MIL with dementia is in denial and thinks she can live on her own. She needs assisted living. How do you approach her?

I had an identical situation, but was fortunate to have a MIL who wound up being reasonable after I talked with her as follows:
Me: "Mum, I feel awkward bringing this up but there is a bad smell that comes from not bathing, and it's getting worse."
Mum: "Oh, I can't smell anything, really?"
Me: "Yes Mum, really. I've talked to your doctor about it because I was too embarrassed to bring this up with you. He said so was he, so I'd have to be the one. He said there are health issues that are a concern when you don't bath."
Mum: "Like what?"
Me: "Like your anal and perineal skin breaking down or getting infected."
Mum: "Oh."
Me: "Also, we can smell the odors all the way throughout the second floor."
Mum: "Oh."
Me: "Do you need help bathing?"
Mum (after a lot of discussion about the logistics): "Yes."

I helped my MIL for five years (she died at 100). Although it won't be this way for everyone, it brought us incredibly close. She even developed a sense of humor about bathing time -- "Time to clean the elephant" (elephants were her favorite animal). We'd laugh and cry and just appreciate human existance.

I do not believe everyone would be so lucky. When a person refuses a reasonable request, they are no longer rational. Your MIL sounds irrational. If you cannot speak with her to at least set your limits, then you are accommodating to an irrational person -- not good. Perhaps enlist the company of another sympathetic person (her doc?) or even your husband (it is HIS mother). Or even Adult Protective Services. I am so sorry you have to experience this, but working through it is like learning to swim when you really don't want to. It sounds like you and your husband have tried to accommodate to her needs thus far. You and your husband have been commendable in your attempt to be kind. Now being kind forces you to tackle more emotionally difficult issues. Keep heart, you will know what to do if MIL remains unreasonable.

Our problem was that Ma kept saying she showered daily, but the skin fungus under her belly and breasts gave her away. You are dealing with the mental capacity of a 4 year old, and if you had a 4 year old with a stinky room, what would you do?

When I was in the NH after surgery, the nurse came in and said "Thursday is your shower day". So she will get a full shower once a week like it or not. Nor would she be allowed to wander the facility with the dingle dangling (LOL). She will likely listen to the district nurse reading her the riot act, so enlist some reinforcement there and shuffle her off to the shower, curses and all.

So sorry to hear that. If this is your house, use tough love techniques. Get it done yourself. Assistant living requires all this to be done by herself. IF she's not able to do this now not because she doesn't want to, then it's time for nursing home. Or assistance in your home or hers. Your dr would have to assess her and help you or talk to elder care in your vicinity. Hope these suggestions help.
Equinox

My mother is much the same.Pee yew.I keep telling her to wash,offering assistance.You cannot make someone bathe.Maybe give her some wipes,that helps here at bit.Plus I have a glade plug in by her door.At least it helps a bit!

My husband and his brother are just now getting involved. They did not know how bad it was since I was the one spending the most time with her. I did go in and clean while she was gone and sprayed everything with febreeze. It smelled good for one day before it started again. I also discovered it was mostly the carpeting which will need to be removed. She puts papers down for the dog with nothing underneath and it just soaks thru. I had to put an automatic air freshener in the bathroom just to be able to stand to be in it for any length of time. We did find an assisted living facility she likes and they are waiting for Dr reports and VA approval. My granddaughter is a CNA and she has agreed to come to see if she will let her help her with a bath. My husband is going to tell her she needs it for the Dr Evaluation if she want to get the apartment. The dog is vindictive and does not like us. He growls and nips and she will not even allow anyone else to walk him but we are trying. I do have a hair salon apt she has agreed to to get her hair washed and cut. That will help. It is so nice to know I am not alone. I feel so guilty sometimes.

As a dog lover (even hard-to-handle dogs) I worry for her dog. Is there a family member who would take him if he doesn't work out at the facility? That's the only solution I'd see that might ease your mom's mind.

It may be trying to protect your MIL when it's being aggressive. It might not be aggressive if it's away from your MIL (on a walk for example) and if it's with someone who likes dogs. They're very intuitive (like cats) about who likes them and who doesn't. Could you afford puppy pee pads, that are made for dogs to use to go inside? They have some kind of bottom coating so they don't ruin your carpets or flooring.

Bingo. Tell you husband that you no longer have the skill sets required to meet you MILs needs. Tell him he will have to hire some skilled care a few hrs a week and their duties should include assisting your mom with bathing and dressing. Then they should take her and the dog on a long walk, outing even if they just sit in the park and you can get into her room to clean and do her laundry.

If MIL balks, let husband reason with her that this is how it has to be for the benefit and healthy living conditions that affect the whole family.

If you can afford it, or mom is contributing to expenses, splurge on a cleaning service for your home, or at least her room weekly.

I would not allow her to have any food in her room period.

You could try the shampoo I use to de-skunk a dog. Mix a quart of peroxide, 1/4 cup baking soda and a teaspoon of Dawn (liquid dish soap). It will foam up. Apply to a dry dog, foam in 5 minutes and rinse. Leaves a very soft coat. This can also be used in a load of laundry or on toys.

Where is her son (your husband) in all of this? Sons usually have more influence over mothers. Has he tried talking with her? As for the dog, you can always entice him/her out with a treat and get it washed. Since it is your house, why don't you just go in and clean it regardless of what she says. You know she is not responsible for what she says with dementia, so don't take what she says personally so you can get things cleaned. Nothing is easy with a person who has dementia, but try and have your husband try too. Good luck!