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She isn't waking up and has low temp and elevated blood pressure and heart rate.

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Well, I am happy this question is here today. I have been telling my partner's nurse (comes once a week) that he is always cold, drinking less water and food intake is lowered. He has tremors, but he has been diagnosed with Parkinson. I am not going to call 911, as if this is an end of life issue, he is ready to go. He is so tired of all the pain and never ending day after day same activities. He has signed his EOL with refusal of NDR and no artificial nutrition. I keep him comfortable and warm. I suggested to the nurse the other day that Hospice might be in order. But, nothing is being done on that. I had the same problem with my husband. I kept begging for Hospice and the night before he died, the doctor finally order Hospice. He was never able to use them. It was too late. So sad. Now I hear you can call Hospice direct. Is that true?
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SO many opinions---I agree with CFC Rochester. My mother's EOL plan specifically states she wants NO outside intervention should such a thing occur to her. No ER, no dramatic measures, comfort only. Moondance is right, at 93, she's likely making the transition from "here" to "there". GG did this, and she was in a NH and up to the morning she died they were encouraging her to eat and to try to get up and walk. This is what made Mother decide she would NOT put us through that. Still--your call, not ours. You haven't provided a lot of background.
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I agree 911. She has dehydrated or has a UTI. Both serious and nothing u can do.
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To me, it sound as if she will be making the transition out of body SOON.
93~she has had a long life. PEACE~BLESSINGS....
When one is getting ready to transition out of body, they stop taking in fluids & food~it is a natural process.
PEACE~BLESSINGS....
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Does your grandmother have a Living Will? A Health Care Proxy? Now is the time to get those documents out and read them. Calling 911 might not be what she wants. As has been mentioned, calling Hospice might be a better choice. You won't want to put her through 911 if that is not her end-of-life wishes.
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My mother is cold all the time, even when it is warm in her room. So I put a sweater and blanket on her then she is better. She is in a home and I have told them about this problem. I hope they are taking good care of her, it worries me.
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If my mother wouldn't wake up and had these symptoms, I would call 911 right away and have her taken to the ER.
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I would also call 911 and have her taken to the ER. It sounds as if she needs immediate help, starting with rehydration and nutrition. She could easily be cold and tremoring because of her debilitated state.

I'd make that call NOW.
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Or you can call 911 (in the US) and have her taken to the hospital for help.
They will get the crisis under control, and there will be a social worker to talk to about next steps after the hospital. You might learn a lot from that person!

If you can fill out your profile more, we might be more help. Where are you?
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Increased blood pressure and heart rate are symptoms of dehydration. It doesn't sound like you can get her to the Dr. I would call a hospice provider. They can act fast. They'll come to your grandma's house or to a facility if your grandma's in a nursing home.
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I wish I could help with advice, but I don't have any training in this area. I think I would check with her doctor and see if Hospice might be in order. How has her health been lately? I would certainly want to keep her comfortable. I believe others here who know more about this will respond.
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