Should we have my grandpa get the trach tomorrow?

Each patient handles the process different. Really it would be in the best interest to go with the recommendation of the physician that has treated him from the beginning. Their are risks with every procedure no matter how big or small. You can go over the process with the doctor so you understand every aspect, but in the end if it's in your grandfathers best interest and his comfort you should let the doctor do it if that's what they think is the best option.