concerned and sad

I am feeling pretty sad about my brother.  I don't know if I am overreacting or not, but I am having a very hard time watching his slow, but unrelenting, decline in health.

I think it was about 10 years ago that I noticed he was having a hard time getting out of his chair.  He simply didn't have the strength to do it easily.

A lot has happened since then.  Both of  our parents have died, my brother developed a-fib, he has gone septic several times, and suffers from pneumonia many times a year.  He has had a stroke, and probably several tias.  He has been in the ICU 3-4 times.   I have stopped counting the times that he has fallen.

Now, since the holidays, he seems that he is more in decline.  He fell around that time, either from balance problems, a TIA, and maybe he hit his head falling, who knows, I wasn't there.

But his processing time is notably slower and he has lost 8 lbs in the last two months.  He has stopped eating lunch.  He says it's for two reasons:  the food is no good, and his various maladies mean the food is not good for him.  He says it is too starchy, which it may be,   Never mind that it's the same kitchen/chefs that prepare lunch and dinner.

I have talked to his nurse practitioner who has run blood tests, and everything shows no change.  She has offered an anti-depressant to increase his appetite, but it will make him drowsy, and I want to avoid that if possible.

I'm also ambivalent about how much intervention to offer him.  I want to offer him as much intervention as anyone else would get, but I also have strong feelings about making sure his quality of life stays as high as possible, which means not asking for invasive procedures if they can be avoided, especially if the test is just to know what the problem is and then there is no treatment available.

I am worried that he might have cancer.  I can't imagine giving him chemo.  If he starts throwing up he will get dehydrated and his blood pressure will drop and he will end up in the ICU.  This is a terrible decision that you have to make for yourself and he is not capable, I know he will want me to decide for him.  I'm hoping the problem is his heart, not cancer.

I have decided to just concentrate on helping him enjoy his life as possible until he has his next crisis that where he ends up in the hospital.  Then we shall see.