Hi Natalie,
I'm sorry to hear of your mother's illness. We all have those ups and downs in relationships... particularly with those we are close to. I think that your desire to connect in a meaningful way with your mom and to learn more about her wishes, her fears, and really, just to feel close to her, says a lot about how much you care about her.
Talking about death and dying is hard to do -- for one thing, it's not something that is usually talked about openly. Even when everyone is thinking about it, there is this impulse not to talk about it... maybe out of fear of causing pain, fear of taking away hope or even fear of stirring emotions that we are uncertain about how to deal with. I guess what I'm trying to say is that your mom may be feeling similar feelings -- She may want to talk about her feelings, but may feel just as uncertain about how to start.
You seem to have thought a lot about your relationship, how you are feeling and your desire to support your mom. You have also expressed yourself beautifully in your posting. I think that the way to start might be to share how you yourself are feeling with your mom. Expressing how you feel and talking about your own fears and concerns may give her permission to talk about her own. Part of having that discussion is giving yourself permission to feel the way you do... to know that it is o.k. to be scared or sad or angry... and to share that part of yourself with your mom. It also means accepting how she feels - that it is o.k. to have one of those unpredictable bouts of crying... and knowing that you don't have to fix it or even make it better. Just being there and letting her know that you love her is enough. It may also mean accepting the possibility that your mom may not want to talk about death and dying. We all cope in our own way. Even if she decides not to talk about her own concerns, she will know that you love her and that you want to do your best for her.
It sounds as though your mom's overall health has been changing recently and that she may not always be able to participate in discussion (either due to periods of confusion, drowsiness, or lack of energy). If you are noticing these changes, it may be helpful to talk about it with the health care team involved in your mom's care. As you noted, these symptoms of being "out of it" may be partially attributed to medications, but there may also be other reasons. The health care team involved in her care may be helpful in perhaps making adjustments in medications or addressing other potential reasons that may be contributing to her symptoms so that you and your mom have time to talk about what is important to you.
If your mom's health has declined to the point that she is no longer able to communicate with you, I would still encourage you to express how you are feeling. Even when people are unconscious, they are able to sense that they are surrounded by people who love them. Talking to her about how you feel may help to give you some of the closure and comfort out of your relationship that you have been seeking and let her know that she is loved.
You are in my thoughts...
Lisa Streeter, RN (Manitoba), BN
Clinical Nurse Specialist
Canadian Virtual Hospice