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You say in your profile that your wife has dementia, and can't hear or speak, so she no longer gets to make any decisions about her care and who comes and who doesn't, as her brain is now broken. That is now all on you and you must do what you know in your heart is best for your wife and for you.
Make the appointment for the agency to come and just don't tell her. Let them come in and do what they must. They may just be a Godsend for you and for her, so quit allowing her to rule the roost, when she can no longer.
You can do it!
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How can she keep them out? According to your profile she has dementia and cannot hear or speak. How do you know she understands the situation? Do what you know needs to be done, even if she has some objections. If you don't let them in how will each of you get the help that you feel you need?
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D, I see that your wife has dementia, and that she cannot hear or see well, but that you remain active and are still driving at 85. What sort of home care are you wishing to have in? I think if she will not consider "personal care" such as bathing and dressing, that is one thing, and you may need to remain in charge of that until the time comes for placement. But if the care you are asking for is basically watching over her safety so you can do your chores, the caregivers perhaps doing light cooking and cleaning, you can order that care for YOU, and your wife needn't be involved other than notification that your wife is there and what her condition is. Do you think that would work, and would it help you at all?
I am also thinking that, at some point, the care of a blind and hard or hearing wife who has dementia may come to be too much for you to do at home? Have you given any thought at all to the eventual need for placement, or to your mind is that O-U-T, out?
I surely do wish you the best.
ing you the best and hoping to hear back from you.
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dkeilt Jan 2023
Thanks for your ideas, my wife can see she can't speak or hear. She still can do the personal things, it's the safety part in the kitchen and everywhere in the house that's needs my attention. She leaves lights on, stove on, water running,refiigerator doors open, and doesn't understand my notes to her. I like the idea about ordering the help for me rather than for her. I have look at some memory centers and they are depressing. Her diagnosis is PPA, primary progressive Aphasia a rare form of dementia. Thanks again, Dick
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Please don't tell the OP he can just go right ahead and have the assessment done without his wife's consent. It really isn't that simple.

Dkeilt, could you describe how the negotiations have gone so far? What's been said, and who has visited, and how has your wife responded?
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AlvaDeer Jan 2023
I agree. No reputable agency will "assess" someone uncooperative. I am hoping more to get help for D., so he can do the hands on care of his wife for so long as he is able, and to encourage him to get help for himself, such as housekeeping, cooking, simply watching his wife to keep her safe while he makes short and nearby shopping expeditions, but perhaps even that later won't work without assessment.
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dkeilt, my Mom [96] was the same way, as both Dad and she needed caregivers to help them with daily life. There was nothing we could say to convince her this was in her best interest. Even her primary doctor tried.

I even tried a trial run of having a caregiver in their house. Mom was like a hornet, she didn't want another female in her house. And the caregiver told me that Mom was having bitter fights with my Dad about this situation. The caregivers lasted less than 3 days. Sadly I had to wait for a medical emergency with Mom [serious fall], hospitalization, rehab, and Mom eventually moving into Long Term Nursing.

This situation is not uncommon, many of us here had gone through the same problem. There is no fool proof answer.
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We did an intervention with my mom. My sister, her husband, and her adult grandchildren sat down and voiced our concerns about not being able to meet her needs. We stayed we wanted to keep her home as long as possible and we needed help in order to do this. We emphasized that the in home care would be help for us to meet her needs.
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Somehow, you must persuade her, to let you do this, because without knowing the details of your situation, it's possible that either they come in the house, or she leaves it. If it comes down to that, put the emphasis on you advocating that she remains at home. (if that's the case, which I'm guessing it is)

I don't expect this to be easy, little in caregiving ever is.
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In-Home Care or Day Care.
These often are the choices.

Because regardless of what your wife doesn't WANT, it is NEEDED. .

It is not possible or reasonable for you to do absolutely everything: all the housework, cooking (or pre-made meal heating) shopping.

Also, sometimes you will just need to go out alone. Just to get a haircut! Or meet up with a friend.

Unfortunately, with dementia, reasoning to understand all this goes.

Having a regular 'sitter' works for many people. Then you get a regular slot of time to go out, sit in your local cafe or park on a nice day. 'Self-care' they call it. It's important too.

One suggestion is to explain to her the help is for YOU.
That YOU want a cleaning person to mop & vac, change the bed linen. Then once they are IN, trust can hopefully be built on & more tasks added.

This has worked in my family.
I wish you luck & success.
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