Approaching a loved one for in-home care? What is the best process?

My mother fought it completely. She had no dementia or cognitive issues, just COPD and extremely poor eyesight. However after a hospital stay we decided that she really just could not be home all day by herself. She didn't need specific care, just someone to help make sure she was eating and could move around ok. She had moved into a retirement home (not assisted living) a couple weeks previously and was still learning where everything was. After the first two days my mother actually liked having her there. It gave her a new audience for her stories.

My mother wouldn’t accept in home help other than maybe a weekly housekeeper, MAYBE. I have a friend who is an RN and who would visit my mother with me at times and help me do some of the work at my mother’s house instead though I lived two hours away. When we couldn’t finish a big project at my mother’s house in one day but I couldn’t stay overnight to continue working on it, my friend offered to stay. During her stay she could also see how my mother was doing when I wasn’t there and she told me that my mother needed regular help, which didn’t surprise me. My friend was actually willing to go to stay with my mother a couple of days a week and we paid her to do so. Since my mother already knew her she didn’t see her as hired help. My mother enjoyed her visits and enjoyed having a clean house and help with various things. When it became evident that my mother needed daily help I hired someone to come four hours a day the rest of the week. My mother wasn’t happy about that but allowed it where she wouldn’t have before.
If there is a way to first introduce someone as a family friend and maybe invite them over to do things like go out for lunch with the two of you your wife may feel more comfortable with the idea eventually. It would no longer be a stranger coming to run the house. Finding someone willing to start off in such a fashion may not be easy but it may be worth a try?

DaveSalls78: Do it with love.

Communication with love from the heart. And reassurance you are not abandoning them

The best approach is the most honest.
Of course, dependent on the level of dementia involved you will know to hone your expectations regarding any positive responses down considerable if your loved one is unable to truly understand what you are saying.
You must simply accept that she isn't in charge any longer; you are. And move on getting things aligned as is best for you both.

You don't discuss, you just do it. You have your post under Alzheimer's & Dementia, so that means your wife's brain is now broken and that there is no reasoning with her, so you must now just step up and do what is best for the 2 of you.

Honestly, I don't think there is a "best" process. You know your LO the best. Do what has worked in the past. If that doesn't work, be brutally honest. You can't do it alone anymore.

Sorry if that was blunt. I've spent a lifetime tiptoeing around my mother. That was the advice that I would give myself... but probably be unable to execute. :(