Ah, just read your posts and see you are going to UCSF. They are supposed to be great. My mom started with hoarse voice in 2008 -- many doctors and many symptoms later, including losing the ability to swallow and now talk -- she was diagnosed at UC Davis. But as with you, it is really now so much about the mother/daughter relationship that was/ wasn't in place before the ALS.... so I feel your dilemma. Let me know if you want to talk more..