She's combative, uncooperative, wants to go home, never showers, terrified, and unhappy. Are we wasting money by switching to a more spacious facility with larger outside space and a private room? She desperately wants to go home, which cannot happen.
I'm always a believer in a person having their own space. Would it be possible for her to have her own room at the MC she's in now?
Don't make the mistake in thinking that a bigger facility means better quality care. It doesn't.
Regardless of what facility you put her in she is going to want to go home. She may not even be thinking of her most recent home. With dementia and wanting to "go home" they could mean a childhood home and a time in their life when they were young and happy. The begging to go home will be a given that will likely continue until her Alzheimer's becomes more advanced. There's nothing to be done about it.
Anti-anxiety medication can help her. They are even prescribing anti-depressants to people with Alzheimer's as well and they have been showing promising results in helping with combativeness, agitation, and anxiety. Talk to her doctor. Try medication before finding her a new place.
Want to go home
Never shower (going to come back to that in a bit)
She will be terrified (even more so if you move her)
Be Unhappy.
No matter what you do, where she goes the scenario will not change.
I do have a problem with the "she will not shower"
I do hope that the staff is giving her a shower. If they are not helping her do the ADL's that she can no longer do then it is time to have a talk with administration as this is what the staff is supposed to do.
She can say "I don't want a shower" but the staff in a MC facility should know how to get a non compliant resident to comply.
Touching back on the terrified part. Is she on medication to help with the anxiety and the unhappiness she is experiencing?
Is this facility trying to engage her in activities?
If not then a talk with administration.
If talks don't work for either and a complaint to the Ombudsman does not work then you can think about moving her to another facility that WILL.
Because in my personal opinion she might be getting more caring and careful care where she is.
She is not going to change wanting to go home. That won't happen.
I would discuss possible trying a low dose anti depressant after a talk with the doc, or even low dose cannabis. Many are having good results with the latter.
I have an awful feeling that outdoors, which she is unlikely to access very much without staff having time, and a private room where she is alone is unlikely to help.
Have you discussed her conditions with the admins? Maybe give them a chance to correct the situation first. Hint that you will register your unhappiness with their facility with their governing accreditation organization, or on Nextdoor.com, or both.
FYI, wanting to go home is called Sundowning and she's referring to her childhood home, not her most recent place of residence.
Is she on any meds for anxiety/agitation or depression? If not, why not? They often help a lot. People with dementia can't bring themselves out of those mental conditions because their brains are "broken".
Good luck to you.