Hygiene Issues in Elderly Parents

Archived Q&A and Reviews


Aging father's urine smell

Sept 2011

My aging father (83) has been diagnosed with Lewy Body dementia. He is still functioning independently but in an assisted care facility. The facility (a VERY nice one) administers meds, keeps a general eye on him and gives reminders about meals or activities happening - otherwise he comes and goes as he pleases at this point.

I am concerned with so many things but one thing I just can't deal with (and minor in the scheme of things) is that his clothing always smells like pee. He has always been a well-groomed and proud man but this is one of the signs that he is slipping.

I am working on getting him to give up his laundry to the facility, but I think the biggest problem is that he will put on the same pants over a few days (not sure how many since I'm not there every day). He has some incontinence probably associated with the Lewy Body/age etc. We have had it checked out by the doctor. No real problem like infection or other.

In the past (2 or 3 years ago) he wore Depends but when I asked him if he needed more of those at the store (and that was hard enough for me to ask), he said ''oh, that problem is taken care of itself. I don't need them anymore.'' I put the leftover package he had beside his toilet...hint hint. It was too subtle I guess.

He is going through so much at this point - frustrated with his memory loss, some nighttime hallucinations, hand tremors and not being able to do many of the things he did before: writing books, driving, fishing, golf, computer work, his own finances.

I almost hate to bring this up to him anymore but the smell is soooooo disturbing....especially when I take him places in a hot car...get the picture? I don't think he'd be angry if I said anything but I think he would feel terrible about it (hurt feelings) and then forget and put on the same pants anyway.

Do I forget about it? Do I say something more direct? Can someone write the script? Will the facility be able to deal with it? (that would more likely piss him off as he has some paranoia issues associated w/the dementia but I would feel better about passing the buck...:)....) Any suggestions welcome. Thanks

I work in a skilled nursing facility with people who have dementia. I wonder if you bought him several pairs of pants that were identical if he would notice that the ones in the laundry were missing. It rarely takes more than 2-3 days for the laundry to bring back items in my facility. If he always had several pairs of pants in his closet, he may not become anxious about the missing pairs. You may want to make sure he has a lot of pairs if he will go through 3 or so each day. Another thing that seems to work is to have you write a letter that gets taped to the inside of his closet door explaining in straightforward language that if he notices some of his clothes missing that they are in the laundry and will be returned to him when they are clean. Most people with dementia have no trouble reading and comprehending simple sentences.

In my facility people who are incontinent are put on a toileting schedule and not asked if they have to go but simply taken to the bathroom every two hours and once or twice each night whether they have asked to go or not. This works very well if the aides are friendly and make it social rather than show up and say, ''come on, it's time for you to go!'', but rather say, ''Hi come over here with me, I have someplace I want you to see''. I rarely see mobile people with dementia accept wearing depends. It's just too foreign to them and the men can't scratch and adjust which really seems to drive them up a wall! Hope this helps cj

My only experience with dementia is with my own father. I have had to say things to him I never dreamed I would and I soooooooo feel your pain. But I think it is best to be direct. It is actually less shaming the more direct you are, because the message you are sending is that this is no big deal, you can handle it, Dad.

I'd suggest something along the lines of Dad, you smell like pee. We need to change your clothes. If he says no, it's fine, say I can smell it, even if you can't. You can add some gentle humor, Women are fussy about these things. Or, A handsome guy like you needs to have clean clothes. I have even also told my dad You used to tell me when I needed a diaper change, now it is your turn. (With my dad, it is showering - he keeps insisting he doesn't need a shower when he really does!)

I have even told him (about the laundry) - the people in the laundry have a job to do. If they can't wash your clothes, they won't have a job. Ultimately, my plea is do this for me. I want everyone to know what a great dad I have and you need to wear clean clothes because I am proud of you. Good luck. It is really, really hard, I know!!

Sorry I didn't reply sooner--I think you said that your dad had Lewy-Body Dementia? You may already know that part of that disorder is that those afflicted lose their sense of smell--so I'm sure he can't smell himself. My loved one with the same affliction eventually had to use Depends, but only after it was more difficult for her to be mobile. sorry for your situation