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She has dementia and never smells it. She will think I am being mean if I tell her she smells of urine. My sister-in-law told her she needed to change cause she smelled. and she told her NO like a child, that she does not smell. She is in total denial on everything, her cleaning days are over. I dont live with her but I come and stay for a week when I can, and it is hard eating there because of the smell. She refuses help from the outside. I am lost for words. I have 4 brothers and they said its my responsibility to tell her because I'm the daughter. When they visit they sleep outside in tents because of the smell of urine and kitty litter. She has no clue why they sleep outside. I cant give the cat away because she really loves her and would miss her badly. How can I tell her without making her mad at me.

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Do you have a way to talk with her doctor? I'd try to do that and also to obtain a lot of information on dementia. Getting her evaluated by a doctor to see if dementia is causing this and to rule out other things like infections, would be a start. Does she normally have incontinence? Does she know what is going on with her bladder leakage? Incontinence is something else that comes as a result of dementia.

What is the plan for her care? People with dementia cannot live alone, past the early stages.

If it's dementia, at some point, the person can not beleft to their own devices. It's like allowing a toddler to live alone in a house and be responsible for their safety, health and hygiene. Convincing her of anything is not likely. I'd let go of the hurt feelings focus. Her health has to come first.

If you don't have legal authority to act on her behalf, then, I'd consult with an attorney in her jurisdiction to find out your options to take control in order to protect her. Sitting in soiled clothes is a health risk for her. Those dirty litter boxes also can cause her and the cats respiratory illnesses.  It's inhuman to the cats as well.  Expecting her to listen and change is unrealistic. She will progress and there may be a crisis. I'd address it now.

Protecting people who have dementia is challenging, but, there is no way to prevent a person with that condition from being upset or angry with you. At some point, their ability to protect themselves is so hampered, that there has to be intervention. Your family can decide if that time has come.

You may also contact her local adult protective services and have them investigate the situation. If they deem that she is in danger, they will intervene and possibly take custody of her if a court approves it So, I'd take it seriously and advise the family that someone needs to address this.

Does she have a Durable Power of Attorney or Health Power of Attorney?

Have you checked her fridge to see if there is any food for her eat or spoiled food that she is eating? Who brings her food? Does she have clean linens and clothes? Who is paying her bills.
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For the cat you could perhaps save up for one of those self cleaning litter boxes and be sure she uses the better litter, not the cheap stuff. If the box is too disgusting the cat will be avoiding it and is likely going in other places, which is going to contribute to the smell.

Sometimes the urine smell gets into the fabric and causes them to reek even after washing, especially man made fabrics like polyester, so giving her clothes and bedding a good hot water wash with enzyme detergents and fabric safe bleach can help. If the house smells that bad I doubt it is just her clothes though, she has probably had accidents that have soaked into her mattress and upholstered furniture too. There is lots helpful advice about this on the site.
Is she wearing a pad or pull ups? If no you will need to insist, if yes she needs to change more often. The whole family needs to make a united front on this, at the very least you and sis together may make more headway.
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Diamondgirl6852, I know this won't be easy, but there comes a time when an elder is unable to make wise choices.... then the family needs to take over. Yes, it will be a struggle because in Mom's mind she thinks everything is perfect.

My parent's house had THAT smell and it had to do with bathroom accidents... like not getting to the bathroom in time. As mentioned above, the smell will continue to stay in the carpets and furniture. And it will get into the walls, the kitchen cabinets, etc. Maybe an automatic air freshening device could help in the time being, as long as the scent doesn't bother Mom or the cat.

Do you think Mom would move to Memory Care, or would she grab the door frame refusing to leave her home. Some Assisted Living facilities will accept a pet as long as the pet behaves itself.

Some elders will say "yes" to doing things coming from a non-family member, such as a caregiver who is dressed in scrubs. There is something about the uniform that makes some elders stand up and take notice.
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I started a post on this a couple months ago---and wow, did I get some great answers. I was unable to get anything implemented at Mother's, as she lives with my brother and he was opposed to doing anything to help. It's HIS house and if the smells emanating from her apt don't bother him, far be it from me to rock the boat.
You CAN deal with the kitty litter smells pretty easily--but I bet it's her "issues" that are worse.
My FIL, at the EOL was bowel incontinent. He would have leakages and be completely embarrassed by it, but wouldn't shower or even change clothes. I begged my hubby (HIS SON!) to say something, but he wouldn't. We finally got home health care and they were sort of helpful. A 19 yo guy is not likely to "force" a 75 yo man into the shower. I had to get just nasty with him and tell him he HAD to get in the shower after these accidents. Meekly, he would. And I told him I'd get in there and scrub him if he didn't. (He did not have dementia, so this worked).
For "between times" I purchased these very large "soapless wipes" that are used in hospitals to wash patients. The are VERY good at fecal matter that is dry and also urine smells. He mostly used these.
The underwear was thrown away--he preferred to wear thongs--so there was zero coverage in the necessary areas. I bought him regular men's briefs and took all his "sexy" underwear. We never spoke about it, but he knew why I did that.
He was in the hospital quite a few times before he died. They put him in adult diapers.
There comes a time, Sadly, when our elders simply aren't/can't make good decisions. We have to step in, for safety and health's sake.
Doesn't your mother think that the "boys" all sleeping in tents b/c of the smell is odd? If she doesn't, that's a pretty telling indication she's not processing information well.
Time for a family meeting and some tough decisions to be made. It was so hard with dad. I still cringe (after 13 years!) at the things I had to say to him and how tough I had to be with him---b/c nobody in the 'family' would say anything.
Best of luck.
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