I don't know if I should call my abusive grandmother

You don’t have to call her.

Your safety and stability still matter, even if she’s vulnerable. Being senile doesn’t undo what happened, and it doesn’t automatically make contact feel okay for you. If anything, it can make things more complicated, because you’re dealing with a version of her who may not be able to take accountability in a way that gives you closure.

That fear of guilt is real, but it doesn’t automatically mean you’re making the wrong choice. People carry regret in both directions in situations like this. Some regret not reaching out, and some regret reopening contact and getting pulled back into something painful.

Calling her has been stressful for you in the past, and that’s your body remembering something real. You don’t have to override that just because other people want something from you right now.
If contact would cost you peace, it’s okay not to do it. And if you feel like you need to do something to ease the guilt, it doesn’t have to be a call.

You’re not her emotional support system by default, even at the end of her life.

If you don’t call, what you’re feeling may not actually be guilt. A lot of the time it’s grief for the relationship you never had, or empathy for a confused elderly person. You can hold empathy for her situation without being directly involved.

And if you feel like you need to do something to settle your own conscience, a phone call isn’t the only option. Calls can be high pressure because they require you to respond in real time and can easily turn into something emotionally draining.

A lower;stress alternative would be something like a short message or card, for example:
‘I heard about your injury. I hope you’re staying comfortable and that your recovery goes smoothly.’

That kind of response acknowledges her as a person and recognizes what’s happening, which often eases that internal pressure without opening the door to a long or stressful interaction.
And about the fear that this sets a precedent: that’s a valid concern. If you do choose to call, it helps to go in with a clear boundary already set, like a time limit and a simple script
‘I only have a few minutes, but I wanted to call and say I’m sorry to hear about your injury. I hope you’re getting good care and healing well."

If she’s confused or doesn’t remember the past clearly, you don’t need to bring it up, but you also don’t have to pretend everything was or is fine. You can keep it grounded in the present moment.

As someone who was abused as a child, I can only share my experiences with you - knowing that everyone is different firmly in mind. I have a lot of baggage, as you can imagine. I suppressed a lot of the things that my father did to me, but as I got into my late teens I became clinically depressed with suicidal ideation and sought psychiatric help. Through multiple years of therapy I regained many of my memories, and realized why I would get migraines every time I visited my parents home. My psychiatrist told me I needed to confront my mother about her refusal to intervene, and she told me I was no longer her daughter - three times. She would curse me out and disown me, and then call me crying that she didn’t mean it and wanted a relationship, only to do it again. My psychiatrist made me see that what she was doing was just another form of abuse - she was joining in to the fun. When she called that last time to disown me, I told her I was done and would never answer her calls again. It was the best thing I could ever have done. She called dozens of times after that, but I no longer deal with the guilt of causing HER emotional pain. I am emotionally much happier without the toxic relationship. You can’t let family members, who never supported you, guilt you into doing something that causes you pain. If they really cared about you they would have helped you when you needed them. They want your attention to her now, so that they don’t have to deal with her so much. Also, people with dementia tend be emotionally volatile, and could be more abusive than in the past. Put your needs first - trust me that they won’t. My mother died several years ago and I don’t regret my decision to let the relationship go without further contact.

I’m so sorry for the pain you are going through, I truly understand what you’re going through as a family abuse survivor. There are many times that I feel perhaps I should try to bridge the gap that I have put between us, having had cancer made me doubt my actions, I kept putting myself through a emotional roller coaster which was only hurting me, instead of celebrating my life and surviving this disease I would start ruminating and opening all the wounds again. I think that you have received amazing responses from the people here who know personally what you’re going through, I say to you that it’s not worth it, enjoy your God given life and close the doors to the abusers, you deserve it.

Stay away from toxic people, even if they are family. Drop the guilt and take care of your own mental and physical health. Go far away from them. You must live your life and carry on. Never let anyone else tell you what to do. Follow your own feelings. Break away from the verbal abuse. Find a way. So many women have been where you are at, including myself. Give yourself permission to to remove yourself from abusers. You will feel free, and renew yourself and your life. You must say, "it's ok to take care of myself". You are worth it. Save yourself my dear. It takes guts, but you will survive without them. Don't take verbal or physical abuse from ANYONE especially family. If there is a god, I hope she helps you. Pray to Mother Earth for help and the strength to move on. Good luck. Be free, save yourself!!! Love to you my dear!

After reading ‘Will I Ever be Good Enough’ healing for daughters of narcissistic mothers, I realized my adoptive mom was deficient in empathy and actually felt more compassion for her instead of fear. We can love people, all people, even if not their behaviors. So I was able to, during the last five years of her life, turn our phone calls into compassion instead of poor me or even poor her.Soooo many abusers have been through more than we can imagine. We don’t need to feel sorry for them and accept their abusiveness but let them know the are loves and prayed for ANYWAY. Distance helps. Boundaries are a must. Phone calls are easy to hang up with love instead of anger. In person sets us up for harder ways to get out. I would say you will never regret calling someone to wish them well but be sure to accept that it’s not you that is causing their behaviors.

My last comments were a little harsh due to my past situation. I do like the comment of sending a card to grandma. This way you are off the hook, and she know you are thinking of her and wish her well. No stress in sending a card. Protect yourself.

ehdog, I like the suggestions about protecting yourself. Protect yourself from guilt and from engagement. A card is a good option, especially if a phone call promises to be stressful. If you text her, you'll have satisfied the request for a call. But then would she have your number and be attempting to call you back.
Tailbone fractures are so very painful, but people don't actually die from them. They might die from surgery with infection. Most don't have surgery and let the fracture heal on its own.