Right now my wife has a urine wet night gown on. She won't let me take it off and put something dry on. This is an improvement from earlier this morning when she would not let me take her to the bathroom so we could take off the wet undies. She would not take her meds. Since then we have managed the undie change and meds. I put some pants on her, but so far the gown is still on her. This is a typical start of day for us. Sometimes she removes the undies and won't let me put clean on. No undies has it's own "issues," which you can imagine. We have gone through one in-home care company and are working on the second company. We went through ten or more care-givers in the first company and are near or past that with the second company. After 59 years of marriage, I just can't figure out when to give up my 24/7 home care and move her to a facility. I feel guilty of even considering living apart from her.
I am also glad you have been receiving some help at home, even if it has been inconsistent. I hope when someone is there with you, it gives you some level of respite and perhaps you can take a nap, run an errand or just sit quietly in a different room.
I am not sure when you "know" it is time to make that move to a facility. I do not think there is any rule that applies to all. I think you get to a point emotionally, not so much physically even.
As an interim suggestion, are there any options in your area to have her stay at a facility for a month or a limited duration to give you respite? What about adult day care programs where you could have her stay for an afternoon?
Double incontinence took things to a different level with my mom. As others said, I would also suggest getting Depends at the store. Some of them have cute pink colors. Use those instead of regular underwear and you will likely go through a couple of those per day, but it will help keep things drier. In the same section of the store, I found some disposable absorbent bed pads approximately two square feet in size which I placed on top of the mattress but eventually got a waterproof mattress pad.
However I would most certainly be making sure that she's wearing Depends or the like. And throw away her old undies and replace them with the Depends, and just tell her that you bought her some new undies.
But DO NOT forget that you matter too in this equation, and that 40% of caregivers caring for someone with dementia will die before the one they're caring for from stress related issues, so PLEASE make sure you're taking care of yourself along with your wife.
God bless you as you travel this very difficult road with your wife.
I think it's time to transition her now. Kudos to you for all that you've been doing for her. May you receive peace in your heart at this new chapter.