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Hi. My family is very complicated. My mother and grandmother haven't talked in probably almost a decade. They hate each other.
Recently my grandmother has been showing signs of dementia and she needs help. My sister and I are only in our 20s. We dont know what to do or how to help her. I've told my mother all about whats going on and she refuses to help at all. All we need is to get her to an assisted living or something but I don't have the legal power to do so. I feel so stuck. I dont feel comfortable leaving my nana by herself because she falls and forgets things. She lost her phone and keys for several days and forgets to eat. What am I supposed to do?

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You need to call Adult Protective Services in your area and report a senior at risk. They will open a case. They will assess for safety. Grandmother may be transported to a hospital dependent on what is found. They will reach out to next of kin. If your Mother is estranged from her own mother there is likely reasons for that. Important however will be that you not attempt to take on that you cannot handle. Grandma may need to become a ward of the State who will take over her placement if she is unable to make her own decisions. You will still be able to visit her and love on her.
If by some chance you feel competent to make care decisions and to manage grandmother's affairs you may be appointed as temporary guardian through social services should grandmother need this. Do know this is a difficult difficult job including the handling of finances which need meticulous record keeping or can land you in a world of woe with charges of elder financial abuse.
Don't take on too much right now. Request a wellness check with APS in your area.
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Who has the legal power of POA and Conservatorship over your grandmother? If it's your mother then she needs to turn it over to you or one of your siblings and that can be done through the probate court in the town where your grandmother lives. If no one has it, then you can petition the probate court to appoint you as her conservator. Then you will be able to place her in AL. You will also be legally able to employ in-home caregivers to live with her and that might help. As POA and Conservator you will have absolute control over her finances and assets. You must pay her bills, expenses, and the cost of her care out of her funds. The court will also make you answer to them and show the financial records every six months (usually) if you're appointed. You are also entitled to draw a salary from your grandmother's funds as payment for being POA and Conservator. You will have to discuss this with the probate court first though. Your grandmother will need to have a lawyer represent her for this process. Sometimes the probate will appoint one to her so the family won't have to look for one.
Don't be too hard on your own mom for refusing to be a caregiver to hers. You don't know how her life was growing up. I find that when adult kids refuse to help their elderly parents the reasons for refusing to do so are always valid. Good luck and I hope things work out for the best.
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JoAnn29 Nov 2020
POA has to be assigned. As a POA you cannot turn over your POA responsibilities to someone else. Only the personbwho did the assigning can revoke and reassign. In this case having a dementia means this can't be done.
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BurntCaregiver is right! You need to establish legal 'control' over nana and take it from there.

Please don't be too hard on your mom. I am moderately estranged from my own mother and I know I'm being judged very harshly by people who don't know, and never will know, the whole backstory.

However, I have zero say in any of her care, so I can sit back and just be an observer.

It is daunting, but not as bad as it sounds. I wish you luck in finding a new situation for your nana and peace for you as you make these choices for her.

You are beyond kind to do this. God bless you!
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Your mother does not have the legal power to put your Gran into Assisted Living either, not unless she has POA.

But it sounds like from your description that your Gran needs more care than an AL will provide.

So what are your next steps? Gran needs a Needs Assessment, this will determine how much help she needs for her Activities of Daily Living (ADLs) and what level of care is appropriate. You can contact her doctor, a local seniors agency or APS to ask about the needs assessment.
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Your question is worrisome... the “what can I do, no one else can/will help” scenario often ends up with the concerned relative taking over the elder’s care. It’s wonderful that you care so much for Nana! You have a good heart. Problem is, your good heart gets stomped in the ground when all others leave the caretaking to you.

Whatever you do... do not move in with Nana.

Do not move her in with you.

Do not quit school/work to care for her.
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If your mother and grandmother hate each other why would you think your mom getting involved would be a good idea? And what do you expect her to actually do as I assume she doesn't have POA? Call adult protective services and have them direct you in finding a place for your grandmother. Under no circumstances should that place be your home.
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"All we need is to get her to an assisted living or something but I don't have the legal power to do so".

Correct. You have the clarity to see the issue right there.

Nana needs help but she can't or won't accept it.

So you are now in the *awaiting a crises* to get any change happening.

Follow the advice to involve APS.

Maybe call Nana very night to check in? Advice her local Police you may call for welfare checks if she does not answer.

