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She looks at me quizzically very often and I can see her searching her brain files to put my name with my face. When she can longer do that, I will be grieved but be OK if she sees me as the nice lady who takes care of her. BUT, if she starts to think of me as her mother (strong family resemblances) that could be a massive problem because her mother was very petty.

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I am so sorry. I have a friend that lives several states away from her mom. She is only able to travel to see her mom once a year. Her mom has no clue as to who she is. She will ask her daughter, “Who are you?” My friend was devastated when it first happened. Now, she has adjusted to it.

When she says that she is her daughter, her mom looks at her like she is a stranger.
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Look at it this way -- if she does mistake you for her mother, you can change her impression of her mom by not being petty and instead being kind and loving.

My mother recognizes me sometimes, but most times I'm not sure. It doesn't help that she's virtually blind and almost deaf, too, so she has few cues to tell her who I am.

She seems to respond to the familiarity of me, and I'd guess your mother will, too. Talk coming from a voice she remembers and the touch of my hand and how she squeezes it tells me Mom knows I'm a friendly, familiar person, even if she can't quite place me.

It goes both ways -- I know she's my mom in spite of the fact she's not anyone I recognize anymore either.
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Why don't you wait to cross that bridge if and when it comes, instead of worrying about something that may not ever happen?(the part of her thinking you're her mom that is)
I have a feeling that if she gets to the point of not remembering who exactly you are, she will know you as "the nice lady" that takes good care of her. And I'm glad to hear that though that will grieve you, you will still be ok.
You are a good daughter to care for your mom so. For that you will be greatly blessed.
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