How do I (25F) help my mom (55) help her mom (80)?

My grandma is 80 and is not in good health.

I would really appreciate insight from anyone who has been in my mom’s shoes.

TLDR of my grandma’s life: was given up by her birth parents, lived in an orphanage, got adopted, then was severely injured in a fire around age 10; she sustained many burns requiring a long recovery in hospital, and due to this she developed a dislike and distrust of doctors (this is of course understandable). She survived the ordeal and went on to raise a family in her 20s but was then cheated on in her 30s and a second marriage didn’t work out 20 years later. I came along a bit after that, and so on.

As a result of all this, my grandma is troubled and has developed a hoarding tendency and probably some kind of personality disorder. We know this and we love her anyway, however her entire life (including when she was mentally sound) she has declined treatment for most health issues. She is unfortunately overweight and inactive, does not eat a healthy diet, and has two bad knees (both have been replaced, and she is still recovering from the most recent one). She lives alone, but close to our home, and my mom checks on her every day.

As of about a year ago, grandma is definitely starting to decline mentally. I won’t bother going into detail about what happened, it’s textbook stuff. We finally got her in for neuro testing and they were able to confirm “cognitive decline,” but without an MRI scan they couldn’t confirm the etiology, and she vehemently declined a scan.

My grandma’s driver’s license expired on a recent birthday, and without telling anyone she drove herself down to the DMV to get it renewed. She didn’t pass their vision test, but was then referred to a specialist, who detected cataracts AND glaucoma but apparently (I wasn’t there) the doctor told her that after some kind of procedure (for the cataracts?) as well as corrected vision via glasses, she would be okay to drive. I wasn’t sure if they took her cognitive state into consideration (if they’re even allowed to do that) but my family doesn’t communicate well about this kind of thing, so that’s what I know.

My mom is the main caretaker in this situation. She seems more or less enmeshed with my grandma or even afraid of her at times, and therefore unable to establish authority or control over the situation. It’s gotten to the point where we ALL know that her keys need to be taken away, but my mom is declining to act, and I think it’s because she doesn’t want to deal with the emotional fallout. I realize I may be simplifying things as I am not the one in my mom’s shoes. However. This is becoming increasingly serious and I am very afraid my grandma will get in her car and something bad will happen.

I know that my mom could accept help from me but she won’t ask for it, for her own reasons. I promise I am sympathetic to this, and apologize in advance if it sounds like I’m judging her too harshly. I just need guidance on what to do.

I don’t have a car, so checking on grandma for her is not ideal, but possible if I were to take the bus. I wanted to brainstorm other ways I could help my mom, or even just communicate to her about how serious this is becoming, because it kind of feels like she is in denial.

For example: Grandma has recently announced that she is going to her out-of-state vacation home this winter, and my mom seems to have somehow accepted this with the caveat that she will go there for the first week to “get her settled in”. This sounds like a bad idea, because once my mom leaves, grandma will be stranded there with no way to get around except her car and she should NOT be driving anywhere, trust me.

I just don’t think my mom is seeing things clearly because of the emotional aspect of the situation. Which I totally understand. I’ve suggested therapy or a social worker and my mom doesn’t think she needs it. I’m just scared and kinda stuck.

Thank you so much if you read this, I really appreciate it. I’m glad a community like this exists.

TL;DR: My grandma is getting past the early stages of cognitive decline, my mom is the main caretaker, I can tell she needs some help in order to face the reality of the situation, but I don’t know what I can do.

Edit to add: my mom does have legal power of attorney but has not done anything with that