Call EMS if there is immediate danger, fire or a fall. Especially falls. If you respond to her phone call & go & pick her up it won't change. Either call EMS & meet them at Nana's house, or even better, at the hospital. If there is no trustworthy adult at the home there is more chance they will transport her. (This has worked for me!)
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Unless your mother has powers of attorney for your grandmother, she is in the same boat with you and your sister. Grandmother must agree to get help unless a doctor declare her "mentally incompetent." Without anybody having a power of attorney, the state may assign your grandmother a legal guardian. This person will make decisions about your grandmother's care at that time.
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How awful for you. I am so sorry. Contact Council on Aging in your area for resources to help.

Is your nana on Medicaid? Start looking at nursing homes. She can’t function alone and it is too much for you to take on.

Best wishes to you and your nana.
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Your Mom does not need to care for her Mom. If she has any obligation, its to make sure that her Mom is safe and cared for. As said, don't try to do this yourselves. It will put your lives on hold. Are there no Aunts or Uncles, if so contact them.

I would call APS. Let them evaluate and see what kind if resources there are available. If they feel GMa needs 24/7 care and Mom can't provide it, you may have to allow the state to take over. Do not let them tell u there is help for you to take advantage of. Just had a cousin go thru this and was given very little info on how things work. Wish he had me involved to a point because I would have asked certain questions he was not aware of. He called me after the effect.
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jacobsonbob Nov 2020
Yes--beware of someone telling you "we can help you make this work" if your Nana ends up in the hospital and is about to be discharged. and the hospital staff tries to get you to take her home or otherwise live with her to provide the hands-on care. As others have said at various times in this forum, it never works out that way, and the hospital has simply "washed its hands" of the situation.
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Could you ask your grandmother if she would like to give you a POA, (Power of Attorney), so you can help her? If she does not already have one, and if she trusts you, it would allow you to act on her behalf and screen any potential financial dealings. "Showing signs of dementia" does not necessarily mean she incompetent, unless she's been legally declared to be so. The financial POA (not medical) is the one you want. It is a short and simple form which can be downloaded from the internet. The financial POA allows you to sign business or financial documents for her if needed. You don't need an attorney for this,
(however, advice from some experienced person might help. And I have no professional expertise... just know what has helped in my family).

You need to have the POA notarized and hope she can remember to ASK you to check any agreements (sales or otherwise) before she signs! This may be a way to protect her from unscrupulous persons that might try to take advantage of her. And the authority this document gives you may help if you need to get her into a care facility.

Then, of course, seek guidance about what kind of care she needs and its availability.
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If it is your biological grandmother you can get power of attorney and prkvide care for her. I went through the same thing with my grandparents. My grandfather had dementia an my grandmother was legally blind n both eyes and no one in my family wanted to do anything about there care. So i steppedbjn and took over I cared for them till the end. U have to go to ur nanas doctor and explain that she needs inhome care. Express your concerns and the reasons for them. And you can obtain power of attorney through the banks for financial but your grandmother has to be with you and agree to it. I wish you the best of luck. And i hope this was helpful.
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From reading your post, it doesn't sound like there is an issue that your nana doesn't want help, just that she needs help and you don't know how to help her. I have been caring for my own mother for several years. Dementia only progresses and as a caregiver, it will forever change your life. You are too young to take this on. Start with her doctor and he/she can direct you to the proper agency to help you begin this process. It is not a unique problem and help is available. Your county Department of Social Services, Department of Aging, or your local Alzheimer's Association are also good starting points. They have counselors available to talk with. My heart goes out to you on the long journey ahead.
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jacobsonbob Nov 2020
Yes, the OP is too young, mainly in the sense that the time spent on hands-on care (which could stretch out to several years, or a decade or more) is too valuable at that stage of life. Those years need to be used to plan the OP's (and sister's) own lives rather than investing that time caring for an elderly person whose condition will only deteriorate. All decisions are a matter of deciding what is the best use of resources, whether time, money, or other factors (or a combination of these), and in this case the OP's life is the highest priority, and decisions should reflect this. Let the professionals do the bulk of caring for the grandmother.
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Would your grandmother be willing to go for medical help to get a diagnosis. While you may see signs of dementia, there could be many things which create an illusion that she has dementia. Falling can be a ear wax or ear infection, lack of hydration or like you said forgetting to eat. A bladder infection can also be the cause of certain issues. While I am NOT discounting that she may have some form of dementia setting in, I feel that it is important that you report this information to her primary care providers if you know them or get your grandmother to see her.
Who is the Durable Power of Attorney, does she has one? If not you could first ask grandma for DPOA. However, this does not give you much authority to do anything, As long as your grandmother is not considered incompetent, she can live wherever she wants, spend her money any how she wants and do and go anywhere she wants. Getting guardianship is another option, however, again if she is not considered incompetent, she can fight you in the courtroom, and you will have spent a great deal of money for a mute point.
IMO the best thing that you can do is to get her to a doctor for a complete physical, then get her to a neurologist for examination for her dementia traits. Make them aware of what you notice. However, be warned she can refuse to go and you will not be able to do anything. You can talk to Adult protective services and file a report about your grandmother such as her inability to properly care for herself. They may or may not do anything.
See or talk to a Elder Law attorney to find out what options exist.

