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Paula,
I'm not an expert but I'll share my thoughts about your situation.
Ensure can provide patients with nutrition and help them maintain weight, but your mom is apparently not getting enough to avoid the weight loss. That puts a strain on everything she and her body try to do.
Her lack of appetite could be a result of her condition or treatment but (and I hate to say this) it could also be a sign that she's giving up on herself or her body is giving out the way that's often seen at end of life. You mentioned that she's tired of the fight so I have to mention these possibilities. I suggest asking the doctor about it (out of her earshot). You know her best, of course, and perhaps you have an opinion about it too. If you're sure it's a medical issue, then you and the doctor can consider ways to deal with it.
If she's fully capable of making medical decisions for herself, you might have a frank talk with her about quality of life. Some octogenarians may prefer a less aggressive approach than the Revlimid/Vidaza approach, even if that means only supportive treatment such as transfusions. If she's aware of the tradeoffs and wants the treatment she's been getting, that's great. You just want to make sure you're honoring her wishes about it. And perhaps you've already had "the talk".
I know this is a strain on you too, and there's no easy approach. I wish you, your mom, and the rest of your family the best.
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