Mom was hospitalized a couple of weeks ago for several issues, most significantly diverticulitis. She has dementia and declined severely while hospitalized. Begged and screamed to go home. In retrospect says she will never go back to that "awful place". Meaning the #1 trauma center in this part of the state. She received excellent care, corroborated by a family member who is herself a top-notch physician. I witnessed the doctors, nurses and staff doing their utmost to help my mom.

Now that mom is home which is what she begged for, she is miserable. Going on about how she has had nothing in her 82 years but misery. Not even remotely true. Indeed, she has suffered the loss of two husbands and raised us as a single parent. She has been quite healthy her entire life, and has never as an adult experienced financial hardship. She has a lovely home and two cats she adores. She and my dad had a wonderful marriage. His life was cut short at 36. She and her second husband ran a restaurant where, although hard work, they made many friends. They traveled and had a nice life together. He developed dementia himself and passed in 2009. Mom has isolated herself since and become more and more depressed. She refuses medical intervention. She has her local PCP, who although competent and very compassionate, is just that. A PCP. He is not trained to treat her now many ailments.

I am in the process of setting up home care for her. I live 75 miles away, my brother lives 300 miles away. I am retired, he is younger and still has a few years left to work. Neither of us is moving in with her, although she is resistant to strangers in the house. She is manipulative and starts crying to get her way.

She has had GI issues her entire life. No treatment and she says "it's just the way I am". Now she's in a mess of chronic diverticulitis, and a benign pancreatic mass that is pressing on her stomach severely limiting her appetite. We thought we had an answer with Boost or Ensure, which she liked, but we discovered it has milk protein. Anything with the words milk or dairy are a big NO.

Not sure where to go from here. We are waiting for a GI referral which is dragging on. She is not a candidate for anything invasive, including colonoscopy. She's too weak to withstand it. I think palliative care is the best we can hope for.

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I have a very good friend who has chronic Diverticulitis, the pain can be excruciating and denial of how bad it is, depression and anxiety tend to go along with it, at least with my friend. I have taken her to emergency more than once over the 5 years we have known each other.

I held her hand when she was given a shot of morphine for the pain. She started to cry, as she had not been pain free for a very long time. The antibiotics used to treat Diverticulitis are incredibly hard on the patient, which in part leads to the denial. Who would want to admit they need medication that is going to give them side effects that are as bad as the thing being treated. The delay is what eventually leads to hospitalization.

My friend is very mindful of what she eats and although she resisted it for years, is now taking Metamucil daily at the insistence of the GI doctor.

We have a great many poopy conversations as I have IBS-D. My situation is at times embarrassing, noisy, uncomfortable etc, but it is not life threatening. The last time my friend was in hospital she had an abscess on her colon, which they monitored daily via CT Scan to make sure it did not rupture.

So for your Mum, try to accept that chronic pain is in itself debilitating. It leads to depression, a negative outlook, and anxiety. Palliative care, especially if it provides pain control would be a blessing for her.
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It does sound as though Mom is entering the time when she needs palliative care and a good geriatric MD, not a PCP.
She has dementia, so listening to her present-day assessment of her life, miserable as she feels now, is neither here nor there. She has every right to look at the long slow, painful and miserable slide toward death through a glass darkly. There is very little upside now, and even in dementia, she knows that.
Get a good assessment of her illness with a good geriatric MD and MRI or Scans, whatever you can (sounds with the diagnosis you have she already has HAD some).
I do think that in home care may not be enough for Mom now given that you and your brother realistically are not there to assess her. I would think she should be in Assisted Living where something other than a home health aid is there to see what is going on with her. Pain management, if needed, is going to make her tipsy, more prone to accident and hospitalization. I think she will need 24/7 care or placement from what you describe. Palliative care, and then hospice. (Honestly, who would NOT be depressed. The elder in bed looking back happily on a life now gone is for the Hallmark Channel)
She lived a good life. You know that. And were there hard times? Yes, they come for us all. What she is mourning in her dementia is that life and the control of it. Of hope.
I am so sorry for Mom, and for you and your bro as well. My Dad stayed well, with his much loved Mom (greatest love story I know) and then sat down in his brown velveteen easy chair watching Monica Lewinsky on Larry King Live and died suddenly with a smile on his face. It's the death we all want. It isn't the death many of us are lucky enough to get. I am so sorry for the pain.
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You can't help another person be happy.

If mom won't participate in her care by seeing the appropriate professionals and trying their advice or treatments, then even more so is her dissatisfaction with her lot in life in her wheelhouse, not yours, to fix.

There are dairy free versions of those protein drinks. Just Google "dairy free protein shakes".

I would certainly offer her the option of palliative care.
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