How do we care for my grandparents?

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Here are some details about my grandparents:

Grandfather:
Incontinent, forgetful, everything is done slowly, extremely stubborn. Almost fully deaf yet refuses to use hearing aid. When talking to him, we have to shout in his ear. He shouts at us as well because he can't hear himself and has a bad temper. Wants things done his way or else he throws a tantrum. Refuses to use wheelchair, walker, or wear diapers or even have a bed pad. Wets his underwear (27 pairs) every day and asks us to do laundry. Tries to get up to use the restroom but by the time it takes him to walk across the hall, he's wet his underwear. No energy. Sleeps for about 20 hours a day. Room smells of stale urine. Did I mention stubborn?

Grandmother:
Diabetic, dementia, basically no short-term memory, sleeps for about 20 hours a day. Requires insulin shots four times a day.

My mother is a widow and has been caring for them for a while now. I work and live several states away and don't get much vacation time to come home. When I am gone, my mother thinks she cannot handle caring for them all the time. Luckily, grandparents live in the same apartment building as mom and she has to visit them several hours a day and finds it hard to find time to do her own work (she works from home).

Grandparents have no insurance (as they did not work in the US long enough) but are both US citizens. They only have Medicare B and D (no A, and no long-term care insurance).

How do we take care of my grandparents and especially deal with my stubborn grandfather?

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Noblerare, please let us know how this goes and what steps you take. We all learn from each other here.
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Thank you so much everybody! It is settled then. I will get them to evaluated for nursing home as quickly as I can. You are right; my mother cannot handle this.
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I'll be brutally honest here, but your Mom's life comes before your grandparents preferences - about a third of caregivers die before the people they are caring for and honestly caring for 2 elders who needs are escalating is a death trap, pure and simple. After your mother is gone, they will have to go into a facility anyway, so why not go now and maybe save your mom's life? It is unfortunate but the reality is that if you live long enough it is up to YOU to accept the situation and make the adjustments, not your family. Your problem is your problem and not theirs. It is not morally decent for you or your mom to risk their health, maybe their life, just because grandparents don't want this or that.
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NobleRare, one option is to find out if a simpler insulin regimen might be adequate. It's very possible the answer is no, and if it is, that level of care should qualify her for skilled nursing. If you qualify for skilled nursing, that should also be when any provisions for a community "waiver" service that would get some aide and maybe nursing into the home for part of the day. Have you been able to get to a senior care adviser or comprehensive geriatric appointment, or even contact and Area Agency on Aging to come in and evaluate and see what else might be possible and necessary? If you are having trouble locating resources, you could private message one of us with your location and we'd help hunt for contact info. If mom or grandparents just don't want to consider outside help, that would be a real judgement call whether to override that or not.
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I still say that it doesn't sound like the current option, them staying in their apartment with only your mother for help, is a viable one. Would the option of having someone(s) come in 4 times a day work? Could you find someone to do that?

And then what about grandfather's incontinence? Who will manage that? And now his health has taken a turn for the worse. Who is nursing him?

Keep checking your options. I'm sure you will feel better if you can know in your heart that you did your best to find a way to keep them safely at home (while safeguarding your mother's health). But be prepared for the possibility that even with your best effort there may not be an affordable way to keep them home.
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That's what I feared but perhaps asking a home care representative to come out four times a day would be okay as well? I don't think grandparents are ready to make that step yet. Very stubborn and set in their ways.
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Good grief! Things don't sound good at all. I feel for you and your mother. These folks need to be in a care facility now. I know it may not be easy but your family has to make this happen.
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I am very sorry to say it, but I also feel GMA and GPA need to be placed where they can be cared for around the clock. This is sad, and I don't suppose it is what you hoped to hear, but unless you can arrange 24 in-home care, finding a good place for them is the kindest thing you can do.
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noblerare, GMA needs a nursing home if she needs a nurse four times a day to check her sugar and do her insulin. sorry.
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Hi everybody, is there any suggestions as to how I can find someone to come four times a day (or at least a few times a day) and give my grandmother her insulin shots? My grandfather used to do it but since his health has turned for the worse, that job has fallen to my mother. She has been doing it for a week now and it has taken a toll on her schedule. She can't go to any of her other weekly obligations anymore because she has to give grandma shots at 9am, 12pm, 6pm, and 8pm. Is there any home care that can do that for her (if only two times or something like that?)
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