Mother-in-law not getting washed at assisted living facility.

Its a law that even a person suffering from Dementia cannot be forced to take a shower or anything. They are not a patient, they are a resident.

What I found when Mom was in an AL they "asked Mom" and of course it was no. I told them don't ask just do it. I never asked Mom if she wanted a shower. I just took her to the shower. They become like children.

Be aware that aides only have so much time they can give to a resident. If they can't get them to cooperate, then they have to move on to the next resident.

I too think an AL is not enough for Mom. Memory Care may be better or even Long-term care.

MIL needs to be in Memory Care Assisted Living which is a world apart from regular AL. You may want to also look into a mild anti anxiety med like Ativan to help her.

My mother was petrified of slipping in the shower at her Memory Care ALF. So I bought her a pair of water shoes on Amazon, the type you wear in the ocean. That did the trick. Oftentimes, elders with dementia have some sort of fear of the shower and it's helpful to see if you can find out what your MILs is.

Best of luck to you.

ALF really isn't able to handle someone with this severe a dementia, and I am certain they have discussed with you the difference in staffing levels and care levels of memory care. They are correct that legally, if she fights them, they cannot do the showering; as you will note in your care packet on admission, in certain "levels of care" (usually I through IV) they can ASSIST in the higher levels of care. But they cannot force her to shower.

You Mom is too severely ill to be in ALF. When ALF tries to care for someone with such severe dementia in ALF they are not only taxing their own staffing levels but they are making things very difficult for residents of the facility who, while they may have some level of dementia, are cooperative and clean and companionable with other residents.

This is terribly sad, because costs of care go up exponentially with these needs.
I can't know what has been discussed between Mom's doc and the POA in this case, but it may be time to try to get on board some low level anti-depressants that may help in a last ditch efford to avoid MC or Nursing Home care.

When my DH and I were caring long distance for his grandfather (POA And Healthcare) the dementia care facility was the a la Carte type. We had to arrange for different levels of care as he progressed thru the disease. It was hard because we were farther away and didn't see him every day. So it was difficult to know what he needed. His children (DH's mother and siblings just lashed out in anger at it-but he didn't want them caring for him because of the family fighting.
I do remember the different meds that were necessary to relieve anxiety and help him feel comfortable but it was a struggle in the mix of getting it right. I'd talk to the directors again to assess if this is the right spot for her or if you need to adjust meds or levels of care.
Im so sorry. This is hard.

There is a fine line between abuse and neglect. Your MILs caregivers need to figure out how to navigate that fine line and every dementia patient is different. Allowing her to be filthy is neglect. But they cannot force her because that’s abuse. They have to figure out how to convince her a shower is necessary which could take getting to know her and some trickery. Talk to the nurse in charge and ask her what their strategy is to get MIL in the shower. How long has she lived there?

I think you need to re-read the contract that was signed when she entered the AL. They don't do certain things unless they are added as "a la carte" services, like laundry, meds dispensing, showering. They won't force her to do anything, not to shower, takes meds, eat or get dressed.

If your husband hasn't discussed meds for anxiety, depression and agitation with her doctor he shoud do this. Dementia robs people of their ability to use logic, reason and good judgment and therefore can no longer bring themselves to places of peace and acceptance: they know something is wrong with them but they can't figure it out or fix it. It's very distressing. So, it is merciful to help them achieve a more calm mental and emotional state through medication. It may take a while to figure out which ones and what dosages but it is usually very helpful.

If she accepts taking meds and a good mix is found, then she may be more cooperative with other things. If not, she may be a candidate for MC.

Also, please educate yourselve about dementia: what is is and how it will progressively change our LOs. I learned a lot from watching Teepa Snow videos on YouTube. You'll find out different strategies to engage in more peaceful and productive ways with your MIL. I wish you much success in finding the right level of care for her.