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I am so sorry you're going through this. We went through many of these same things with my dad. As he deteriorated, he became distant and would talk and lightly call out to his grandma, not in a panic, but calmly. She had, of course, died long ago, well before I was even born, but they had been very close. We thought he was having problems with his brain but when he had to tell us something he was very clear and lucid. I just finished a book called Final Gifts, written by 2 hospice nurses, and they say seeing people who others can't see is very common from those in hospice, and does not usually have anything to do with the medications they are on.
I never think it's a bad thing to review the pain management process with your mom's health care team. Most doctors and nurses are usually open to doing so and answering any questions you have, at least that has been my experience (there's always some thrown in there that are short and don't have the best people skills, but I've luckily found this to be the exception rather than the rule).
I hope you get some answers that put your mind at ease, you and your family will be in my thoughts during this hard time.