Tracheostomy tube: Does it help prevent aspiration pneumonia in dementia patients?

My mother has late stage alzheimers,and Parkinsons along with previous strokes. She has been on a feeding tube for almost a year, and has been experiencing aspiration pneumonia frequently. She has been on a ventilator twice before and made it off. She is in ICU on a vent right now. It has been 5 days. The doctor has asked me about doing a tracheotomy tube. He says that this is needed because of her constant respiratory and aspirations, and really the only alternative that could help. She can not control her mucus and her lungs pretty much fill back up in two to three months. She has had two broncoscophy cleanings which is invasive. The doctor says that she can be better treated and suctioned with this tube. My concerns are quality of life issues, and losing the ability to speak. To this point, I have told doctors to do all they could to help my mother. I am sure my mother will pull at this tube as she does the feeding tube. I have no idea how this would be for her in her confusion and have a fear that it could make the time she has left on this earth miserable. I really do not know what she would want. I really need to make a decison in the next 24 hours before they start to ween her off the ventilator. Has anyone experienced this? Is it possible to talk with a trac that is used to prevent aspiration(has a cuff balloon)? How to dementia patients handle this?