Falling down for no reason would indicate neurological problems to me. And maybe this is anthropomorphizing a bit, but I would be inclined to equate the constant meowing with the unsettled ramblings and rantings of an elderly person, which would make them an indicator of fear/confusion--basically, mental suffering. If Mia were a person perhaps you could reach her, find a way to explain that everything was still all right, but as she's a cat, it's unlikely.
Just being completely honest here, I hope you don't hate me for this, but I'd probably go with a quiet, painless euthanesia as well, if the choice were up to me. Not because of the annoyance factor, but because I would assume that her quality of life had gone down enough that it was wrong to prolong the suffering just for the sake of keeping the humans company a little longer. In my defense, I'm also usually a fan of hospice care for terminal human patients instead of extreme medical treatments that extend life by only a small fraction.
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