On comfort care, but is she dying or not?

For the last 3+ months my mom (93, unspecified mid-stage dementia, thin and frail but otherwise in good health and quite capable of holding a conversation, albeit a sometimes muddled one) has been sleeping most of the day and steadily losing her appetite -- the nurses at her assisted living called a couple times to express concern and ask if she's always been a "picky eater" (no, she has not). I had also noticed she was eating very little even of her favourite foods, and could no longer walk half as far as before without getting exhausted.

Then four weeks ago my mom slipped and sat down hard on her bathroom floor. It left her sore and shaken, but the doctor and nurses checked her carefully and found she could still bear weight and walk normally with her walker, so it didn't seem like she'd broken anything. A week later she had a second fall getting out of bed -- same result. But after a few more days her pain was getting worse and not better, so I took her for x-rays. They found she had a fracture in her spine and three more in her pelvis, and admitted her to hospital that night.

A couple years back, when my mom was more clear-minded, she signed a DNR and told me that if anything happened to her health-wise she didn't want to go through a lot of tests or treatments, just to be kept comfortable. She's always been a positive and grateful person, not typically depressed or antisocial, but she's often wondered aloud why she's still here on earth when my Dad and all her friends are gone, and talked about how she's looking forward to heaven. So after a few days of seeing Mom on a ton of pain meds, barely eating and sleeping at least 20 hours a day, I asked her if she wanted to work on trying to get up and moving so she could return to her AL, or just stay in bed and wait to go "home to glory". She didn't hesitate to pick Door #2.

I relayed Mom's wishes to her doctor and nurse, and asked they thought it was premature to apply for hospice. They did not, and were glad to refer her, though the doctor warned that since Mom doesn't have a terminal diagnosis -- the tests didn't show anything wrong with her apart from old age, dementia and the fractures -- the hospice might not consider her eligible. Even though she looks like a skeleton, she's still eating and drinking sometimes, and I'm told dementia patients can go on for years that way.

Anyway, the last 3+ weeks with Mom bedridden and on comfort care have been a constant guessing game. Whoops, she can't pee and needs a catheter. Oh dear, she keeps getting confused and pulling the catheter out. Never mind, she can pee again so we don't need it. It was a good day, she was alert and happy and we had a nice conversation! It was a bad day, she's confused and agitated. One day she's telling everyone who visits that she's going to heaven! The next day she thinks she's getting better and going back to her care home.

The one constant, which I'm thankful for, is that Mom doesn't report any pain or discomfort. She's getting fantastic care, as far as I can see. But every time I think there's a clear sign she's going downhill -- like the nurse saying she won't eat more than a couple of bites -- I find out the next day that "she ate her whole breakfast today!" Two days ago she was so confused and agitated it seemed ominous, but today she was brighter and more cheery than I've seen her since she got into hospital. It feels like I'm riding a roller coaster blindfolded, not knowing where the next turn is or when the ride will end.

It sounds awful to say, but my biggest fear is that my mom will not die after all this, just be left bedridden for months or years to come. She's always said that she's had a good long life and she's ready to go -- but her dementia makes her forget even that sometimes. A few days ago I didn't think she'd make it to Christmas, and today I was googling for more long term care homes in our area that I might need to add to her list!

Has anyone else here been through a similar process with an elderly loved one in hospital who has dementia and fractured bones but no terminal diagnosis? How did it pan out?