Why do antonio's family call ultima,"la Grande"

Antonio’s mother is even more attached to her because Ultima helped her in childbirth and was her companion during her lonely years on the llano. Antonio’s mother is concerned that Ultima must live alone on the llano during her old age and urges her husband to bring the curandera to live with them. She must be addressed as La Grande, Antonio’s mother asserts, and then reminds her children of the great honor that they should feel at sharing house with such an esteemed figure.

Out of respect.