How do we get Mom to see the need for longterm care?

Depending upon whether your mother-in-law has early or middle stage dementia, moving her at this time could prove challenging. Not because it is her choice or something that she needs See also:
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See all 660 questions about Alzheimer's and Other Dementias to necessarily agree to, but because in her mind she is quite capable of caring for herself and perhaps even capable enough to care for her dying husband. No amount of reasoning with her or outlining what she can’t do anymore will advance your cause and may even lead her to dig her heels in further.

That said, I’m wondering if you’ve considered the alternative. One thought would be to bring in home hospice for your father-in-law (a covered benefit under Medicare) and supplement the home care provided through hospice with private home care as needed to fill in the gaps until his death. Unless your mother-in-law is able to pay for assisted living or a nursing home out of her own pocket, or she already has Medicaid to do so, managing the care of both of your in-laws at their home may be your only option for the time being.

If you do decide to move forward with plans to transition your mother-in-law now, I would suggest keeping the conversation very simple and having the person whom she has the best relationship with take the lead. It’s also critical to plan the transition with the staff at the facility you choose. One thing I’ve seen work in similar situations is a gradual admission whereby a new resident begins by visiting for longer periods of time over the course of a few days before spending the night.

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The answer given by Maria gives an excellent alternative if it is possible to arrange. If you must go ahead and place your mother-in-law in a home (like I had to with my mother) it is an extremely stressful time. Depending on the stage of her dementia, chances are the stress will last a short period of time. When we took my mother to the nursing home, she did't realize it was a home. She thought it was a restaurant. We fully expected the roof to blow off - but it didn't. She wanted the taxi driver to come pick her up - she felt he left her there by mistake. The hardest part is the guilty feelings you feel. You have to realize that it is where she needs to be. Remember, if she was in her right mind, she would understand. Give it time - stay away for a week or two and let her get use to her new surroundings. We communicated with the home every day. Eventually (sooner than later) she settled in to her new home. I know exactly how difficult it is. I have been through it. It seems impossible, but allow the home to help you and friends and other family too. Don't take it on alone. Good Luck.

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