2 minutes ago
My 77-year old mother has Alzheimer's and 2weeks ago had an apparent stroke. A clot in either her cerebellum or brain stem is suspected, though all CT scans show nothing. Before this happened, Mom had some aphasia, though age could say some short sentences. She knew who we were, and was still oriented in the present day. She couldn't manage a fork anymore, but would willingly eat what we fed her. She could no longer walk and was incontinent, but she was cheerful and loving and happy.
After the event, she was intubated for a time to protect her airway, but was weaned from the ventilator within a few days. She sleeps a lot, but has progressed to the point where she will turn her head and look at someone who says her name. She will watch people walking across the room, tracking them with her eyes. She also does a fair bit of staring into space, and when she does look at you, there's no sense of recognition.
She does not speak, and does not follow any commands/requests (squeeze my hand; blink twice for "yes"). The hardest thing is she won't cooperate with swallow tests. She clenches her teeth if we try to place any food in her mouth. For now, she's on an NG tube to give her strength and time to recover.
What we're struggling with now is where we go from here. A geriatrician offered the opinion that the stroke pushed her into last stage Alzheimer's, that she won't recover more than she has, and that we should take her home and provide comfort care until she passes away.
Today, the doctor in charge of her case gave an opinion that she may recover more, to her baseline. He recommends inserting a PEG tube which would allow her to be taken home and cared for as she recovers. (I'm committed to keeping her at home and out of a nursing home. We've had a live-in care-giver for her for nearly 2 years.)
She has no living will, and I am her health care agent. My quandary is which do I believe? If she's now last stage Alzheimer's, it would be cruel to insert the tube and keep her in a state that will never get better. But if she's a stroke victim with a chance to live a life like she'd had, I'd hate myself for robbing her of the chance.
I love my mom deeply and am not ready to lose her. But I want to do the right thing by her, if I could just be certain what that is.