Seeking Guidance: Tough Decisions About My Aunt in Critical Condition

I’m in a very tough position right now and could really use some advice. My aunt is currently in the ICU, and her condition is extremely serious. Here’s what’s been happening:

(note: All this happened after she slipped and fell. Not sure if it was because of the ice OR all of the above that I had NO idea about.)

  1. She has a history of congestive heart failure (CHF), smoking, and lupus, which I only recently learned about.
  2. She was hospitalized after a fall, where she was found to have a pulmonary embolism (PE) and COVID-19.
  3. Her kidneys are failing, and the doctors said dialysis isn’t an option right now because her blood pressure is dangerously low, and dialysis could make her worse.
  4. She has already coded three times and been resuscitated each time. The doctors have asked if I want to continue CPR if she codes again.
  5. They’ve warned that if she recovers, her recovery would be extremely difficult, involving potential dialysis, long-term rehabilitation, and significant lifestyle changes.
  6. I’ve learned she is a fighter and has overcome a lot in her life, but I don’t want her to suffer unnecessarily.

I’ve spoken with my dad (her brother), and he suggested maybe trying CPR one more time if she codes. I feel conflicted. I don’t want to give up on her, but I also don’t want to prolong her suffering. She’s in such a fragile state that it’s hard to know what to do.

My Questions:

  1. Should I allow another round of CPR if she codes, knowing it could be traumatic for her body and might not improve her quality of life
  2. How do I honor her fighting spirit while considering the possibility of comfort care?
  3. If she recovers, how can I prepare for the challenges of supporting her through what would be a very hard recovery?
  4. Are there alternatives to dialysis or other treatments for her kidney failure given her low blood pressure

I’m traveling to see her tomorrow, and I’m trying to prepare myself mentally and emotionally for whatever comes next. I just want to make the best decision for her. Any advice or insight would be deeply appreciated. It feels so surreal and been crying all day. she's like my second mother.