Asa savak...
I am a medic and can tell u tht she will probably get worse. I cant wrap it in silk as this is the harsh reality and one needs to accept it and manage the situation.
Living in west will give you latest medical care and home based paramedic services but it will cost you an arm and a length.
Whereas living in pakistan might not give you the best medical care but the support that she will get from a full time caregiver (always hire 2 ppl unknown to each other) plus a daily visit of a physiotherapist along with a visit by a nurse would be affordable.
If you end up engaging a good team of an foreign qualified neuro and a psychiatrist in karachi then it would benefit her alot. These are things u cant manage or plan in west.
Now let me give you an advise brother and for your sake i hope you listen to this selflessly.
Over the years i have seen people provide patients/ parents the best medical care tht money can buy and they have literally purchased and arranged care and machinery that is mind boggling but they repent their actions and deeds as they did not give their parents personal time and attention. I will give u 2 brief examples..
1...
A close friends mom died recently after remission of breast cancer and it spread all over. He provided the best treatment for her, air lifted meds from abroad and bought her paramedic staff care and was present on her every appointment with the oncologist. He built his business and still managed her appointments in between the trips and meetings. Now a few yrs after she has gone he still repents for not holding her hand or feeding her or for taking her out for a drive etc. The guilt is killing him from inside. He has started winding up the business to a more comfortable level so as to give more time to his dad and family but every phone call and meeting shakes me to my core which is strange as we drs become emotionally strong over the years.
2...
A colleagues father died after a long battle with blood cancer. He bought every medical care you could think off. I mean literally.. He travelled with him to islamabad, karachi and sent reports globally for 2nd opinion. He took his dad out to northern areas and markets on his good days. When he was on his death bed for a few months he was with his dad carrying him to wash room and feeding him cerelac, corn flakes and grounded nuts plus cereals. When he died they had only 1 lac left with them and he was under 4 million debt. He had sold off literally everything. Now he lives contended and over last 7 to 8 years god almighty has showered him with wealth and cobtentment that is beyond belief and is worth envying infact.
The moral of the story is.. Cut ur mom, urself and ur family some slack and think long term. I am telling you now brother whatever you do with her can make u a man or can make u a hollow man who will see the same fate. I aint an islamic preacher but due to my profession i have seen enough to say the above.
May god make ur mom better, may God help u in taking the right decision. Ameen
Hi @AsifIjaz. Your response was most insightful. Thought I would give you an update
The doctors and others originally thought it was Parkinson's but most Parkinson's cases show people going through a general decline over atleast 10 years. However in my mom's case she has really deteriorated at a rapidly fast pace to the point where it is now clearly visible at all family outings and functions and can just not be hidden anymore.
My baby sister got married this week and how my mom pulled through was a miracle but she now is more or less dependent on others and has it not been for my aunts, parents best friends there is no way she could have pulled through.
But her speech has slowed, mobility has slowed and declined, her hands don't shake like Parkinson's but she has fallen badly a lot of times due to low blood pressure problems because of the meds she has to take and then to counter it she takes on medication to increase blood flow to the brain.
Like I am on study leave from work for two months for my final CPA exam and have finally seen first hand on what the situation is. I follow her around, don't let her climb stairs alone, heck we don't even let her close the washroom and she fell down badly in the washroom and I had to go in and it took her at least 20 min where she kept getting up, down and then she crawled to her bed and then told me to get her the blood pressure tablets
But most people are now suspecting that this is not Parkinson's at all and it is something else because normally someone with Parkinson's does not show such a rapid decline
Getting the help she needs is a huge pain here in Canada. Every govt sponsored caregiving program has a huge list of requirements where they come visit the patient and then you have to meet a certain sickness threshold to qualify and it will not necessarily be the same caregiver coming daily but someone different and a lot of these people are not all compassionate. Even private caregiving organizations take a while before they get back to you.
But I honestly think my mom can get much elite care back home in Pakistan where like you said 1-2 full time 24/7 nurses, a daily physiotherapist, psychiatrist, top most qualified neurosurgeon can pay a visit whenever required at home and it is much less a hassle to obtain all this back home.