Best wishes to you,
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AL is very expensive! If your nana does not have the resources, then she has to get on Medicaid and they will pay for a nursing home, but that is a long miserable process (I have done it) and you should not have to do this. The Medicaid process will take over your life. APS is the best way to go in that case.
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Dear one,
You have the power to sumond a social worker as a relative because you have Duty of Care as every human being does with one another. Do not rely on the opinion of your mother as she actually doesn't want to be involve (and she is laying also the foundations of how she would like to be treated when she is older and fragile).
A social worker will assess your granny's condition and bring carers at specific times when support is needed (personal care, meals and medication for example). Provide emotional support for her: visit, phone and take her out -even for a garden or park-...connect. It is highly rewarding as you bring human companionship to her life and sweet memories to your heart when she's gone.
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helenb63 Nov 2020
I think it's a little harsh to perhaps imply that the mother in this case won't deserve any help when she is older because she has a difficult relationship with her own mother. No one else can know the pain and damage an unloving mother can cause, so I don't think anyone should judge the mother here unless they know all the facts.
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That is very sad. Must be a lot of bad blood between them. It shouldn't have to fall totally on your shoulders. I think social services might be able to help you. You are a good person to care. Good luck.
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Does your grandma have other children or any living siblings who can help? Has grandma made a will, designated a power of attorney or other legal documents?

Is she getting her bills paid and taking her medicines on schedule? If grandma is handling these items okay, then she may be competent to make her own decisions. If not, then follow the advice from others about getting her help.
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You have received a lot of good information from the others. If I may suggest,Do no jump in but instead, if you want to help without being inundated, maybe contact her health insurance company and ask for a social worker or a case manager and they will be able to help you figure out what your nana needs and get you on the right track. Some Medicare plans cover in home care and assistance, they will also be able to assess her situation and report back to insurance company what her needs are with recommendations. Hopefully you have a better relationship with your mom than your mom and grandma. It is not your responsibility to fix this. But it is sweet that you want to help💝
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Hmmmm - a very frustrating situation. First, I want to say don’t judge your mother. I am an only child of a very abusive parent. My childhood was traumatic. We hadn’t spoken for many many years but I stepped in and now manage her finances. But I wish I hadn’t and I wish I had let it go to state guardianship. I manage things from a distance and have very little contact now. So your mother may have very good reasons for staying out of the picture.

Second you cannot take this on by yourself. It’s all too complicated and you have a life to live. There are experts out there in the field. My mother never wanted anyone to be her POA. She thought that she would be competent forever and life would just go on. She didn’t recognize how her life was falling apart and her health was failing. She still thinks she can drive and live on her own even though she cannot even bathe, toilet, or dress herself. I would recommend contacting Adult Protective Services. Explain your concerns and tell them she has no caregiver. They may find her competent or they may be able to help her with some in-home services to start. My mother refused all help and it wasn’t until she had been sent to the hospital twice and was found to be in a bad situation that I was able to intervene and get her to a safe place. But before that, she refused all care and Adult Protective Services found her to be “just fine.” My mother was great at covering and the best liar in the world!

Third, I work in tandem with my spouse and daughter. I have done the hard work of pulling all her paperwork together, talking to an elder care attorney, finding her an affordable AL and paying her bills. I communicate with her professional care team. But I have no contact with her. It was too traumatic for me and she was very abusive, even with dementia. My daughter does the hard work of visiting with her on occasion and fielding her many crazy phone calls. My spouse will run errands and provides me with tons of emotional support.

I never discussed much the history of my abusive relationship with my children. I worked hard at giving them a better life. And my mother appears to be a sweet and caring person to the outside world. But she has isolated herself from almost everyone due to her behavior and likely undiagnosed mental illness. I tried many times over the years to point my mother in better directions so she wouldn’t have to live the life she does now. But was always met with hate and scorn.

No one should have to care for a person they hate.

