Have hope or accept reality?

[dsacoda]

My 78 year old mom was in the ICU a year ago for what should have been a standard stent placement. She had complications that landed her in the ICU. While she was there, she suffered delusions and memory loss. She was severely weak after this hospital visit. However, after she returned home with loved ones around, her memory came back gradually and delusions completely went away. However, a year later ( about 5 weeks ago), over a few days, her muscles became very weak and she could not walk. She landed in a terrible hospital that just had her laying, and she got severe edema in her legs. Then it moved to her upper body, so she went from not being able to walk, to not being able to move at all, with exception of her head. She finally got a transfer to a wonderful hospital and improved quite a bit and while there, they were very encouraging that she could have physical therapy and recover from this. They tested her for tons of things, and finally determined that she must have had muscle atrophy due to inactivity for so long after her last hospital visit (my sister was taking care of her and did everything for her from cooking to walking her dog).

While in the hospital this time around, she started to gain use of her arms again and could somewhat feed herself. She landed in the ICU again, however, because they couldn't get her blood pressure back up after putting an A line in. She declined slightly again, and was having delusions again. She returned to the floor and she got slightly better, and then they discharged her to a rehabilitation facility. They were very neglectful at this facility-- they would not bring her water (or sometimes even her food) and they would hurt her by turning her roughly and cleaning her quite hard and would not come when she called for the nurse. This facility was far from our family, and they would not let them stay over, so they had a hard time getting to her. This facility did nothing to keep her mentally alert. They would keep the blinds shut during the day and not turn the television on for her. She was terrified and begged to go home, and we feel she declined significantly. She would have delusions and lost strength in her arms again, and we never did see much physical therapy being performed. The family finally got a discharge to take her home, but all of this now has weakened her so much that even now at home she is in and out of clarity of mind, and she is very weak and is sleeping a lot. We decided to let her rest today because of all that she has been through, but are also trying to talk as much as we can to stimulate her mind. The question I have is I don't know whether to hold hope that she will come back from these delusions and I don't know whether or not she actually will get better or if the doctors were giving us a sense of false hope? She is still very swollen in her legs, and she leaks fluid as the edema goes down. But she still is unable to move, and even her arms are worse again after being in that nursing/rehab facility. We had an ER doctor that is a friend of the family come by and said we should spend as much time with her as possible. One doctor also said that it depended on whether she is a strong 78 year old or a weak one in terms of her recovery. Do they simply not know? Are they sugar coating? Is this an unusual situation? I can't seem to find anyone else going through this. I don't know whether to push her to work on using her arms, and start pushing her to sit up in a wheelchair, or whether I should allow her to be in peace and comfort. She is in quite a bit of pain when she is rolled over for cleaning, and she hurts when placed in a wheelchair for a small period of time. The physical therapist is supposed to start coming to the house. I am actually not with her -- I am in a doctoral program and have young children-- but flew down there last month and will fly again this week to see her and help. If anyone has any thoughts on this situation, I would greatly appreciate it! It is tearing me up inside. My mom and I are best friends and she barely has the energy to talk for a minute on the phone. I want to do what is best for her, but I also keep wanting to hold hope that she will recover from this. I don't want to lose her.