Bless you!! What a crazy journey you have had with your Mom. Obviously her bones are very brittle to have that many breaks. It is always a hard call to decide what to do and what not to do. What is comfort care and what is proactive live extending. We don't want to prolong dying but sometimes we don't want to prolong living either. I think the question is.... what is comfort. That is what we want for our loved ones... comfort. I think you have to take a cue from Mom. She has told you what she wants. She has not complained of that excruciating pain the doctor predicted. Fixing the break, again, another surgery, another anesthesia, more blood... when does it stop?
The blood and blood work number is telling you something. Obviously there is a problem beyond the break. Hospice can manage any pain that she might have. One thing that many don't get is that dementia can also affect the pain center. Mom broke her hand. Oh we needed to pin the break because of pain, mobility, blah blah blah. Since it was not a major break we opted not to. Mom has NEVER complained of pain. There was no grimace or other nonverbal indication of pain either. It healed with a calcification and she went right on using that hand once the soft cast was off. Then I noticed other things that should hurt but didn't. Obviously this disease has been good to Mom and blocked the pain centers in her brain.
My grandmother had Alzheimer's. Mom agreed to massive antibiotics and other treatments to cure her sepsis. As Mom said... "In my ignorance I didn't know any better!" My grandmother was bed ridden and incoherent for the rest of her life. The doctors "saved" my grandmother but Mom's question was "For What!" She let us know, if we had that choice please let her go. Just because a situation is treatable doesn't mean we are bound to treat it. You have to look at the outcome for Mom. Will it improve the quality of her life and is she in a place that she want to continue.
Personally, that is a choice we all have to make for ourselves and our loved ones. I would and have chosen Hospice. One thing that sticks in my mind is when a nurse told me that doctor do a great job of helping you live but a lousy job of helping you die! They are trained to extend life at all cost.
Hope this helps. I do understand the difficulty of the choices you have to make. Just know there are no wrong choices. Choices you have made were right in the moment with what you knew. Now you have a new decision to make and you will make the one that is right for you in the moment. Go with your gut feeling and what you know Mom wanted. Weigh all the advice you get related to the source. Ask questions and take your time.
You have done well so far and you will from here out. Know I keep you all in my thoughts and prayers....