Addressing conflict in interaction with old grandmother

Question

tl;dr: My hot tempered grandmother has gotten even more short fused and unpredictable with age, which has lead to conflict with my mother (who lives with her) and me (who lives abroad but calls weekly). How can I address the conflict without harming the relationship?

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I love my grandmother. She had a great role to play as I grew up. However, as time passes, the effect of age brings issues that I find very hard to deal with.

The most important aspects to remark are, as I see it: - I've been living abroad for a couple of years, but I've made it a point to call home once per week (more than that is not possible due to time difference and technical constraints). My mother lives with her. I was visiting home a couple of months ago. - Her memory fades. She remembers us and some things (like the fact that I'm abroad), but she forgets the names of things and often what we've said. - She tends to draw dramatic consequences from prosaic events. For instance, if I call earlier than the last few times, she will assume I had an accident or something along the lines. - She doesn't hear well, and often pretends to have understood when in fact she didn't. My mother is often nearby and helps her in such cases, and I got her some good noise-isolating headphones, but it is still a major obstacle.

It is often enough that I tell her about my week and reassure her whenever she has some misled fear. However, occasionally it is not. Last time I was visiting, I offered to cook sometimes (periodically, but sporadically, every Sunday for instance). It was at first welcomed and even praised, but once she decided that it meant we were forcing her to eat a specific thing and refused to eat. My mother tried to remark that it was a rude thing to do, and my grandmother entered a self-deprecating state where she claims she is a burden.

Just yesterday, I was in the middle of our usual conversation with my mother, after which I would normally talk to my grandmother. Apparently my mother took the call from another room as she uses to and my grandmother interpreted that as a red flag. As my mother tried to minimize the fact and explained that it was just circumstantial, my grandmother assumed we were hiding information from her and refused to take the call. After some attempt of mediation, she took it, rudely asked for news and left after a minute. I was absolutely confused and couldn't think of anything to keep her on the phone for longer. My mother also reproached her behaviour this time, remarking that her (my grandmother's) words may be hurtful for us, who love her.

I try to understand all the complexity that comes with age, and hope to find a way to reduce the stress and anxiety on my grandmother. However, this is passing a toll on my mother's nerves and mine. We don't know how to address these scenarios and whenever they come they ruin everyone's mood and peace.

So, finally, my question is:
How could my mother and I prevent these reactions from my grandmother from escalating, ideally while also preventing them to happen often in the future?

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Edit 1: As requested in the comments, I update the question to remark that it has been a problem for years and, throughout that time, her doctors have dismissed the situation as "normal for her age" and never pointer to Alzheimer's.

Answer 1

Setting senile dementia aside (which may as well be the case here, but I'm no doctor), she may also be depressed (or distressed). You cannot do much about her behavior if she suffers from Alzheimer's or dementia (except providing her medication of course), but you could do things to ease her confusion and make her happier and less aggressive:

• Get her to the doctor and buy her appropriate hearing aids. This way she will not feel irritated from not being able to hear properly and she'll at least hear your discussions clearly and will be able to communicate better.
• Get her to the doctor for general health checks so you know if there is an underlying problem you are not aware of (my grandmother had mini strokes and we didn't figure out until she had a major one).
• Tell your mother to allow her/assign her tasks she can handle, so she'll feel useful and not a burden as she now thinks.
• Your mother should also take her for walks often or even to the movies or theater - staying home for too long may depress her and make her even more fearful of going outside or suspicious of strangers.
• Give your mother as much emotional support as you can (given you are now away). If needed, you and your mother could hire help, at least every once in a while, so your mother could rest a bit, have alone time and do things for herself. Taking care of disabled people can be very stressful and make things tense between them, so it may bring out a vicious cycle of arguments.

In other words: keep your loving grandmother healthy, entertained and busy - this is what everyone needs regardless of their age, the only difference is that an old person may need more health checks. We also tend to remove responsibilities from them because we think they cannot accomplish as fast or as efficiently as us, but this can hurt their confidence and leave them feeling useless. Last but not least, this is a matter that needs a lot of patience, which I think you'll have given you love your grandmother so much. Good luck.

Answer 2

Your grandmother is in a time of her life when things get very scary. Her body no longer works the way it used to, she's starting to forget things and more likely than not she's afraid that since she's no longer a 'useful and productive member of society', she will be left to a fate of loneliness and misery. Even if there's nothing medically or mentally wrong with her (which is increasingly unlikely as she ages) these are some very basic human emotions that are very common in people of advanced age.

Unfortunately, not everyone is capable of dealing with these kinds of emotions in a useful and constructive manner. They can be come paranoid because they feel that people are trying to take advantage of the fact that they don't understand everything anymore. They can get very scared when someone they don't recognise starts interacting with them familiarly. Having nothing to do with their time can leave them to dwell on negative thoughts too much, sending them in a spiral of negativity. They can get unreasonably angry when things don't go the way they want, often because they feel like they're losing control over their life.

In some cases, they even realise that their behaviour is only making things worse, but the frustrations and fears are just beyond their capacity to cope with and the knowledge that they are making things worse for themselves leads to more fear and negativity.

Knowing all this gives you two general directions in which to proceed: you can either try to help your mother and grandmother through this difficult time or you can decide that you have plenty on your plate as it is. clueless' answer outlines what you can do to help your mother and grandmother through this difficult time, but I felt it important to mention that it's okay to put your own life first. If you don't take care of yourself, you can't properly take care of anyone else either. Simply keeping in mind where the fears and anger are coming from can help you interact with your grandmother more positively.