Question: I need a 2nd opinion for my wifes condition.

She has COPD and is using an O2 concentrator at home set for 4 liters per minute. Her O2 levels as indicated on the finger oximeter has been declining for the last few weeks.
On July 21, I called ambulance to get her to the ER since her O2 levels were down to 50%.
When she arrived at the ER it was discovered the her blood CO2 level was up to 160 mEq/L and PH was too low.

She was moved to ICU, sedated and put on a ventilator.

Currently ventilator is at a peep value of 8 and O2 of 70%. Her blood CO2 levels are down to 50-70 and PH is good. O2 levels are 94.

Yesterday I was told the she will need a tracheotomy by end of next week if she don't improve.

She is given the following through IV.

Fentanyl for pain releif.
Sedative.
Insulin to lower blood sugar.
Calcium channel blocker for Afib.
Steroids.

Here is additional info.

Age 66.
Height 5'11
Weight 325 lbs (obese)
Previous smoker, but stopped smoking 3 years ago.
COPD.
Mild congestive heart failure, and Afib episodes.
Bad hips and is walking with help of a walker.

I need here to make the decision about tracheotomy since we were told that it will involve a longer hospital stay and then a long nursing facility stay.
Now she is not in a condition to understand the the options, so we need to get her off the fentanyl and seditive.

Is it possible to remove the ventilator tubes in her throat and use a breathing mask to wake her up so she can get to point of understanding the options and be able to talk?

She might decide against the tracheotomy because of her underlying other physical problems and cronical pain.
The reason is that there has been times when she woke up after a nap and was crying because she woke up, all because of cronical pain.

Please advise.