HONOLULU -- Those who know Madelyn Dunham said throughout her life she has been "strong willed" and ambitious.

Dunham's health has slowly deteriorated and during his recent visit to Hawaii Sen. Barack Obama spoke about his grandmother's condition.

"Her body is not in great shape she has osteoporosis which means she can't travel. She can't sit for a long periods of time on the plane so that's why it is so important for me to take these trips back to Hawaii," Obama said.

According to Obama's campaign advisor Dunham situation is serious. Her brother said on Tuesday she is "gravely ill." Click more to hear from him.

"She has been frail for quite sometime now," Obama said.

He calls her "Toots," short for tutu. Dunham raised Barack Obama since he was 10.

Dunham turns 86 on Sunday.

University of Hawaii professor Alice Dewey is a longtime friend of the Obamas and remembers Dunham's tenacity.

"She was a very determined person as you began to get to know her she knew her mind and followed her principles," Dewey said.

Dunham was one of the first women vice presidents at the Bank of Hawaii. Co-workers said she was a well respected business woman.

Dewey is not surprised Dunham's grandson could be the next U.S. president.

"She probably stayed on his case make him tow the line and behave himself with the best of intentions and great affection for him," Dewey said.

Obama is leaving the campaign trail at a crucial time just two weeks until the election. Dewey said she doesn't believe Dunham would ask her grandson to come.

"Well, she would say, 'If you think you should do it,' and trust him to make the decision," Dewey said.

Obama's decision to be at her side in her time of need does not surprise those who know him.

"The whole family is quite special," Dewey said.