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I used to be a Sp.Ed teacher working with severe autistics (which has really made me a great member of a dev team). I had many students who could communicate, but did not have the fine motor skills to speak. High tech is sometimes more than you need. I know you're willing to spend whatever it takes for your grandmother, but in this case, a little time investment may be wiser than a cash investment.

My first suggestion is American Sign Language With a minimal amount of effort you can be communicating simply, and there's no reason to not spend more time learning more and stepping up to high end communication. I find ASL so useful that I've taught it to my friends for communication in loud bars, silent communication in meetings, secret messages we wish to pass in a room full of people, etc.

In terms of full fledged speakers, since you are not looking for a permanent solution, I'd recommend just using a OSX notebook. Open up the terminal, and type 'say hello world' You get the hang of it really quickly. On the windows side, Read Please is quite competent, and has a 30 day free trial period. Plus there is probably wifi in the hospital...

If you don't have a laptop that she can use, I would suggested printed boards. The 800 lbs gorilla in the field is Mayer-Johnson. Look around their products and see if maybe you can get away with something like their Picture Exchange Communication System. Essentially they are cards with pictures on them that can be used for communication. It's not a great system for an adult, but if you need something temporary it's only $179.

I wish your Grandmother a speedy recovery.

Google Desktop; Firefox and/or Opera; OpenOffice and/or AbiWord; and the requisite antispyware/antivirus apps, of course. Oh, and Google Desktop.
I also make heavy use of the following:

ClocX
Windows XP PowerToys (highly useful, especially TweakUI
Notify CD (bare-bones but elegant CD player)
ReadPlease (text-to-speech)
Foxit Reader (a much faster PDF reader than Adobe)
Trillian (multiple IM)
foobar2000 (audio player)

The "incredibly realistic text-to-speech converter" isn't so much of a online desktop-app replacement but a demonstration of the AT&T Natural Voices extension for desktop software like ReadPlease and TextAloudMP3. Highly recommendable though.

Here's the advantage: I can't afford AT&T's excellent Natural Voices and other commercial offerings that make the standard free stuff that comes with your OS sound like crap. Its not just aesthetics, the free voices are simply difficult to understand most of the time. Download Coolspeech(share) or Readplease(free) and find out for yourself. Yuck.

Considering the link has been slashdotted already, I can't listen to tell you what kind of voice they're using, but if its a good commercial voice then more power to them. If its just Microsoft Mary, or whomever, then you're right its a waste of effort and bandwidth.

What better way to be easy on your eyes than to have your computer read to you? I use a text-to-speech reader for E-texts. The free versions (as if I would buy software!) Readplease 2000 -Can read very long passages, very good for reading e-texts (I've used it to read for 1/2 hour without intervention before, maybe longer) Readplease 2003 Sorry, they only work with Windoze(TM). I recommend you install both versions. Readplease 2000 is better for reading books, Readplease 2003 has better visibility (that is if you are going to read along with it instead of just listen) but can only reading chunks of text smaller than 16000 bytes.

Beos has fewer applications, sure, but it also has a consistent interface...

Those two things are related. As soon as you get a real rush of programmers and popularity, you can kiss your consitency goodbye. You're always at the mercy of some idiot who thinks that his "revolutionary new idea" (bitmapped buttons / custom window frame / dark grey on black text) is worth throwing own consitency and ease of use. You just can't win, they outnumber you. Enjoy it while you can.

An automated spell check is insufficient. It won't catch you when you say you posses excellent communication skills. (This is as opposed to possess. Look it up if you don't know the difference!)

One really great (windows) freeware tool I use all the time on any important written document is Readplease 2000. It reads the document out loud, making many hard-to-detect errors easy to find. It is also useful for people who are vision impaired because you don't need your eyes to 'read' the content of a document.

Some other pet peeves are the confusion of possessive pronouns versus plural pronouns (its|it's|it is|it has) and in general, messed up plurals versus possessive words.

If you're the type whose final carefully-checked document has grammar errors, then get someone else to check it! It constantly amazes me how often people whose first language is English and have an English-based university education still mix up homonyms.