If you have a good relationship with your grandmother try asking her what her wishes are when she needs help. See if she has put together any paperwork. Call Adult Protective Services. But don’t expect a miracle. You may have to wait for a major health crisis for anything to happen. And don’t expect any Hallmark moments.

Please keep us posted.
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NavyVet90 Nov 2020
Great advice! I am with you, especially the "No one should have to care for a person they hate." I also dealt with toxic parents and couldn't stand to be in the same room as my abusive sociopathic father. Yet I got stuck with all the responsibilities of their care. I have no children and certainly didn't want to become the parent. My 'Golden Child' siblings offered zero support, financial or emotional. Of course the 'better' parent died first. I already had PTSD and the stress of the past 3 years nearly killed me, ruined my health and my best retirement years that I'll never get back. At least the pandemic lockdowns gave me the excuse to finally go No Contact with Dad. (He passed at the ALF in May.) Caregiving will take over your entire life in the best of relationships. I'm sure the OP's mother had her reasons for being estranged. I hope the OP doesn't put her own life on hold to get involved. Leave it to the professionals I always say.
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I'm sorry you are going through this as you and your sister obviously care about your nana. Alva Deer's first response gave you some good advice, and to call Adult Protective Services as a first step.

If you are still reading here, do you know why your mother is estranged from your nana? I agree that there is usually good reason for it, but I can't help but wonder why your mom wouldn't at least help YOU? You have valid concerns for your nana's wellbeing and safety, as does your sister. Can't your mom stay away from nana if the situation is that bad, but help you and your sister in the background even if it's just to get your mom under the guardianship of the state? At least then somebody is watching out, and this doesn't fall on you and your sister.
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Who has Power of Attorney/ guardianship? Frankly why do you leave this detail out?
I assume your Mother does not have these powers?? I assume there are no other children IE your Aunt and Uncles?
First find out who holds this power? Perhaps your grandmother has not surrendered this authority??

You and your sister are legal adults and your are a family member. Your age is not an excuse to avoid stepping in. I assume you do not have the obligation of raising your own children yet or are married so candidly you have the time and freedom to help here. It is not uncommon for grandchildren to step in and step up. You and your sister simply need to invest some time getting educated.
First you and your sister should sit down with grandma, have a note pad. Ask questions in a manner that she will answer you. IE give her time.
Ask if she has a will? If she has a will ask if you can read it? Ask if she has assigned a guardian and a POA? Ask what she wants to do? You need to determine if she is going to accept change willingly or will it be a struggle?
If you elect to get involved you will need to get a clear understanding of her financials.

Your Grandmother may already have plans set up they just have not been implemented??

Find your local or county Senior support organization. They will have people there that can give you guidance. as far as your grandmothers state of health reach out to her primary Dr and get their insights as to her current state and prognosis. Candidly not eating for multiple days, falling these are signals that should NOT be ignored. She may be purposely trying to end her life thru starvation. I mean if her only daughter has abandoned her and she is alone, think about it.

BTW losing the phone. Switch her back to a plugged in the wall land line that way she will always know where it is. Get one with a good speaker phone. Best Buy sells them.

If your Grandmother has an attorney? Meet with them and find out what kind of plans if any your Grandmother already has in place. Normally a Will will already have a guardian designated.

If your Mother is unwilling to step in, there are no other siblings, and you are genuinely concerned about your grandmother you and your sister may have no option but to step in. BUT keep in mind in todays world these commitments can drag on for years. And your grandmothers condition will NOT get better it will only worsen. If you take this on it will be a tremendous learning experience and has the potential to help bring your family closer IE Mom and her Mom may have some sort of reconcilation. But it will be work and once you make the commitment it is difficult to unwind. This is not a "Ill try and see how it goes" If your approach is a "try" you need to have an alternate lined up in case you can no longer handle it. Best of success
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This is a difficult situation for someone in their 20s, but it's doable. Ask for help when you need it. Before you call Protective Services, which can lead to putting her under State guardianship (which is often terrible), have a discussion with your grandmother. Hopefully your grandmother is willing to move to assisted living and may just need some help finding one and moving. Much depends on her financial situation. Many states and cities have free counseling for elders so that she can take advantage of programs for seniors. Social workers often know how to direct you to the right places for information and help. Are there other children besides your mother who could take on some of the responsibility? The person who is willing to take responsibility should get Power of Attorney (POA) for her financial and medical decisions. You get POA through a legal document and it would be best to have an attorney help you. Your grandmother can pay for an attorney from her funds. In addition to POA, she should have a will if she has assets (like a house, car, accounts or investments, etc.), a living will (this has her medical directives, such as no resusitation, no feeding tubes, no heroic measures), and some banks also have their own POA forms. You grandmother needs to be able to sign all of these documents. If you will be POA you should get a copy of the POA, will and living will documents. You may have to go with her to the bank and the attorney to get these documents signed. Once everything is in place, it's not so difficult if she is willing to move to an assisted living facility. The other way is to hire aides to go to her house daily or a few times a week to help her with shopping, make sure she's eating, etc. It's harder, in my opinion, to watch over aides than it is to make sure an assisted living facility is safe and taking good care of her.
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You should look into in-home care for your grandma right now. I would not push her into a facility right now. People tend to do far better in their own home and you have more control over what is going on that way. So many facilities are on lock down yet. It is horrible and the people inside are getting increasingly depressed and loosing contact with those that love them.

