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

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!

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.

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!

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?

So glad you brought this up my mum had been washing a bit since my aunt is here?? when theres no family she would stink and get nasty if I brought it up? this is very hard to deal with as you may see from my other posts my friend told me she could smell pee when she entered the house. I wasnt embarrassed only as my friends mum had als and she understood its when other people arrive you are constantly cleaning up and spraying around. We have a new carer and I aksed that she give my mum a bath not wash her but supervise outside the door even? this is not working as my mum does not want this and is ok on her own? its so hard but this is her house at least you can be a bit more demanding in your home although i dont think it makes much of a difference they just dont see it like we do so so sad my mum would not go out in the garden unless she had makeup on to look at her now is just heartbreaking! Like pstiegman my mum swears she washes by the sink she does a bit but she puts her incontinence pads on under her pyjs with no knickers on to support it then you see what looks like an animal danggling from her pjs hanging down her leg ive stopped nagging as im getting nowhere and find this so hard to deal with only because she gets aggressive and anything for a quiet life! The district nurse will be here soon and i can ask her what I can do?
So far the only advice ive had from the healthcare is that she cannot live alone if I go then she must go into a NH how do you make her she will not go? I want her to come and live with me until its time for a NH. Seems to me that in the US there is more homecare given than here I can get 3hrs a week thats it even if youre dying??

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.

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.

Doggie - I have done volunteer dog rescue, behavior and training for over 40 years. Here's how you can handle the walk. Get your MIL a tape measure and get the size of the dog around the body behind the front legs. Go to a pet store and get a harness. It must either have metal belt-type buckles or metal snap-ins. Don't buy plastic snap-ins as they CAN break with sufficient pressure. Any body harness (except the figure-8 which is made for cats) is OK as long as the fittings are metal. Attach at least a 6 foot leash to the harness. Have your MIL put the harness on the dog, then the dog on the floor if s/he wasn't already. Have her hand you the loop of the leash, and without any obstructions such as pulling the dog INTO your mom or furniture, slap your hand on the side of your hip/thigh, say WALK, turn away and start walking unhesitatingly. If you must, drag the dog if necessary, it will not hurt him because the harness isn't around the neck. Again, hold the leash firmly and move quickly without hesitation. You have the element of surprise on your side but if you lag or show a "poor dog" mentality, he will already know he has the better of you. Animals pick up on our emotions, our FEELINGS, so you must maintain a calm, assertive attitude that will relay to him the vibration and odor that you are confident and reliable and that you know what you're doing. Once you get the dog out of sight of its owner, who gives him power, he will initially be confused, weakened and most likely become compliant with you. I would suggest you bring some small tasty treats, such as freeze dried liver pieces, that you can chuck on the ground slightly in front of the dog should he decide to sit and/or not move forward. Don't try to touch or pet the dog, which could get you snapped at when it's in this confused state. Once you get the dog moving, if he begins pulling or straining ahead of or away from you, turn 180 degrees without hesitation and walk in the opposite direction. If these simple leash training techniques don't work, you may have to consider lying therapeutically to your MIL and telling her she can't have a dog in her apartment (frankly, the way you have described her, I don't understand how she will be placed in assisted living unless it is a totally full service assisted living similar to a nursing home?). You should then find a way to re-home beloved doggy with a dog owner or volunteer willing and knowledgeable to take on the retraining. Whatever the dogs behavioral problems are, it is certainly not the dogs fault and almost all dogs without exception can be rehabilitated with time and effort. As you are saving your MIL, PLEASE also say the dog.

She dotes on that dog. She walks him but not for long enough. Without the dog she would just give up. Her mind is clearer about the dog than anything else. She carries it like a baby, it sleeps with her and even goes to the bathroom with her. She cares more if he eats than her. She forgets whether she fed him or not so he gets too much food. If he doesn't gobble it down right away "he doesn't like it" and I need to buy different. She mainly needs assistance with bathing and medications. The dog is accepted at the facility but he is not been cared for properly. He used to be housebroken but is no longer. I do not like dogs at all and ones that I have to clean up after doesn't help. I care for my 15 month great grandson and he has more than once found the dog poo and the dog pees on his toys. She is unaware how I feel, however, I think the dog knows it. It is a Shitzhu. Sorry for how I feel about dogs to the dog lovers but I cannot seem to change it. I am not mean to them but I don't give them affection or want them on my lap. I cannot afford to have him groomed and she insists he doesn't need it. I guess she is used to the odor and it is bad. The first thing visitors say is "what is that smell". It is really embarrassing.

The dog who is stinky, unkempt, people aggressive & pees on the floor WILL BE accepted at the facility? Are you sure? What haps to mom, who would "give up without the dog", if she's moved into the facility and they have a problem with the dog? Just suggesting you have a backup plan.

The back up plan will have to be decided by my husband and his brother. Does anyone have any suggestions? It is not healthy for any of us to live like this. I cannot care for her at the level she is at.

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.