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God bless his sweet little heart 
As a grandma myself this is very touching 
I hope at some way you and your mom can have a few talks with your son about how natural and beautiful it is for us to graduate to heaven. Regardless of your religion or beliefs heaven is for everyone and we all get go should you choose to believe it or not. I do believe this could lessen his scare and turn it into a positive and make it less difficult. I’d definitely have a few talks about it and comfort him and let him know death is the inevitable for everyone at some point. And we just don’t know when. But it needs to be age appropriate of course. possibly needs counseling if he’s not able to be consoled. Sending hugs and hope he is well.
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This is a very hard situation none of us can even imagine this
Its a fight I have myself as my mother is now 64 and with most of her siblings passing over a period of 5years due to cancer freaks me out even more, however
I feel that you need to be stronger not only for yourself but for him, his not getting a stable answer or feeling from you, if you’re weak his even weaker…
Remember the most beautiful thing is meeting up with our loved ones in heaven, The world is not what we should live for but the hereafter remember this is also mentioned in the Bible…
Try to send his thoughts more to that sothat when she dies he would feel more comfortable knowing she is in a better place than here
Try having him watch movies of heaven or also bring up the topic of the fruitfulness of being in heaven sothat he can get used to it because if she’s ill that means she would be suffering let him know how painful it is for her to be suffering when she won’t in heaven
And I’m afraid to say you don’t prepare him this might ruin him forever
I was like that when my grandfather turned 60 (15years ago). I believed that people die when they turn 60 and always talked about how I don’t want my grandfather to die because I love him. He is turning 75 this year and still alive. Talk to him and ask him why he thinks his gran is gonna die and also tell him that his granny will always be in his heart no matter what happens
Are you religious? If so talk to him about the after life and how much better it is than here. Tell him she will always be with him no matter what and it’s a part of life. People die and it’s ok to be sad and grieve but the world is not ending bc they did. It’s just beginning for them.
Teach him about what God promises. Following faith and teaching kids about what heaven is helps. We lost our 26 year old son in a car accident. We have explained his death to the grandkids using this. It has helped tremendously. When they find feathers and pennies and dimes they know their uncle has sent them.
First of all no one can predict or totally prepare for death. Anyone of us can die at any second and all of us will eventually. Instead of agonizing how you will deal with it if your mom passes first, which she may not, enjoy every single second you have as a family. Secondly, is there any chance that your mom resembled her mother before she died so young that they could be mistaken for each other in dreams or pictures? Maybe your grandma is visiting your son as a spirit and because they look alike he is thinking it is your mom and she’s going to die soon. It is very common for Angels to come to children. He may be getting visits that he can’t explain from his great grandma and not quite understand this is not your mother. I’d casually show him pictures of your grandma as close to the age your mom is now and see if he reacts. If so, there’s your answer and he can rest that that’s the lady in Heaven and his grandma isn’t going any time soon. 
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He needs therapy to help him learn to cope before it happens. If it’s at this level already when it does happen it will be much much worse. And this level anxiety can and will start to bleed into other parts of his life too. It might be good for you to have someone to talk to as well.
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I tell my children all the time , death is a part of this wonderful thing called life , I have never been afraid of death , I’ve lost family members old and not so old the truth is we never know when our time here will end and trying to live a perfect life is unrealistic , I’m very close to most of my grandchildren and my great grandchildren , I babysit my 13 mo old greatgrandson every day , and I say the same things , I hope I live long enough for them to remember me and to have good memories of me , I want them to celebrate the life I had and not the person they will lose , I tell them what my sister told her granddaughter right before she passed away “ I will always live in your heart, even if I’m not here , I will live on through the memories they have of me “
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The only guarantee we have in life is that we are going to die, it’s how you live that matters. So make your memories now, enjoy what life brings, and take comfort knowing there’s something better waiting when we pass.
Go to the park, feed ducks.