What do I do when my grandfather is ready to die?

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Let me start with I was a caregiver for my great-aunt for 518+ days until she passed. My concern now is for her brother, my grandfather. Of the 2 children & 3 grandchildren, my mother and I are the primary caregivers for my grandparents(my mother's parents.) I learned alot caring for my great-aunt and try to apply it to my grandparents. They live alone. My grandfather, within the last year, has become depressed and relcusive. His sister passed away almost a year ago and he just turned 88, the age she was when she passed. He sleeps until 4-5pm, rarely bathes without repeated prompting, and refuses to leave the house. My grandma is awake at 7am and demanding. Gram is in denial thinking a dr visit would "cure" him. and tries to "make" him do chores to get him to exercise.
My grandpa says, " I wish the Lord would take me!" I love my grandparents and respect them tremendously. I'm, also, not afraid to stand up to them and tell her she's out of line with him.
My issue is from last night. He took a shower: 3 hours in a hot, steamy bathroom- showering, trimming his nails, shaving, etc. He can walk with a cane, but is still unsteady. We have a rollator which he does not use in the house. We know the steamy bathroom is not good for him, but he is resistant to change his 30 year rountine. He was so weak after his shower that 2 of us practically had to dress him and walk him to his recliner.
Earlier this summer, we contacted the local ombudsman/sr services and for a short period he was in a respite program. He refused the services and they terminated his care. Our local ombudsman is know for not being very helpful. My great-aunt was in a neighboring state which was so much more helpful. but she was in a nursing facility. I'm not opposed to putting him in a home if thats whats best for him. Any suggestions on what I should be looking for that could help him? Since he doesn't get up until late afternoon, the regular daytime aides aren't necessary.

I'm leary of in-home care since my great-aunt had some things disappear in the nursing home and while my grands arent' wealthy they have some sentimentally valuable things. My home is already filled with my great-aunts things and have no room for my grands stuff.

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I'm going to second in-home care, though I am biased and work for the Visiting Nurse Service of New York. If you are nervous about hiring someone independently, look into a certified agency. They will do all the background checks as well as extensive training for home health aides. (http://www.vnsny.org/why-vnsny/vnsny-difference/teams-of-professionals/certified-home-health-aides/) Good luck and stay well.
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In-home care can be great. We don't all take stuff! :-) Also, Hospice is appropriate - not "just" for the one who will be dying any moment. They help with more than you realize until they come in and work their magic. Just take what services you require, and hold off on the others. A visiting nurse will be able to tell about his mental state.
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He is already on 50mgs of Zoloft. Gram believes the dr will give him PT and/or another pill and make him all better- problem is Pap won't do what the dr tells him to(exercise, etc.). There's an emotional pull in that house and they both have to be "right" everytime, more than the typical bickering. Pap has heart/stroke/Parkinson's issues already. Clergy has come and Pap puts on his happy face and says he's fine. I even shoo'd everyone out of the room, myself included, and he still puts on a good showing for any visitors. He's stubborn, the Italian in him, and very proud!
He was close to his sister, but they were SO much alike and fought all the time! 16mos apart, but they could have been twins! His older sister passed 4 years ago of stroke/heart issues. He adored her! When my aunt passed last year, she was 88 and suffered for a couple years. Now, one year later, he's 88.

He still has a sense of humor periodically. I dont' know how much help in home care would be. I know he also has sun-down syndrome. His sleep patterns are so distorted tho. He's awake from 4pm -1am and sleeps the rest of the day. Twice we had visitors from out of state come to see him and I had to beg him out of bed to see them. Once he was up, he was his jolly self in front of them.

My aunt was cut and dry- he's just all over the place!
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NK:

Sounds like atypical depression, but a MH specialist will tell you for sure. I'd try Nancy's suggestion(s). Gotta get him to move and to talk about what's biting him so hard that he seems to have given up.

My mother, when depressed, yelled "Ay Diablo llevame 'please.'" I'd respond that it'd take him a few years to get ready for her and to Pura-proof everything so she wouldn't be able to take over. She'd stare at me for a few seconds, then burst into laughter. Next thing I know she'd be telling me about her problems. ... My point? Talk therapy. Give it another shot. It works.
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Gram is not off base with visiting the Doc. Granpa needs to be evaluated to rule out healt issues. Maybe getting him to talk with clergy, a Dr. will get him to open up about why he's giving up on life.
Caregiving isn't always easy, bless you for caring for your Grands.
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I don't know that gma is all wrong here... there is nothing that 'cures' but possibly he is depressed... would he be open to taking anti depressants for awhile to see if that helps??? And it is different for men.....Sonny will tell me he is fine when I can see he is not.... I just have to keep asking, and eventually he'll tell me what is wrong..... and I am sure gma's harping on him is her own fear of what she is seeing happening to him..... let us know what happens and hope that going to the Dr. will provide you with some answers.....
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Was he really close to his sister? And is he on med's for the depession? He has stoped doing things that he loved doing once that is a sign of depession, take him to the doctor and get him checked out. He may still be grieving for his sister he needs help in moving pass this.
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I've thought about Hospice, my aunt had it. Emotionally I think he would qualify for Hospice, but I think he's physically not "there" yet. I could be wrong and will look into that. The worst they can say is he doesn't qualify YET!

We do have a Sr Center that he LOVED and visited regularly. He stopped going last fall while my Gram still goes about every other week. He's very religious and even refuses to go to church. He hasn't been there since this past January and I believe thats because he's embarrassed to be seen so frail, but I don't know for sure. He's a typical guy when it comes to talking about things. He changes the subject or plays oblivilious so its very hard to tell just what he's thinking. Thank you for the support!
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Nana, what about a senior center for your grandpa? Maybe what he needs is a reason to get up in the morning. I do know however, that when a person has had enough and wants to be 'with the Lord' I totally get that. It is unusual isn't it though that his wife is still alive and he's talking about dying? I thought that was more for people who's spouse's have died after 50+ years and they're not looking forward to going on without them. Ask him what's the deal.
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Can you have Grampa evaluated for hospice care? If he truly is in end stage the hospice program could be a great comfort to him, to you, and to Gramma.
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