Demented grandmother who won't take meds or be changed

You are getting hung up on details that can be sorted out after your grandmother is settled and secure. What your grandmother needs right now must be the priority. She is at significant risk from a catastrophic fall or from infections - even sepsis - as things stand.

Your grandfather might be able to take public transport or a taxi to and from the care home. Or, since he is also beginning to experience alzheimers/ dementia, he might not accurately recall whether he visited one day a week or seven days in a week.

I wouldn’t necessarily prioritise ‘safety’ over happiness for anyone, but I definitely would prioritise the wellbeing of the family as a whole including your mum and uncle. This is in no way sustainable. Therefore I think your grandparents are going to have to go into care. Unfortunately they may also have to be separated. That would happen at some point, and most of us assume it will be death that separates us, but it won’t always be that way.

I am assuming here that there is something available in terms of social care in some form - obviously the most urgent need is for your mother to find out what that is. But does she even have time to do that while caring?

Are your grand parents connected with the Spanish healthcare system? Is their dr aware of the situation and have there been any care assessments? Have your mum / uncle contacted social services on their behalf?

you say that your uncle is living in the Netherlands but also in their Spanish apartment?

Clearly what’s happening is not sustainable, and social services have to get involved. Are they? Is your mum’s Spanish good enough to do this?

Is the one year waiting list for a place or for a funded place? I'm guessing you have been in touch with the equivalent of Adult Social Care in Spain about what they can offer. I think it is interesting when people run down what we have here to hear experiences of what is on offer in European Countries. Do they not offer the option of someone coming into care? What would happen if your mother/uncle just stopped coming?

What is priority?
Keeling your mum healthy?
Very important here.
Sad as it isyour grandmother needs way more care than your mum or uncle can reasonably give without crashing
Look at homes in spain.figure the costs.
Getting her or them on planes to uk is probably now not feasible or realistic given dementia and continence issues etc (do they even take her out locally? Or not any more? )
And find out costs but as they have assets they would pay and a dementia facility depending where in uk is 1500 plus per week. What are costs in spain?
My relative paid £2200 in uk per week but that was essential as dementia progressed. Staff ably handled her shouts when changed etc and it took two staff each time

For night time wandering an alarm alert via a doorway alarm or pressure pad may help you feel you can go to sleep even if you are disturbed.

There comes a point with dementia where a person needs to be safe, more than they need to be happy. If they don't have capacity to make that decision, someone else might have to. Is there an equivalent of power of attorney operating in Spain?

Do they have financial resources? If your grandma went into a care home, could you sell the house to fund your grandpa staying with her too?

One of the female residents at my DM’s care home thought she was running a boarding house! As she evidently had in the past. She once told me that so and so still owed her nine quid for last week!😂

Sorry if I have missed it but are they British citzens?

If your relatives return from Spain they WILL qualify for NHS treatment. NHS is a residence based system.
For the first three months they will be reliant on their existing Spanish insurance for ELECTIVE care. But any emergency treatment is funded from the point they arrive.

Agree 100%.

I have a very aged aunt who believes she's staying in a sedate hotel while essential repairs are made to her house. She is very happy there. It's a 'lovely hotel with great views' and the food is 'first class'. The other 'guests' are pleasant company and there are no young people having parties and making noise at night.

I’m a carer and work with adults with dementia. I think the single most important thing to remember when dealing with people with dementia is to never argue with them. People hold onto emotions much longer than they remember specific moments. So if you argue with them they will hold onto the anger and confusion for much longer than they will remember the specifics of what they were arguing over.
So when trying to get someone to change their pad for example you try once, if they are not willing then walk away or change the conversation for a few moments. And if your with someone long enough you tend to get to know how long they will remember a conversation for. Once that time has passed you try again from a completely different angle. And you keep doing that until you get where you need to be. But you have to keep the emotion and frustration out of it. Or you won’t ever succeed.

It does sound like your grandparents need more help than it’s realistic for their children to provide. So I would really encourage them to try and find either a care home or home carers to take the pressure off.

Sorry, but that’s rubbish. People with dementia will so often have needs, serious needs, that, sadly, often have to trump what they want. A person with dementia is often just unable to understand that what they want simply isn’t possible.

My DM would certainly have liked to stay at home, rather than move to a care home, but had no conception that she could no longer even make herself a cup of tea, and e.g was constantly locking doors and hiding the keys, so that in any emergency, like fire - and she’d already managed to set fire to the kitchen once - she couldn’t have let herself out.
I could go on…
In short, she simply wasn’t safe to be left alone at all any more - a care home was the only viable option. We did look into live-in carers, but since she was up and down and wandering at night, that would have meant more than one on shifts, which worked out rather more expensive than the very good care home we found for her - with all the costs of running a house on top.

Honestly you’re going to have to get social services involved and get them both the individual care they need. You can advocate for them staying together, but this isn’t safe or really working for anyone.

That doesn’t make a British care home necessarily the worse choice for the grandparents. Even with the weather difference. And would certainly be better for OP’s family - who will still need to oversee the care and visit even once they are in a home.

With all due respect, this seems to be something that needs sorting sooner rather than later.

It doesn’t have to be done in the depths of winter. Other than the weather, a British care home may be less of a shock, depending on when and how well they learnt Spanish.

If she’s refusing pad changes is the skin damaged? Getting a GP to refer to hospital would be a way of getting her in the system (assuming it’s the same in Spain) and then into a home. There comes a point where what they want is not deliverable or realistic, and all involved need to stop breaking themselves for a fantasy.

What a crazy unsustainable situation. The only option is a care home for both of them in Spain. It will only get worse. And they can live without each as my in laws have done for the past 2 years. Both have dementia but mother in law is significantly worse and in a care home.

Not countries. Is it in their best interests? A local to them care home may be but a huge move to the UK in the depths of winter?