Sadly, it looks like my grandma is taking a turn for the worse. She's the one who had a bad fall while out rambling in the countryside the other year. Recently, she is starting to show memory loss, some of it significant. Right now, it's not hampering her life, but we've been warned that it may start to be more of a problem for her. So plans are being put in place to help her keep her independence for as long as possible. However, she'll probably need to have more support than she currently has where she's living.

It's a case of "brace yourself" - she's been as sharp as a razor until fairly recently - my visits have always been subjected to me given pages from various magazines to read and then discussions about them - subjects from Stanley Kubrik's filing system to that new hung Stephen Fry's been on about have been discussed. But last time there was less of that, and we had confusion over my birthday present this year. She could not remember if she had sent me something (she had, so I made a big point in telling her what I bought with it).

So changes afoot, not all good. We'll be doing what we can to keep her happy and comfortable. My mum's there this week sorting out her flat which needs some refurbishment.

It's never easy when changes like this occur.

Several of Best Beloved's elderly relatives went through slow degradation of their faculties, and it was hard to bear sometimes when we'd known them in their prime. The elderly friend who died a couple of years ago, had been as sharp as a knife for most of the time I'd known her. Like your gran, she would catch me out and test me, and hold lengthy philosophical discussions long into the night. It was terribly hard to watch her slip away, where a series of strokes had robbed her of almost all her remaining dignity. In the end, we think she just gave up the struggle. She had no life left to live, and there was nothing we could do to help.

I guess it's one of the inevitable side effects of ageing. The longer we live, the more likely it is we will lose some of our mental agility. I hope I can manage to hang on to most of mine to the bitter end. Not for me mouldering in a grotty home somewhere, surrounded by crumbling wreckage, if I can help it.

Sorry to hear that. That happeded to my grandma too. It started with short term memory loss (ie repeating things she'd just talked about) and over the last couple of years before she dies, it got to the point where she didn't even recognise her own family.
I hope that doesn't happen to yours.

I've seen this happen - some very wonderful people can decline, and it can vary in the steepness of decline.

I hope you cherish your moments together.

I know it's a bit hard to think about these things and might come across as horrible to mention these things, but I think now might be the best time to do all of the important things. Get her to make a will, an advance directive. Think about resuscitation status. Think about lasting power of attorney. What does she want? What does she want if she becomes more confused and needs more support? What does she think about residential and nursing care? Have you thought about costs involved?

I can't remember if this is the grandma who is married to your grandfather who has only recently come out of hospital. What about his thoughts and wishes? What about the impact on his life if she gets moved in to a NH/RH? What about his support, social life etc?

Well, it was my dad who recently came out of hospital. She's my sole surviving grandparent.

I know she has a living will. It was placed on a table prominently when I visited her a couple of years ago. She didn't mention it, but I was certain that I was meant to see it. I told my mum, just in case she was unaware of it at the time (she knew), and I reminded her of it more recently. I think they have had such conversations any way.

My grandfather - her husband - was a doctor, and a very highly respected one when he was alive. My grandma is very scientifically minded, and has a medical background herself (not in a capacity of a doctor, but in a laboratory basis).

So she knows the score, and has clearly made decisions while she was more capable. It's a bugger to have to think about such stuff, but she's clearly helping us make those difficult calls by leaving instructions. My mum is with her this week, as I said, so all this is being talked about. You have to go fairly gently with her in this area, but she's seeing the sense for some changes being made already. All the legal stuff is starting to be planned and plotted. I know my mum has access to the bank account now.

So it's in all in hand. Her GP feels it's important for her to keep as much independence as possible, and he feels that her strong character is working in he favour. I'll mention the stuff you have to my mum just incase she's missed anything out.

I agree with keeping independent as possible - it really helps from a mental/psychological perspective.

Apologies about the mix-up between grandfather/father. Honest mistake.

IMO, it's about "best possible outcome" and "worse possible outcome" - eg what are you going to do if she goes completely nutty and starts running around the streets, stark naked and refusing any help, becoming violent against her own family. It sounds funny and implausible but it's happened! It'll be frightening for her to think about these things, I'd imagine, but planning ahead can help deal with problems in the future if they happen, eg if she gets admitted with pneumonia, is confused and refuses to take her antibiotics.

As many of you know, Best Beloved is no spring chicken and has been declining in health a little since his diabetes and sight problems kicked in. He's still mentally agile, and able to fend for himself, but Paul's post has prompted us to begin discussing about the future.

In a way, it's a good thing that such things can be talked about openly before events overtake us. We're certainly wishing you and the family well, Paul. It's not fun, it's true, but it has to be for the best in the long term.

Thanks. Glad I spurred on some conversations elsewhere. I feel it’s best to have plans in place sooner rather than a mad scramble later.

I just had a further thought - one you may well have already had and acted on, but still...

While you still can, take a camcorder and set it up to record your Gran while you talk to her. Get her to recall her life, her experiences, her reactions to events and so on. It will be therapeutic for her her, and preserve her memories for your family. It's her history and is part of your history.

I once recorded my Dad's Mum when she was with her sister. Damn me if I haven't lost the tapes, but they told funny stories and reminisced about their early life. I wish I'd looked after them now, because I really miss my Nan now she's gone.

Sorry to hear that Paul. You're definitely not alone.

That's really good advice Heather. I wish we had more footage of my grandparents. Still, my Dad has a load of his fathers diaries from WWII so they are quite interesting.
Sadly my own Gran (last surviving grandparent) has been slipping in the memory department for some time. We're extremely fortunate that my uncles and mum are able to take turns looking after her in her own home. She knows she's gradually loosing it but actually getting her to admit it's a problem can be difficult at times. I phone every week and quite often have the same conversation 3 or 4 times in a row.

Did anyone else catch "Can't Take it With You" on BBC 2 earlier in the year? Sir Gerry Robinson presented a series about the importance of making a will with real families as the examples. I really wish someone else in my family had watched it.

I took a verbal account from my grandparents to stick into a journal (something to hand down generation to generation) but that video idea is even better.

Yesterday was troubling. She has got worse very rapidly. I had to do an emergency food drop yesterday, and she's very hard work. The incisive mind is still at work, but now instead of what we used to be able to talk about, she now believes in some grand plot against her. Her questioning was Orwellian in scope and sadly very cyclical.

I managed to see her district nurse before I dropped the food off, and the assessment so far us that she gas short term memory loss, and she's nit in any danger. There are health visitors calling in a few times each day to check on her, get food ready and monitor medication. Next week more assessments are taking place, and a memory test is scheduled in another week or so.

So things are in hand, but the situation is now more immediate than it was.

I'm sure I speak for others when I wish you and your family all the best with what must be a very difficult situation.

definitely, its a bad time your going through but all our thoughts are with you.

My thoughts are with you.

My concen is now what happens next? It's not too far of a jump to go from believing there's a conspiracy to believing everyone around her is there to get her. If she slipsto this state, things will be very difficult to manage. Unfortunately, you can't predict it.

This reminds me of when I was first let loose on the wards. One of the elderly female patients wanted to call her family. I helped her from the bed, assisted her to the phone and showed her how to use it. She called her daughter and then told her that there was a coup and she was being held against her will, and all of the staff were imposters. I didn't know whether to reel in horror or start laughing. Thankfully one of the nurses smoothed things over with the daughter and led the patient back to the bed.