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I would place them in a facility. Not being willing to deal with this is beyond home care.

For their own wellbeing they need professional care.
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Give them a choice: Do you want to stay here with proper cleanliness, or do you want to go to a facility? Staying here in insanitary conditions is not a choice that you can make because you (and I) will be reported to the authorities. They will take you away, and I will be in trouble.
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Redirection, tell them it's time to take a shower and we need to get ready to go somewhere they enjoy going or doing (lies are ok if they won't remember). When they get into the bathroom, diaper comes off. They get cleaned up. Keep reassuring them we are getting ready to go have fun.
Back in the bedroom, have them sit in a chair and hand them clothes to try and put on. Meanwhile, notice the bed needs changing and offer to get it done while they are getting dressed.
If your LO is anything like ours, he might have a shirt kind of on by the time you're done, offer to just help fasten his clothes (even though you are really dressing him).
Now is the important part, redirection again! His mind is set on what you said earlier. Now we pretend in a fun way that we just got ready for what was really on the schedule for the day. Get him thinking that's what we did to begin with.
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Heavens, Jean! You're disabled yourself and this is your husband who is refusing to co-operate?

Does he say why?

You don't need your husband's permission to ask for help in your home. If you and your husband both have the same doctor - even if he is refusing to go - I should give the doctor a call and ask for advice about nursing and personal care services. Alternatively, get in touch with your Area Agency on Aging (or equivalent) who will also have information and advice for you.
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