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What does the prognosis look like - my mom is 76. She is being treated for COPD, Type II Diabetes, Stage C CHF, Sleep Apnea (which she uses a cpap for) and newly diagnosed Stage 3 AKI/CKF. In addition, she is overweight and dealing with very painful spinal stenosis that radiates down her leg to her ankle. I'm trying my best with her, but understandably she's miserable. She was recently discharged from the hospital after a 2 night stay with pneumonia - and it sounds like she starting an upper respiratory infection. She's resistant about me to bring her to the ER and now she's not talking to me.

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I think your Mom is very seriously ill and I am sure you understand this. She is obese with a failing heart and the heart, likely damaged with the diabetes, and the poor sleep quality along with the lungs and copd is a recipe for disasters one on top of the other.

I am uncertain if your Mom lives with you? With the severity of the spinal breakdown added to failing major organ systems it is likely time for decision making as to how much caregiving you are able to continue to do, and as to whether palliative care may not now be an option. She is going to need quality pain medicating for the spine, and the weight will make that tremendously difficult.

I think you need social services, social worker working with you here to approach your mother. She is managing to avoid reality of her dire situation by simply refusing to acknowledge it. I doubt that will work for you, as her caregiver. This level of care cannot be accomplished with one person, namely you.
There is going to have to be some tough honesty, whether you mother likes it or does not. You are enabling a denial that you are not going to be able--mentally OR physically--to support.
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About Me
I'm the youngest of 3 (I have 2 older brothers). My Dad passed away in 2009, my mother has slowly and progressively declined since then. I live upstairs from her and try my best. I work full time and I am her primary "assistant" of her 3 kids (my brothers do absolutely nothing, even though we all live in Connecticut). I love my Mom, despite her mood swings that I get to ride on. She is the epitome of "needy" and doesn't realize how hurtful her words can be. Some days I just feel wiped out and mentally drained. 

Stage 3 kidney disease doesn't require dialysis......my mother lived with it for 15 years and died from CHF which is the big issue with your mom. CHF stage 3 can kill her unexpectedly before anything else.

If the spinal stenosis is causing her sciatica in her leg, I recommend she use a heating pad and ice alternately. Ice helps me more so than heat (I have pretty bad spinal stenosis myself). Sciatica is extremely painful to deal with. I don't mistreat my husband when I'm in pain though. Too bad your mother takes her issues out on YOU, who's there to HELP her. I'd back off and tell her to hire paid help and if she mistreats them, they'll walk out.

You say she was recently released from the hospital for pneumonia after only 2 days, with COPD, and now appears to be starting an URI. It could be the pneumonia did not clear out of her lungs entirely and she needs more antibiotics. She can call the doctor to discuss her symptoms. Or wait for full blown pneumonia to redevelop and go back to the hospital. With COPD at play, the lungs are her weak spot and cannot function properly or rid themselves of mucous as they should. It can be a blessing she's not talking to you right now, but she's looking a gift horse in the mouth. WE can't care more about a person than THEY do. Take a break from her histrionics while she sulks.

I don't know if mom is hospice ready yet, but you can speak to her doctor next time she lands herself in the hospital. I'd insist she hire paid help for herself, one way or another.

Best of luck to you.
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The kidney failure is being caused by the diabetes.

Your Mom has so much wrong with her and all life threatening. Maybe you should have the Hospice talk, if she does not want to see doctors anymore. The COPD and CHF are robbing her of oxygen. The kidneys are shutting down and not filtering her blood which means toxins are being released into her system. Sepsis could set in and that could kill her. I doubt if she could do dialysis. Its hard on the body. With Hospice, she should be kept comfortable. Will get an aide 2 or 3x a week for bathing. If she will not except Hospice get a DNR in place. Her PCP should have the form.
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Doesn't sound good, but she is young, sounds like loosing weight may help a lot of her issues, and being diabetic I'm wondering if they can put her on ozempic, much luck to you both
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I've been through trying to help a mother resistant to going to the ER and/or taking any medical advice from me. It's very frustrating. Since mom was recently discharged from the hospital could you follow up with a PCP or local doctor just to see if the pneumonia is clearing? This is much less stressful and time consuming than going back to the ER. If she's not talking to you, might a friend or other family member take her?

As far as her prognosis, not one here can answer that. We can say that a lot of folks on here are caring for elders with very serious, complex and potentially fatal diseases, yet they can go on for months and years, and their needs can exceed what a family member can provide. It sounds like you may already be at that stage.
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