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It is very possible that the accusations of fraud will go nowhere, even if you don’t have documentation of what you have spent. Unless you really have been doing the wrong thing, the facts will speak for themselves, for example if the police become involved (unlikely). Yes it is a good idea to do more record keeping now. If current expenditure is clearly justified and is also in line with past levels, it is another indication that your behaviour has always been appropriate.
As Ahmijoy says, it is worth thinking about whether someone else is planting the suspicions, and doing something to confront them. It would probably be someone who wants money, either immediately or in a bequest. It is also worth thinking about other relationships in the family – make sure that the people who matter are aware of your issues, so that they don’t just hear one suspicious story from your grandmother.
However the most important thing may be to see this as an indicator that your grandmother’s competence, and the relationship you have had with her for the last 10 years, are probably in the process of change. Things will get worse, not better, so it is worth getting a range of things in order while she is still legally competent. Do you have a POA, so that you can legally manage her finances? Is there a HIPPA document, so that you have the right to talk to medicos who are concerned about privacy? Does she have an appropriate will, with an appropriate executor? Have you talked with her about her future wishes, and are they recorded in an Advanced Care Directive? Are you clear about any steps that should be taken in advance about Medicaid and Medicare issues, if the costs of her health care escalate?
Unfortunately it is not ideal to start dealing with these things at a time when your relationship is under strain. Perhaps you could think some more, and write again if you would like to work through how to approach things. Good luck!
Is it possible that someone has poisoned Grandma’s mind against you? Someone has convinced her that you’re stealing from her? If you don’t already have one and Grandma’s mind is ok, draw up a Caregiver Agreement. Ask for an allowance to buy her things. And keep the receipts! If you’re living with Grandma, what bills do you have? Would it be possible to get a part-time job and pay them yourself?
If you begin keeping all the receipts, you will be able to prove where her money went.