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He has 2nd stage dementia. My father-in-law refuses assistance from me, when his brief needs changed. He will scream at me non stop. It would not matter much if his skin was not developing sites. His sons are not always here to assist. He will sit in a wet brief +pants all day if allowed too.

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I'm sorry nobody else has chimed in with some better answers for you. The fact that you are paid to care for him complicates things, doesn't it, because I imagine the rest of the family expects you to gratefully shoulder the entire burden😒. Given that his intimate care needs will only increase perhaps it is time to renegotiate your role as a caregiver and look for other options.
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If you stop to think about it not many of us would welcome having our DIL or SIL helping us in that way. I believe in doing everything possible to preserve the dignity of those with physical and/or cognitive decline and allowing them as much self determination as possible. Is there any way you can delegate this task to someone else, a paid caregiver perhaps?
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I am the paid caregiver.He dislikes women helping him,and because I am family this makes it more difficult.He has burned bridges with his other daughter-in-laws from his rudeness.
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