Can anyone share an experience with removing someone from a care situation against medical advice? What happened?

That's horrible. I'm very sorry for your loss.

Honestly, with the proper care, she has gotten (physically) much stronger. She's got some kidney issues but her heart is strong. No diabetes. No blood pressure medications. I have not seen anyone die of Alzheimer's so I don't know how fast her physical health will be affected by the decline in her brain function. I don't think she'll be eligible for hospice right now and I know he thinks hospice is 'letting people die'! We'd have to call it comfort care. But it's worth a try.

That sounds like it was very hard and also very rewarding for you. He can afford the nursing home. He may not be able to afford the in home care but he'll go broke trying to.
I think he is terrified of nursing homes. He is making decisions based on terror and denial.

The social worker is really going out of her way to help develop a safe discharge plan for her. The problem is the caregiver strongly feels that caring for her is "his job" or should be done by family (preferably female) and there is no one who is able to provide them with hands on care. He let some caregivers come in over the past two years but has severely restricted what they were allowed to do. (He allowed them to do housekeeping, laundry and stay with her when he left the house. He would not allow them to do any activities with her, He argued with them when they tried to provide personal care such as dressing, bathing and grooming.) They did their best within his constraints but she just wasn't getting the care she needed at home. If he would allow for care, she might be safe at home. It is his absolute denial of her deficits and reluctance to allow others to provide proper care that makes a discharge unsafe. It is heartbreaking.

She has late stage Alzheimer's. She is incontinent but can be helped to use the bathroom. She can feed herself but is a choking risk and must have soft food and be supervised while she eats. She is a fall risk. She was taken from the home unable to get out of bed alone. She had severe edema, fungal infections, low oxygen levels and was not eating. She was a two person transfer when she entered the nursing home. They have gotten her walking again and she is much stronger. Because she can now get out of bed alone, he wants her home. But unless he adjusts the care he allows (and so far, he isn't arranging to do that), she is going to decline physically again. Her family is very happy she is doing better and they are all enthusiastic about her returning home. It's as if no one is connecting the the nursing home's care with her physical improvement. If they just return her to the same situation she was removed from, she won't do well. And he is even more reluctant to alert people to her physical needs now because she was 'taken away' from him.
He visits very frequently.
They have no local family that can provide care.
His physical health is not great but he would not be considered disabled.

Our hope is that he will accept the recommendations for a safe discharge. That would involve accepting help in the home. The social worker says that if he insists on removing her against medical advice, Adult Protective Services will be contacted. Poor them.

It's love. But it's also control.

She is physically stronger because she is getting the proper care. Her dementia is much worse. She no longer speaks and sleeps most of the day.

It's her caregiver who is the problem. He has all the authority and his lawyer met with him and says he understands the concepts and the consequences- he's not incapable of making decisions. (Unfortunately)

He was afraid to bring her to the doctor because he said "They'll take her away from me." Which they did once he called EMS because he couldn't get her up off the floor. She was very bruised, very weak, had pneumonia, edema, she wasn't eating...if she had been taken from a nursing home in that condition someone would have filed a complaint!
Now she's physically stronger but her dementia has gotten much worse.
He said to me. I'll never call EMS again.
He is a frightened old man. He doesn't want her to die. He doesn't care what insurance coverage he loses or what it costs him. He thinks he can make the dementia better if she is at home. And he takes zero responsibility for the shape she was in when she left his home.

Im sorry you find that belief annoying, I find it more annoying that Ive personally witnessed it many times. Medically uneducated families and elderly are easily railroaded by "medical professionals" just like with anything there are good ones and bad ones. A good PCP would set up in home services. There isnt anything that happens in a nursing home that cant be set up for the home. Therapies, visiting nurses and physicians, even blood draws and many diagnostic tests will come to you these days. Patients are still shipped out of nursing homes for the more complicated care.

She's in a Medicaid bed. They aren't making lots of money on her.

Did you read that she did not want suggestions for action?

Her primary care physician has already told him he won't provide care to her if she leaves the NH against medical advice. It's a very sad situation. Thank you for your response.