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On the times she goes to the toilet she has started to do her job without pulling down her pants.

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I’d like to say to the OP that my method described above was not just a cute tactic. It was born from exhaustion, desperation, experience and consideration of the alternative. Pulling no punches the alternative was to leave her in her upholstered chair which would result in a big mess not only in/on the chair (or other location) but across the living room and hall carpet, the bathroom floor and both our clothings. Most likely just when it’s time to fix dinner. 

The momentary indignity for her affected me deeply, was never easy to inflict, and every single time I had to psyche myself up for the task. I loved my wife. Both in our 80’s. You will have to learn to do what you gotta do. What ever it is. You’ve a tough road ahead.
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Shane1124 Nov 3, 2019
I don’t think you need to apologize. Sounds like you do the best you can everyday. I agree with your actions. Sometimes there is no other way.
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In addition I purchased an additional peritoneal wash spray that connects to your toilet and you can clean her properly after she does her business. My mom loved it and much less expensive than a bidet commode.
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Unfortunately you’re in a hard place but maybe ask family or friends to stop by and speak to her on a personal level to help in this process. You could also consult with her physician to expl that hygiene is the most important concern to keep healthy. It also sounds like some kind of Dementia is starting and you can ask for an assessment to be done to determine if you can have some help a few hours a day to get her back on track and work with you on this concern.
I wish I could suggest more but without just doing the process of removing her depends and placing With clean ones.
sometimes speaking to her when not on the commode about changes and let’s try together to do this, you will need outside help. Some spouses don’t want their loved one to help in that area. Wishing that something soon will change.
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Move to pull-ons if necessary by throwing away all other nickers, and get care in to ensure she is helped to wash at least daily, a lot of people are for some reason embarrassed to have partners help with toilet issues. Get Dr to do cognitive assessment if one has not been done, it may just be age, it may be dementia reaching a point where she is not understanding. Commode nearby is useful but not if she is not removing nickers before toileting.
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I suggest calling her primary care doctor and requesting homecare. They have a team who can come in, including nurses, social worker, PT, etc, but what would be most helpful for you immediately is the professional who comes in 3 days a week to wash patients. (Make sure the Homecare agency has one that does this. Not all do. Request another, if not.) They are good at their job.

The homecare PT can do exercises and recommend ways to make getting around the house easier for your wife. (Maybe a commode by the bed would reduce incontinence?) The nurse can provide samples of products and discuss how to prevent infection down there. The Social worker can explore local services such as a female aide who comes in a few hours a week on a long term basis to help out with intimate tasks your wife might be more comfortable doing with a professional caretaker than her loving husband.

Otherwise, I like qmnpxl’s answer. Just find a way to do it. Joke, cajole, do whatever is appropriate for your dynamic and works. Over time, it becomes easier for both of you. Also, go to the pharmacy and buy Depends for her. There are some that look like panties and others that are clearly diapers.
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Shane1124 Nov 3, 2019
His mom would have to have an acute need for a doctor to order Homecare services. Incontinence is not an acute need.

Maybe OP would consider paying an aide out of pocket each week to help her bath. Maybe she would feel more comfortable with a woman washing her.
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Is your wife refusing assistance from everyone, or just from you? If only you have tried, it might well be worth seeing if she'll co-operate better with someone more nurse-like or maternal - do you have friends or family to call on?
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Reply to Countrymouse
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Maybe a stranger can be hired to at least clean her up every day? Incontinence is a TOUGH one. So very challenging! Is she in pullups or diapers?
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This won’t be a very profound comeback butt:

My wife never did like having me pull her pants down, that is at toilet time :-) so I used a combination of wheedling, cajolery and brute force. Mainly I got on my knees and whipped her pants down before she could object. The pants/panties were down, before she could say, “Don’t do that.” She still said it but too late. Ahh too bad dirty shame. I always apologized but it wasn’t necessarily readily accepted. None the less………..  Of course you must be diligent and vigilant and ready to move when the opportunity arises.

Next up on my feet and sat her down. Now performance of THAT operation is for another discussion.
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Reply to qmnpxl
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Wife needs Depends and needs help when going to the bathroom.

I didn't have this problem, maybe someone else has and can help.
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