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Refusal to shower is not an "embarrassing and sensitive subject" for a person w/o cognitive or mental health issues. It is a socially accepted norm in our society and an expectation, especially when living as a guest in someone else's home.
At the minimum, grandma needs a new doctor or neurologist who understands dementia and how to test for and diagnose it properly. And she needs to be taken by the hand to the shower 2x per week and bathed by an aide who's experienced in such matters, or by a family member. Watch a few Teepa Snow videos on the subject on YouTube first.
Give grandma a choice....she either plays by YOUR rules now or goes into managed care. Tough love is required now, not walking on eggshells.
Sad fact here? You tell her honestly and it will be hard.
I faced the same problem.
Before his diagnosis with Lewy's my brother had loss sense of taste and smell. He knew this. He was a most controlled, monklike and fastidious man with an emaculate house. Nevertheless he hated deoderants all his life and used them grudgingly because he knew he needed to. When I visited him shortly before his diagnosis I noticed that not only did HE suffer from underarm odor, but he was not washing his teeshirts often enough and they were no longer coming clean with washing.
I had to sit him down and tell him that the smell of underarm odor was not only on him, but in his closet and on his clothing.
He couldn't believe me. He said to me "Well, __________and _________ never told me I smelled!!!!!" (His ex and his best friend). And I had to tell him "Perhaps not, but they would never tell you ANYTHING that had the power to hurt or upset you, and so your little Sister is left with the job".
We did the clothing. ALL of it. And he again used deoderant.
Later after he was diagnosed, as we got him into ALF, I made certain that it was in his care plan that there was no longer any sense of smell and he had to be reminded about shower and deoderant.
You cannot avoid honesty. If there is dementia present you are going to have to do more reminders than you wish to. It hurts to have to do this. It hurts you and it hurts the one you love. But you are doing this out of love. And it has to be done.
Also she could get UTIs and other issues not showering. I tell ya I don't feel to clean down there is If go 3 days without a shower, she can't be very comfortable
Your family can start by giving her a false reason to shower, whatever you think will motivate her: we're having visitors tomorrow; you're going to an appointment tomorrow; etc.
If some of the smell is from being incontinent, then all her cloth undies should be thrown out and replaced with disposable ones.
But as others have suggested, she really needs a diagnosis. Hopefully someone is her PoA...
https://www.agingcare.com/articles/how-to-help-with-bathing-and-personal-hygiene-top-tips-from-caregivers-212010.htm
https://www.agingcare.com/articles/elderly-parents-who-wont-shower-or-change-clothes-133877.htm
Another thing is, and I hate to say it, but sometimes letting them get dirty inspires them to eventually want to get clean, because it's not about them not wanting to clean but doing it on "their terms", even if those terms means not cleaning up right away after an accident or once a day. I know this, because had some absolutely miserable showdowns with my mother. I'd beg and plead and warn her that she'd get a UTI, and this would turn into her twisting my words around and saying that I was accusing her of having an STD and sleeping around. The last showdown we had, she absolutely refuse to clean up even though she was absolutely disgusting. I left her alone, but cornered her in one part of the house, as she was tracking "stuff" everywhere.
By magic, after a few hours, she finally decided that she wanted to take a shower because she was so grungy, she caved in. After this incident, every so often, she calmly asks me to help her take a bath, like once or twice a week, as opposed to weeks. There are days when she absolutely has to take a shower, but that's when I volunteer wipes, which are better than nothing.
You should be honest with her at that point.
"Grandma I know you have a medical condition and you can not distinguish odors. Because of that we have noticed that you do have a body odor. I know you are particular about how you look and this is something that you need to take care of. If you can't do a good shower yourself we can get someone to help you." "We can have someone come in 2 or 3 times a week"
You also remove ALL of her regular underwear and replace it with disposable pull up underwear.
If she does not agree with this simply tell her that you are going to have to look for Assisted Living facility for her as you can no longer tolerate the odors from both the body and the urine.
this is a tough talk to have but pull up your big girl pants and do it.
I didn’t realize my mother was not putting deodorant on the correct place until I was with her at the hospital to get ready for discharge . She was putting it on the sides of her breasts not her arm pits . Besides having dementia, it was very difficult for her to raise her arms due to very arthritic shoulders . I hadn’t realized how difficult it was for her sooner because I had not seen her dress herself .
In retrospect I should have realized since she needed help getting her coat on for years .