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You can't be an effective caregiver if both parties are not comfy with the nudity issue. Which I can't see even from her standpoint or yours.

Where are your parents? Where are your aunts and uncles? If they aren't willing to deal with this, why should you be?

Kindly tell mom or dad--whichever one has this mom--that you cannot. Put it on them. If they can't find a nanny-slave among them, then they as the primary inheritors will have to negotiate the $200K/year it will cost to have someone around the clock potty grandma every two hours so she can be "at home" or do it themselves or get grandma to assign POA so they can put her in a home if she won't go.

This is their problem. Not yours. Save yourself and make boundaries in case your parents are thinking of doing this to you.
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PeggySue covered it thoroughly - the big picture & responsibility especially.

But just in case no-one has spelled the following things out, I will.

Dementia covers many types. It is life-limiting & progressive.
And there is no cure. Sorry. It really sucks.

What's your plan?

To help Grandma stay at home? OK. It's a good plan. For how long?

Stay home for *as long as possible* is commonly said.

Think about what *as long as possible* will look like. Top reasons are safety issues like wandering or being unsafe cooking/bathing, also behavioural issues like shadowing, high anxiety, paranoia. Another big one is incontinence.

That's where you are. So if Grandma is incontinent - she needs depends/similar. If she cannot change them herself, she will need someone there to oversee & verbally prompt her. If this is not enough, she will need an Aide to do it.

If this is past the level of help you can do, it's time to reassess the plan. To include an aide/a team of them.

Maybe Grandma is in very early stages & a casual hint is enough for now? "Hey it's time to freshen up". Or as I prefer, be direct, use facts. "Your pants need changing. I am putting the clean items in the bathroom for you."

Or is Grandma resistive?

As scensory, memory, mobility, planning are all needed for the task, as skills decrease, more help is required. Living alone becomes much less possible.
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Sounds like grandma is incapable of recognizing that her clothes smell and her diaper is soiled. At this stage someone will have to assist her or do it for her.

Your grandma has Alzheimer's. Her condition will get worse and worse and she will need more help and supervision around the clock.

Who else is taking care of her besides you?
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Here is a link to help you find advice and information for your area:

https://carechoice.nd.assistguide.net/home

There is quite a lot on there, including a toll-free helpline telephone number.
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I’m going to make a statement that will no doubt sound harsh, but should be considered.

Unless “grandson” is entering a hands-on profession in geriatric care, he should not be responsible for the intimate personal care of his grandmother.
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I hope you’ll draw the line and never assist with this. It simply isn’t your job and won’t be good for either of you. Let the family know your boundaries in this and that another plan is needed
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PeggySue is spot on, I'm afraid. If you are caring for grandma with no knowledge or experience with Alz/dementia whatsoever, how are you qualified to do so?? Not to mention, why is it your job to do so??? Where are your parents in this??

If you intend to be a caregiver for an elder with Alz/dementia, educate yourself on the subject; go to Alz.org and read read read, call their toll free number and speak to a live person. Watch Teepa Snow videos on YouTube about handling elders with dementia; about bathing the ones who resist/refuse, about toileting them, dressing them, follow her hand-under-hand technique she talks about and demonstrates in her instructive videos.

You're in over your head as are all people who take on the care and management of elders with one of the dementias at play. Without support, education and training, you'll reach burnout in no time flat. Please realize that and let your parents know by giving them your 2 weeks notice of intent to leave this job with grandma. What happens to YOU when she starts staying up all night, playing with her feces and getting it all over herself and the bedroom? The questions you ask us now are just the tip of the iceberg.

Best of luck.
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How and why are you responsible for caring for grandma?
I do hope you are getting paid to care for her.
You should have a Caregiver Contract and in it you need to spell out what you can do, what you will do and what you will NOT do.
Now...
IF you are to be the sole caregiver for grandma you will have to begin assisting in her ADL's. (activities of daily living)
Personally I do not think a grandson should be responsible for this. (I also do not think a granddaughter should be responsible for caring for a grandparent either, so it is not just your gender)
If you are going into the field of caregiving or other medical field that is one thing. But to become her caregiver because you are living in her house is another thing.
Grandma will need help with not just changing her clothes and her incontinent underwear (pull- up or tab briefs)
Grandma probably also needs help cleaning herself after toileting. She probably needs help showering as well. You are either going to have to do this OR tell whatever family member that should be responsible that you are setting boundaries and there are some things that you will not do.
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