My son says I am in denial about how "bad" my grandmother is, how do I know when to place her?

Time's up for Gram, hon. You've done enough. If you dropped dead tomorrow, she would go into some facility, think of it that way. This way, you can put her in a facility you have seen, and you can go visit all the time, every day if you want. Otherwise, your health is going to suffer, you life is going to suffer, it's TIME! DO IT! I tell my own kid I don't want her sacrificing her health and life for ME, I will go quietly. Why not? All my friends and family have severely diminished, I can't do all that I used to do, I don't like driving any more. Things come to an end. So it goes.

Lassie, you are wise!

If you're asking yourself this question, then it's already time.

I quit one job to take another with different hours so I could make a weekly 4 hr round trip to assist my parent. I ended up moving them within minutes of my house and when mom died unexpectedly 10 weeks later I moved my dad in with me. At this time his dementia wasn’t two bad but after 4 months he moved in to a newly built assisted living residence nearby. Now nearly 4 years later he is still there. His has declined quite a bit in the past year and is on hospice. Unless we sold our house there wouldn’t be a way he could have continued living at my house being wheelchair bound the past 18 months. His place is amazing and I visit briefly mostly every day.
You have amazing sons who are looking out for what is best for you and grandma. Check out facilities nearby so grandma can be safe and you and your sons can visit often.

If the house was placed in your name close to 5 years ago, it might be worth "sweating it out" just a bit longer to reach and pass the 5 year milestone before getting Medicaid involved. If you can get someone to help at home for a little while, that would be good. You might want to check with an eldercare lawyer to see what happens if your grandmother can get into a nursing home using private pay until her other assets are used up if this point comes after the 5-year period. (Maybe someone here already knows the answer to this--would the nursing home already "have their eyes" on the house and try to claim it could have been used to pay for her care if the 5-year point comes while she is still on private pay?)

Although I agree with the answers given here, I want for you to know that there are some things you will run into when she moves out. She will be disoriented, and may not be able to communicate distress. If you can, search for a place with great ratings given and know that all possibilities will have differences. It is most important that the staff gets "good grades". Also look at the current residents. If they seem happy, then you will have a good clue into how other folks who have already been place have adapted.
Also important is that the place is close enough for you to visit often. This is for you and your son to pay respect to her. She may not remember this sometimes, but you will. In some ways you are teaching your son how to take care of you when your time comes. You have raised a good man, and as a family go through this together with good communication, and take your time to find something that you and your mother can be happy with. God bless!

I guess I'm not surprised but it still amazes me that siblings, like your sister, are able to justify such strong opinions to themselves. She has her reasons for not being more involved and as you know she is paying the price by missing out on some great time over the years with Grandma but feeling it's ok to protest anything you feel is necessary for Grandmas care when she isn't willing or able to participate in that care at all never mind 50/50, she's way out of line. Your grandmother obviously recognized that when she was planning and had full mental capacity because she set things up the way she did, putting you on the deed and later turning it over to you completely. My grandmother left her house in trust giving my mom life use (it can't be sold until my mom decides or passes) because she recognized my mom gave up her own home, making Gma's her life home when she moved in to care for her. My mom lived there caring for GMa for 15+ years before she passed and now 12 years later still does. My mom's siblings aren't wild about it because they have no say and can't get any money out of selling it now, they need to wait and they make that clear from time to time but they also know it is what it is. I know they are torn because they know my mom did give up having her own home to care for GMa and my mom living with and doing all the main care for GMa was a blessing for them so they can't really argue the reasoning but then sometimes they do a little. It isn't a rift between them and my moms siblings came to visit and offered respite once in a while, they were still involved as much as possible given they live hours away (opposite directions) but my grandmother set things up to make sure my mom wasn't ever going to be thrown out of what she made her home and your grandmother has done the same, your sister doesn't have to like it but she does have to live with it. Your grandmother actually went one better by turning it completely over because there is no reminder or carrot for the future, the house is yours and I imagine it's way more than fair given you paid the bills there even before moving in.

As far as your grandmother goes, I'm sure you could care for her yourself if you were to make that your business, your career but it isn't. You have already had to take full time leave and that full time need isn't going to change when your official leave is up, this is not your profession so you wont earn an income for caring for this paitent, you are at the point where your entire life needs to be put on hold to keep her home which means it's time for her to have full time care and the only affordable way to do that is in some sort of skilled living situation away from home. Again while you could make it work the truth is you would be making it work you wouldn't be providing the best possible care and circumstances for both your grandmother and your family anymore. Many elders, particularly when they get so far gone mentally that their surroundings don't matter the same way to them, are much happier when they get to skilled living of some sort. They have other people, peers all around them, activity and people like them not just people who are far more capable. All their needs are taken care of without the guilt of "placing that burden on loved ones" or shame of wanting to hide the bathroom accident. The days are full and activities are easy because they are right there, I have often heard that moving to skilled living gave someone a new lease on life of sorts, they perked up rather than going down hill which is what family expected. I don't know if it will be this way for your grandmother, I don't know how aware of anything she is. But it might end up better overall and especially for her than you think.

Talk to a tax expert and an elder law/medicaid lawyer ASAP! The house title changes may not have been in your and her best interest.
Consider looking into board and care homes--usually about a dozen residents more or less, and a less institutional environment.