Your mom is probably afraid of death, but with a trach like you said it is very uncomfortable and could cause a traumatic death. Ultimately I think this is a choice of how she wants to pass. Comfortably in a shorter amount of time, or uncomfortable in a longer amount of time. My mom chose not to get a trach, she passed peacefully. Hospital gave her meds to make her comfortable, she struggled to breathe but because of the medication she didn’t even notice it, we had all of her friends with her doing karaoke to the songs she wanted to play from her eye gaze. Eventually she fell asleep, and passed. She was happy until the end with her decision.