There are programs out there that can help with paying for in-home care too. We have one here called IRIS. But their are others and it varies state to state.
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If mom is the only child and refuses to help, then start checking in to assisted living yourself. If there are any other children, talk to them. There's no reason that you can't help her make legal decisions. It doesn't not necessarily have to be assigned to your mom just because she's a living child.

If grandma is still coherent, would she allow you and/or your sister to help her. . . meaning. . . share personal info about her finances. You're going to have to know what her income is, what is in the bank acct(s), properties she owns, etc. If she is not going to give you access to those things, you probably need to talk to g'mas doctor to see if he can help you. If grandma is agreeable to your help, go immediately to an elder attorney to get power of attorney and medical power of attorney completed and signed by all before something big happens.

If grandma does not want help and will not give you info that you need to help her, then you may have to call adult protective. Give them the info about safety issues so they can evaluate her in the home.

Sure hope grandma is an agreeable sort with you/your sister and at least has an interest in moving to an adult facility. Will make your job much easier if she can make the decision,
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Whatever happened must have been very traumatic for you kids. I know you love your grandmother so I suggest that you speak with her directly and then start doing your research to find a safe place for your grandmother to live and tell your mother and grandmother what you are doing. I can’t imagine what level of cruelty and perceived offense would allow your mother to sit by and do nothing for her own mother when it is obvious that her mother needs care. But other people on this forum also seem to be consumed with resentment of having to step in, and in some cases, hatred for a parent they have never loved and do not want to take responsibility for. Your concern shows that you have character and intelligence. Use it to find safety for your grandmother whether your mother likes it or not. Your mother seems to have a really big problem that she cannot conquer. Did your grandmother drown a child or beat your mother senseless when she was young ? Your mother needs help more than your grandmother. Rigidity and unwillingness to forgive is a terrible prison people make for themselves. Do what your know is right and take it one day at a time.
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rovana Nov 2020
Maybe you are being unfair to mother - she may well have had years of trying to deal with her mother who simply refuses to cooperate or even listen to advice. I can well understand why mother does not want to get involved if she has experienced (perhaps for years) her mother's stubborn intransigence. Why waste the time and energy?? To what purpose? And is it really likely that grandma would share financial/medical info needed to get care? If what is really being spoken of is that mom do the care of grandma on grandma's terms...then NO. Has to work for all parties.
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not totally sure but can you contact an office of aging for a "concerned elder" that is alone and not taking care of themselves?  they might be able to help or get things started for a evaluation.  its a shame that the mother/grandmother do not talk, but not everyone may know all the circumstances involved in that situation.  you can't force your mother to take care of her mother.......wishing you luck and maybe someone has some better suggestions.
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1. Don’t judge your mom , you were not there....
2. You and sis have your whole lives ahead of you ...
3. There are things that you can do and things you can not do.
4. Check with the “Council on Aging” in Nana’s area. They will head you in the right direction.
5. If Nana allows it, start to gather everything that might be needed to find her help. She may not cooperate .. You will need financial info, including all assets, income and expenses , If she has a WILL or if someone has a Power of Attorney in her name. Does she own her house or is there a mortgage on it . Find out her medical diagnosis if you can.
6. She needs to be some where where she will be safe and cared for by PROFESSIONAL people that are trained to work with the elderly. She need to me somewhere that you and sister can visit and bring her smiles and LOVE.
7. Her assets will be used for her care but when that is gone Medicaid can help .
Good luck and do not take on more than you can handle. Caregiving is a full time job and some times thankless..
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Imho, you could check with your grandmother's town's Council on
Aging, who should have an elder case worker and also a social worker. Start there.
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Call Adult Protective services and "ask for help". They will come out and evaluate and help you with a plan.
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