My mother has hormone-receptor-positive, HER2-negative, advanced-stage breast cancer. She's been taking Faslodex for it since 2017. She began exhibiting signs of dementia in 2014 and in July 2018 we moved her to a memory care unit. We probably waited too long to do that. She is at the beginning of Stage 6. She has no memory of recent events. She has very few memories of earlier life (ex. she doesn't remember any of her past homes, that her brother and sister are both long dead, major events in our past lives) but she does still remember me. She says the same things over and over, but its about 5 minutes of talking and it all makes sense (its always about the garden where she live now - she's impressed with the variety of plants).
Mom always said two things to me my whole life: don't put me in a home and don't let me die of cancer. Now she's living her two worst fears.
Faslodex can hold off the advance of mom's cancer for many more years to come, her oncologist has told me. But mom has declined very quickly cognitively since entering memory care. And physically she's declining too (her teeth are beginning to fall out. She's getting wounds on her feet from her fragile skin splitting. She has no feeling of pain anywhere - the dentist worked on cavities without any reaction from her and the podiatrist said her foot wound should be painful but he treated it with no reaction from her).
I am mom's medical POA. I have no siblings and my dad died 25 years ago, so there's no one else to consider. At what point do I make the decision to stop the Faslodex and let her go into hospice?
I'd welcome any advice.