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Mom is in AL. The facility passes the smell test but she does not. The facility has her on a toileting schedule. She resists. Mom does not realize that her briefs need to be changed. Her chair, which I regularly recover with mattress protectors, stinks. Mom gets showered twice weekly. It can be more if required. I provide the briefs. How do I convince my mother, with advanced dementia, that her briefs (diapers) need to be changed more frequently? How do I convince her to accepted the necessary help with toileting? And..how can I mitigate the lingering odor in her room? Fabreeze is great but even that has its limits. Is there anything I can place in her room to continuously help to eliminate the odor? She is oblivious to all of this.

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Odoban removed cat urine odors
from my garage cement floor a few years ago and the smell never returned. Now I use it on furniture, carpet cleaner and car seat for my incontinent Dad. It’s available at big box stores like Home Depot, Lowes, and Walmart. I buy the gallon concentrate eucalyptus scent for fabrics but note there is also a bio stain version with special enzymes for urine and other bodily fluids. I have not tried it because the regular version works for my needs.
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jacobsonbob Sep 6, 2019
FWIW I certainly could have used a product like this some years ago when a tomcat took advantage of a car window I had left open--it took 4 years for the odor to disappear completely! (LOL now, but certainly not when it happened...)
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If the smell in her room is overpowering it is likely that more than the chair has become saturated with urine and nothing short of a deep clean with appropriate chemicals is going to remove the smell.

It sounds as though your mother is in an AL that is more appropriate for people who are mostly independent and whose need for assistance is minimal. Bottom line is that she isn't receiving the care she needs, unfortunately administrators will often promise much more than the facility has appropriate staff to handle. Her dementia is only going to get worse and with it will come physical decline, I think now is the time to look for a higher level of care.
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Thank you all. My mother's AL also provides memory care. She is gradually evolving in that direction. Like me, or me like her, she does not like to be told. Still needs some sense of control. I get it. My expectations need to be adjusted I think. I will speak to the head nurse regarding my concerns.
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JudinWA Sep 6, 2019
Hi WVson1. I think your best statement is the realization that your "expectations need to be adjusted". That is though one to do. Having worked with families of Seniors in all types of health and care situations for 40+years as an RN that statement really resonates with me. Often it really starts with the primary caregiver, in this case it sounds like you, being willing to adjust their views, expectations and overall ability to address and cope with a parents' changing needs. Then the next step becomes what is it that Mom really needs--to be in control. How does one address the issue and allow Mom to be in control? So many different ways to go about this. For the situation of being incontinent, short of moving her to Memory care, as you do not seem ready, take time to really evaluate all her actions and behaviors related to elimination. Times, awareness or lack there-of, actions or little behaviors that she may do that signify that she is going to eliminate, looking for something. When does she take off clothing, or doesn't she at all? be ready to "sneak in" or substitute clean clothes for soiled at time of eliminating,

How often in a day are you able to come, or can you set aside 2-3 days to be there a lot of the time to learn her behaviors with regards to elimination (not just show up and she is soiled again.) the overall goal would be a little pre-emption to be able to gently replace soiled for clean.

Is she still sing the toilet some of the time? if so what time of the day? When she has her pants down, step and and gently replace with clean. Or if she takes off clothing at night, put new clean clothes out without her really being aware, and replace soiled, including briefs.

But with the goal of getting her to think she is in charge, not you. After all she has been in charge of this activity for most of her life.

Maybe she simply does not like the style of briefs you have chosen, but does not understand that. I have one family that calls their Mother's briefs her "party pants". She has always liked to dress up, and always wore nice underclothing. there are some nice looking briefs available (albeit a little more expensive). but by changing the type of brief and tapping into Mom's love of nice clothing, they're able to address the issue. So maybe there is some way to look at the whole process differently. As you said changing, not lowering, your expectations based on Mom's lifelong habits.

All the best. It is not easy. eliminating odors is another problem, and there are a lot of good suggestions here. I would avoid scents that simply cover up, and go with ones that eliminate. And I agree with the animal lovers, housepet odor eliminators are often the best and the least expensive overall.

Finally, the basic problem may come down to the fact that you are her child. And have never been in charge of personal care for your parent. Often, by having facility staff provide care, your Mom will be more receptive. This removes you fro the loop, and from being the "bad guy". Staff are particularly trained, especially those with Memory Care training, to deal with this and other particular issues arising with Dementia. Adding increased caregiver hours will cost though, and that is another consideration.
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I would plan a day that she can be kept out of her room for most of the day, have someone go into her room and saturate anything cloth or porous plastic/vinyl with straight white vinegar. Vinegar kills the enzymes that cause the odor. Make sure that you get the floor under the places that she sits or sleeps. It will be strong, but it goes away as it dries. I would close her door and put a few fans with the window open.

What does the facility recommend for getting her to change her depends more frequently?

I had to sit face to face with my dad and tell him that I know that he can't help it and I know that he would be embarrassed, so lets deal with this by wearing briefs, changing them when they are wet. He was mad, but once he realized that he was more comfortable it wasn't a problem.

Oh, if her cloths get saturated with urine, a regular wash may not get rid of all the odor. Check her closet, it may be time to take them home and do a vinegar and baking soda soak or replace items.

I don't recommend covering the odor, it doesn't really work, it smells like covered up odor. White vinegar is amazing, it will even get the stains out and it is cheaper than any other options(3.50 a gallon), non toxic, and can be stored in her room. I would keep a gallon and a spray bottle handy to spritz any spots as they occur.

Best of luck, that is a tough one.

You can also use kitty litter under her chair and bed as an odor absorber.
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Reply to Isthisrealyreal
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To all of you suggesting fabreeze, air fresheners and essential oils please be mindful that you are in a facility with other people. For me, being around fabreeze sends me to urgent care. Scented products can trigger her neighbors who have allergies or asthma. Go after the odor, stop trying to cover it up. Work with the facility and make it THEIR responsibility to make sure the odor issue is fixed. After all, they should be the experts at handling these things.
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My husband (age 92) with dementia still knows when he has to go. This is about odors. He accidentally leaked down the side of the mattress and box springs. I sprayed them with a mixture of vinegar and baking soda, but that wasn't the greatest smell either. I found a great solution using animal odor spray I saw with other sprays in the drugstore. It is foamy and you just let it dry. Has really worked and does not have an overwhelming odor like other sprays.
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We had the exact same scenario with my mom. I was hesitant to move her to Memory Care as I thought she would be very resistant to the schedule. She has thrived there since and she is CLEAN!!! I wish we had made the move sooner.
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Try a few drops of Vanilla around her room. Really works. Plus pleasant for us.
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Memory Care checks them once an hour here....and takes them to the bathroom. Regular assisted living is nowhere near as vigorous. My mother peed in the elevator once in AL......thats when she finally agreed to wear Depends regularly. I was glad nobody else was in there with us to witness her embarrassment. Sigh. You just can't get rid of the odor of urine entirely, I'm afraid. It will help a lot when your mom is on a regular schedule of Depends changes, and when her old clothes are replaced with new ones. I'd also lay down Extrasorbs on her cloth covered seating for protection.
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Reply to lealonnie1
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If it is to difficult, which I get, shoes and socks off, drawers off, depends off, wipe down, depends on, drawers back on, shoes and socks on, whew, I am worn out just thinking about that every time I pee.

Have you modified her wardrobe and shoes to make this process less burdensome? I would find some nice slip on shoes (when you find ones that work, get a few pairs so she is covered for a year) and put her in a skirt (elastic waist, mid calf to provide leg warmth, presto). That would simplify the entire process to a few seconds instead of a long project.
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