Stage 1V BC in 90 year old

CKek - Please understand that these are only my personal opinions and experiences. They may not have meaning for you.

Your post hits home for me for several reasons.... I had my mom in nursing care for more than ten years; the last three in a skilled nursing facility.

She had end-stage Parkinson's, and some Parkinson's-related dementia.

I was working 60 hours a week, yet felt I had to be at the nursing home every single day, so I would zoom down there on my lunch hour and zoom back to my desk. If I'd had a family then, I don't know how I would have done it.

Over the years I got so many calls that she had been taken to the hospital, near death, and every time, she would rally. That kind of emotional roller coaster is so draining. I finally started asking the staff: is this it? Is this the end? And they always said the same thing: "No one knows."

I made sure that whenever I DID see her, I would tell her how much I loved her, and what a great mom and role model she had been for me. That way, if she did pass and I weren't there, I would have no unfinished business.

I'm glad you are seeing a therapist. You need an outlet for so many emotions that we go through at times like this. If you are not able to see your therapist as often as you want, you might try writing your thoughts down in a journal. Sometimes getting them out of your brain and onto paper allows you to relax and let go of them.

We know at age 90, your mom won't probably won't get better, and with Palliative Care, it really is just a matter of time. But no one has a crystal ball. What I CAN tell you is that once the patient stops taking in any food and water, it is usually a matter of days. I went through that with my mom when she passed in 2009, and I just went through that with my MIL when she passed in January of this year. She was 93.

I think I would try to talk to the Director of the Palliative Care service (or the Social Worker) at your mom's facility and relate some of what you have posted here. Trust me, they have heard it many times before. 

Also, you should have access to Hospice counselors, even if Mom is not officially under Hospice care. They are there to deal with family members, not just the patient.

Find out if Mom's pain is under control. Find out if there are different drugs she can take that do not exacerbate her anxiety and depression. She may need a different approach to treatment. (For example, Haldol can increase anxiety... there are other drugs for nausea.) Ask why she is taking the drugs she is taking.

Could some of her crying out be from dementia made worse by her cancer and her drugs? 

If so, that may not be directed at you, and taking it personally is just hurting you.  Mom may just be confused and frightened. The staff should know exactly how to calm her down.

Find out what their plan is for Comfort Care... in other words, is there a point where they will they stop administering food and water?

It sounds like you have been a wonderful daughter, yet still feel the need to make things better, somehow. I think by getting Mom into Palliative Care, you can unload some of your guilt by knowing that she is in the hands of professionals who can care for her and make her comfortable. (As long as they know how upset she is, and that they need to work harder to find a way to make her feel comfortable.)

As for your being with her until the very end, that's a hard call. If each visit leaves you more and more depressed, then maybe it's time to cut back. You can remember and honor your mother in your own way without being in the same room with her. Not everyone handles a parent's final days in the same way.

But I think that if you want to be there at her passing, that is something that the staff CAN tell you... when it comes down to a matter of hours.

I think that we would all like is for our parents to simply go quietly in their sleep. Unfortunately, that isn't the case. It's a sad thing to watch, but personally, I have a strong faith that has always gotten me through. That hasn't been the case for my brothers and sisters. We all responded differently, as did my DH's siblings with their mother.

I am so sorry... this is a tough time. But you have done the right thing, and are not one bit selfish to be thinking of your own mental health at a time like this.

Sending you big hugs....