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She is still using her car. We live 4 hours away from her so can’t do much to help her. We want her to live near us in a facility that is able to help, but we don’t know what to do when she keeps saying no to everything.

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Driving???? Omg, disable her car immediately before she kills someone! She no longer gets to make decisions now with AD at play. Whoever this person's POA is can move her into a Memory Care Assisted Living facility against her will in an effort to keep her safe. Otherwise, it's only a matter of time before you get The Phone Call that she's in the hospital from a fall, a broken hip, or wandering and having gotten lost, etc. From there the social worker can help her move into managed care.

Ignore all the No's and get the woman to safety with her POAs help and a written dx of Alzheimer's. Above all else, disable that car!
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If you live that far away, I would not consider in home care without someone overseeing it. I mean where they can be there often enough to make sure the person is being cared for and not taken advantage of. Someone needs to manage the aids. One may not show up for a shift. Has an emergency and has to go or is sick. And she would need 24/7 care. No one suffering from a Dementia should be alone, its too unpredictable. And the cost, may be cheaper to place her in Assisted Living or Memory care.

If she has no money, there is no program that will cover 24/7 care. I so hope someone has POA. If it needs a doctor or doctors to make it effective, then get it in writing that she is no longer competent. It is no longer what she wants, its what she needs.
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Is she living alone?
When was she diagnosed?
Who is POA or guardian, or is there currently one?
Answers to these few questions will help us to answer you.
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According to your profile(which you may want to remove your name)your loved one lives by herself, but can no longer use her cellphone or computer or drive beyond a 10 mile radius.
Is your husband her POA? Or is anyone? That will make a huge difference in her care, as the POA can step up and make decisions for your loved one with dementia, of course depending if it's a springing POA or not.
When ones brain is broken(as it is with Alzheimer's)they no longer get to make the decisions regarding their care, and thus why having a POA is so important.
Someone now has to step up and do what is best for your loved one and her safety, so I'm hoping someone is her POA, and if not you may have to file with the courts for guardianship.
And the thought of someone with a broken brain still driving is very frightening to me, as they can easily kill or severely injure someone. She needs to be reported to her doctor and the DMV as someone who needs to have their license taken away. Statistics show that most accidents happen within 1 mile from ones home, so just because she's only driving within a 10 mile radius means she's still at a very high risk of hurting or killing some innocent person.
You have your hands full for sure, but I hope you will start now in getting her the help she needs and to getting her license revoked.
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Joanied, welcome to the forum. I am around your family members age, and just because she no longer uses a Smartphone or a computer is common, with or without dementia, doesn't mean anything serious. Modern technology has become too complex for some of us. Is she able to use a landline? That is pretty much ingrained in our mind since we grew up with landlines.

My Mother also had refused strangers in the house, nor would she downsize into a house easier/safer for her and Dad to maintain. Sadly, we had to wait for a serious fall or illness where we would need 911... hospital... rehab... senior facility living. We had no choice of rehab, it was where there was an open bed, same with the nursing home as Mom now needed a professional village to help her.

You mentioned you want your sister-in-law to live nearer to you. Please note moving someone who has dementia will only accelerate the disease, as everything, and I mean everything will be unrecognizable for her. Better for her to remain in her own city/town.

Senior facilities also have Independent Living. My Dad moved there after my Mom passed, and he had a very nice 2 bedroom apartment, large living room, and full size kitchen. The monthly rent included weekly housekeeping/linen service, plus meals in the restaurant style dining room. He just loved it there. Would that be something your sister-in-law could budget for? A facility that also offers Memory Care. The newer ones are built like a hotel :)
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As far as living alone, yes, that causes a lot of concerns, but what jumped out at me wa the fact she's still driving. That's where the 'independence' ends.

Whether you can shore her up so she can live alone or not is a very secondary decision---but she MUST stop driving.

Just yesterday I was out running errands and I was behind a lady who was so small she couldn't really see over the dashboard. She was waffling all over the road, and luckily people were looking out for HER--but I kept behind her as long as I could. It was school pick up time and she would have driven through MANY school crossing zones. One crossing guard steeped out into the road almost in this lady's FACE and was waving her "STOP" sign and the older woman just blew past her. Had there been kids there, she would have hit them.

Once that license and car are taken away, you can focus on the next step. But please, get her off the road!
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