture if this is only for Christmas dinner.

She can put several down and cover them with a towel, then it is easier for her. She should assign him a couple of chairs and everyone help keep him in them.

Maybe your brother would be willing to give him a shower before dinner and clean clothes could be purchased at a thrift store.

If this is a long term issue, his skin will still smell after a shower, so a nice perineum wash for down there can help.

I pray this works out as a nice holiday for everyone and not what it could be if uncle becomes stupid.
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ScoutBloom Nov 2021
He REFUSES to shower. No one will convince him, let alone the nephew who helped screw up his free ride. My mom's been providing my uncle with clean clothes, including my late father's, for years. He won't wear them.
Thank you, though, for the Chux suggestion. He's deliberately making a difficult situation intolerable.
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Thank you for this.
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Scout, any developments?
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ScoutBloom Nov 2021
He went into hospice this week and died yesterday. Thank you for asking.
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